National Nurses United

access the care they need. Unlike me, they don't make healthcare decisions based on whether or not we can afford the care, whether the copay is too high or we will be able to pay the deductible. Medicare provides insurance coverage to more than 55 million people, roughly 17 percent of the population, including 46.3 million people ages 65 and older and 9 million people with permanent dis- abilities under age 65. This year on July 30, Medicare celebrates its 50th birthday, and National Nurses United members and healthcare advocates around the country are throwing a party for this federal program that has lifted millions of older Americans out of poverty and suffering. And it manages to do this at administrative overhead rates that put private insurance companies to shame: about 2 per- cent compared to 17 percent. It has reduced health disparities relat- ed to race, ethnicity, and socioeconomic status. Medicare has wide public support, and 60 percent polled say they do not want to see it cut, compared to 70 percent who support some cuts in defense spending. The program has been such a success that advocates of universal, guaranteed healthcare argue Medicare should just be expanded to cover everybody regardless of age, as it is in Canada. There is a bill in Congress, H.R. 676, that would do just that. We need to tell our legislators that we want them to support H.R. 676. Despite its popularity and time-tested benefits, Medicare is con- stantly under attack by those who philosophically do not believe healthcare is a human right and see a market for private insurance companies to make money by selling insur- ance to old people and denying them care. Sure, no system is perfect. We need to do a better job of controlling costs and there are things Medicare does not cover that it should, such as long-term nursing home care. But there are lots of things Medicare does right, so nurses and single-payer healthcare advo- cates like myself argue we need to protect, improve, and expand Medicare—not kill it! When I was in the hospital recently, Medicare coverage would have completely changed the situation for me. I saw the upset on Larry's face as he watched me struggle with my life-threatening illnesses and try to fight back against a profit-driven system that finds ways to cut corners whenever possible. Several times during my hospital stays, I was horrified to learn that treatment options were altered to save money for my insurance carrier. The strong antibiotic that was originally started for me and was working marvelously on the septic infection was switched out for another antibiotic when the insurance utilization people decided it would be too costly to manage the dosing of the ongoing IV treat- ment as part of my home nursing care. The medication they changed to was not only a bit cheaper, it was also more suited to IV adminis- tration by my and my husband through my PIC line without have a nurse present. Larry and I were frightened beyond belief at the prospect of giving me IV drugs on our own. We had never done any- thing like this before, nor wanted to. But if we could be taught to do this, the insurer would save on nursing care visits. At another point, the insurance folks even tried to deny me wound care, but the surgeon who removed my vein and placed 10 drains up and down my arm from wrist to chest wall fought back and told the utilization reviewer that Kaiser absolutely needed to provide daily wound care. Everything was a fight, a fight you never want to have when you are so sick or badly injured. In contrast, we have never had to fight for appropriate care for my family members on Medicare. My mom, Ina Boyles, is 87 and lives in California. She is a Medicare beneficiary and has a supplemental cov- erage plan through my dad's former employer. As a survivor of polio, she has physical problems that require care, medications, and follow- up that she gets without wondering if that care will be approved by an insurance company or if she'll be straddled with huge bills she cannot pay on her modest, fixed income. So what does she worry about? She worries about me and my care. "I don't like to see you have to fight when you get sick," she told me recently. "It hurts me, and I worry if you will get what you really need." The current situation makes everyone feel so bad and unequal. Yes, my relatives on Medicare see some issues that need attention in the current Medicare coverage they have, but the issues are small J U LY | A U G U S T 2 0 1 5 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 23 "When my grown children asked me what I was most worried about, it wasn't being killed by the virulent MRSA bacteria and its related complications. No, not the dying part. I told them I was most worried about the bills and the lost work time; I was terrified about the money." (Continued on page 27) From top left: Donna Smith and her husband Larry during healthier times; Smith with her 87-year-old mother Ina Boyles, who benefits from Medicare and worries about Smith being under-insured; Smith's arm, showing drainage tubes for inci- sion, after an operation to remove an entire vein infected with hos- pital-acquired MRSA.

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