National Nurses United

NewsBriefs:October 2007 10/18/07 12:04 AM Page 13 From left to right: International RN leaders Pauline Worsfold from Canada, Angela Gorman from Wales, and Judith Kiejda from Australia discuss how universal single-payer healthcare works in their countries. HOUSE OF DELEGATES 2007 Comparing International Health Systems hy reinvent the wheel? That was the idea behind inviting registered nurses from the United Kingdom, Canada, and Australia to the 2007 House of Delegates convention to share stories of how their countries adopted universal, single-payer healthcare and to discuss the ongoing challenges of maintaining and upgrading their systems. RNs Pauline Worsfold from the Canadian Federation of Nurses Unions, Angela Gorman from the National Health Service union UNISON, and Judith Kiejda from Australia's NSW Nurses' Association captivated the audience by explaining how all patients are able to access basic health services in their countries and how their nurses are free to concentrate on providing care, not worrying about how their institutions will turn a profit. Though each described ways in which their systems sometimes fall short and can be improved, the general consensus among these nurses was that they are grateful to live in countries where healthcare is a guaranteed right and would never trade what they have for an American-style system that depends on employer-based coverage provided by private insurance companies. The idea that healthcare should be run to make a profit is alien to them. W OCTOBER 2007 "It's just not Canadian to make profit off sick people," said Worsfold. Gorman described how she once attended a U.S. conference advertising a session on how to "Get the Most of Your Billing" and was befuddled by what that meant. "What is 'billing'? I thought," recalled Gorman as the audience roared in laughter. "Is it a new piece of equipment? A new procedure?" She explained that, as a nurse in Wales, she has complete freedom to practice without keeping cost considerations foremost in her mind. The nurses also directly addressed some of the myths and realities surrounding their single-payer systems, namely the idea that wait times for accessing care in their countries are unacceptable. They explained that urgent cases never have to wait, but that, yes, elective surgeries or procedures for non-life threatening conditions—such as hip or knee replacements—must wait in line. There's no reason, however, that the government cannot invest more dollars or take steps to improve the system. That's what happened in Canada, where Worsfold described how the Medicare system launched a campaign to shorten the waiting time for hip and knee replacements from 47 weeks to 4.7 weeks. The panel also described how citizens of W W W. C A L N U R S E S . O R G their countries feel greater ownership of their health systems because they contribute tax dollars to run it. "I'm very concerned about how money is being spent," said Gorman. "It's my money that's being used to pay compensation." Privatizing influences are constantly trying to infiltrate all three countries' systems, however. They've gained the greatest foothold in Australia, which now has basically a two-tiered system: a public system of mainly hospitals that is free and accessible to all at the point of service, and a private system through which many people receive elective surgical procedures paid for by private health insurance. Australia keeps muddying its system through an ever-elaborate program of rebates and payments between the public and private sectors for patients with private health insurance. "It'd be so much easier if we cut the [insurance] middleman and put the money that the government puts into private hospitals into improving the system," said Kiejda. All three nurses encouraged CNA/NNOC members to keep fighting for true universal healthcare. "Politicians don't change their minds because they see the light, they change their minds because they feel the heat," said Worsfold.—staff report REGISTERED NURSE 13

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