Nurse Volunteer Group to Coordinate Emergency Nursing Mission
The nation’s largest organization of registered nurses tonight activated its nationwide disaster relief program to recruit nurse volunteers to provide assistance to residents of earthquake devastated Haiti, the National Nurses United announced Tuesday night.

Registered Nurse Response Network sent more than hundreds of  nurse volunteers to the Gulf region following Hurricane Katrina. RNRN has also sent volunteers to Sri Lanka after the South Asia tsunami and to help following huge Southern California wildfires.  RNRN is affiliated with National Nurses United, AFL-CIO, the national union and professional association for Registered Nurses.

Details are still being worked out, but nurses can sign up at the NNU website, www.nationalnursesunited.org.
NNU will also provide follow up information at www.twitter.com/nationalnurses for details and plans.
The 150,000-member NNU was formed last month through the unification of California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association.

Through RNRN, the organization hopes to send nurses to provide emergency short term and long term medical support, as it has in previous major disasters. Following Katrina, for example, RNRN volunteers worked with local healthcare and emergency agencies and officials in mobile clinics, area hospitals, and other healthcare settings in Louisiana, Mississippi, and Texas.

“We are calling on nurses throughout the U.S. to join us in this critical effort,” said NNU Executive Director Rose Ann DeMoro.

“Nurses will be fundamental to the disaster relief process, to provide immediate healing and therapeutic support to the patients and families facing the devastation from this tragic earthquake,” DeMoro said.

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From our friends at the NYT …..

A Less Than Honest Policy

By BOB HERBERT

There is a middle-class tax time bomb ticking in the Senate’s version of President Obama’s effort to reform health care.

The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care.

Which is exactly what the tax is designed to do.

The tax would kick in on plans exceeding $23,000 annually for family coverage and $8,500 for individuals, starting in 2013. In the first year it would affect relatively few people in the middle class. But because of the steadily rising costs of health care in the U.S., more and more plans would reach the taxation threshold each year.

Within three years of its implementation, according to the Congressional Budget Office, the tax would apply to nearly 20 percent of all workers with employer-provided health coverage in the country, affecting some 31 million people. Within six years, according to Congress’s Joint Committee on Taxation, the tax would reach a fifth of all households earning between $50,000 and $75,000 annually. Those families can hardly be considered very wealthy.

Proponents say the tax will raise nearly $150 billion over 10 years, but there’s a catch. It’s not expected to raise this money directly. The dirty little secret behind this onerous tax is that no one expects very many people to pay it. The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans.

These lower-value plans would have higher out-of-pocket costs, thus increasing the very things that are so maddening to so many policyholders right now: higher and higher co-payments, soaring deductibles and so forth. Some of the benefits of higher-end policies can be expected in many cases to go by the boards: dental and vision care, for example, and expensive mental health coverage.

Proponents say this is a terrific way to hold down health care costs. If policyholders have to pay more out of their own pockets, they will be more careful — that is to say, more reluctant — to access health services. On the other hand, people with very serious illnesses will be saddled with much higher out-of-pocket costs. And a reluctance to seek treatment for something that might seem relatively minor at first could well have terrible (and terribly expensive) consequences in the long run.

If even the plan’s proponents do not expect policyholders to pay the tax, how will it raise $150 billion in a decade? Great question.

We all remember learning in school about the suspension of disbelief. This part of the Senate’s health benefits taxation scheme requires a monumental suspension of disbelief. According to the Joint Committee on Taxation, less than 18 percent of the revenue will come from the tax itself. The rest of the $150 billion, more than 82 percent of it, will come from the income taxes paid by workers who have been given pay raises by employers who will have voluntarily handed over the money they saved by offering their employees less valuable health insurance plans.

Can you believe it?

I asked Richard Trumka, president of the A.F.L.-C.I.O., about this. (Labor unions are outraged at the very thought of a health benefits tax.) I had to wait for him to stop laughing to get his answer. “If you believe that,” he said, “I have some oceanfront property in southwestern Pennsylvania that I will sell you at a great price.”

A survey of business executives by Mercer, a human resources consulting firm, found that only 16 percent of respondents said they would convert the savings from a reduction in health benefits into higher wages for employees. Yet proponents of the tax are holding steadfast to the belief that nearly all would do so.

“In the real world, companies cut costs and they pocket the money,” said Larry Cohen, president of the Communications Workers of America and a leader of the opposition to the tax. “Executives tell the shareholders: ‘Hey, higher profits without any revenue growth. Great!’ ”

The tax on health benefits is being sold to the public dishonestly as something that will affect only the rich, and it makes a mockery of President Obama’s repeated pledge that if you like the health coverage you have now, you can keep it.

Those who believe this is a good idea should at least have the courage to be straight about it with the American people.

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So, all the great fanfare and all the king’s horses. The great and almighty U.S. Senate has spoken. I will have to buy private health insurance – forever, amen. The defective product that has left me wanting for real healthcare for all of my adult life is now a step closer to being the law of the land.

A lump of Christmas coal all polished up with sparkling rhetoric.

Here’s what the Chicago Tribune said this week, and I agree:

On Sunday, the Chicago Tribune published an exhaustive front-page analysis by Northwestern University’s Medill News Service and the Center for Responsive Politics of how it was done. The main culprit: “a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation.”

The study found that 13 former congressmen and 166 congressional staffers were actively engaged in lobbying their former colleagues on the bill. The companies they were working for — some 338 of them — spent $635 million on lobbying. It was money extremely well spent — delivering a bill that, by forcing people to buy a shoddy product in a market with no real competition, enshrines into law the public subsidy of private profit.

As we approach the end of Obama’s first year in office, this public subsidizing of private profit is becoming something of a habit. It is, after all, exactly what the White House did with the banks. Just as he did with insurance companies, Obama talked tough to the bankers in public, but, when push came to shove, he ended up shoving public money onto their privately held balance sheets.
This is not just bad policy, it’s bad politics.

Now, back to my own thoughts as a patient:

I went broke while carrying health insurance, a disability insurance policy and a small healthcare savings account. And if I get sick under this mess of a plan, it will happen to me again. Little has changed except that millions more of my fellow citizens will join my ranks.

How does it happen to insured people under this plan? Easy. Step-by-torturous-step. Slowly. Like water-torture.

1. Buy health insurance at work or on the new exchange;

2. Avoid using insurance due to co-pays, deductibles and out-of-pocket maximum exposures – not to mention lost work time and the worry about losing one’s job in a tough economy;

3. If symptoms are noticed, treat by internet medical site suggestions and over-the-counter drugs until no other option but going to a doctor are available;

4. Attempt to make appointment with doctor but first find one who accepts both new patients and your insurance;

5. Go to doctor and pay co-pay up front before ever speaking to anyone about medical problem;

6. Sit in outer waiting room for as long as required, missing work and worrying;

7. Sit in exam room waiting for doctor for as long as required;

8. See doctor for five or six minutes, if lucky, during which time you will either be prescribed some expensive drug to fix a problem the doctor isn’t sure you have, referred to another doctor who may have a month or two wait for appointments, be directed to get some tests done you aren’t sure your insurance will allow or pay for, and do it all sitting in your underwear or less;

9. Leave medical office owing more than what you thought your insurance and co-pay advertised (and never get an explanation for how that is possible) and never sure if this experience was much different than being to a used car lot where the sales folks have assessed your financing mechanism before showing you anything at all and then only show you what fits the financing not what you need or want;

10. In the alternative, if you collapse or wait until symptoms get so severe that going for an office appointment is impossible, go to an emergency room – repeat steps five through eight – and either be admitted to the hospital if your insurance is adequate and you have any available sick-time from work (if not, beg for drugs and to be released) or go to number nine.

11. Need a dentist? Too bad. Have dental insurance? Still too bad. You might get a cleaning and some x-rays, but getting the care you may or may not need will be again totally related to your ability to pay whatever portion of the dental work is not covered (and amazingly, every penny of what dental insurance will cover will be eaten up by whatever problem you may or may not have) – in the alternative, avoid dentists or just pull teeth as they go bad;

12. When the bills roll in, try to pay some after trying to find out how you can possible owe hundreds if not thousands more than the insurance policy you have indicates is possible;

13. When the collectors call to collect all of the balances due, try to negotiate payments but endure threats of lawsuit, garnishment and worse as the collectors report back to the doctors you saw for a few moments in number eight;

14. Try to get your meds – if too costly, go without;

15. Try to get well – if you cannot, go back to work;

16. Try to act like this is all wonderful and you are grateful to have any insurance at all;

17. Get sued by a collection agency for a doctor bill or hospital bill you cannot cover;

18. Sell your house and use whatever proceeds you have to try to pay some of the debts;

19. Collectors for the doctors and hospitals are not happy if you don’t pay it all in full and up-front most of the time;

20. Feel stress, fear, anguish – but don’t gripe and don’t show it at work – buck it up, chump;

21. Sell keepsakes and anything valuable to try to stay afloat;

22. Stress, more stress. Fear to answer the phone. Friends and family fall away as they don’t want you to ask to borrow money;

23. Keep working – sick or not, keep working or you’ll lose that damn insurance if you cannot pay the premium – or you’ll be back out on the exchange trying to buy another policy that is cheaper and even worse;

24. Watch your elected officials claim victory and history as they work to make sure your kids and grandkids must suffer the same fate if they need healthcare in America;

25. Have a Merry Christmas, so says your U.S. Senate.

Don’t think this can happen to you because it hasn’t yet? Count your blessings this Christmas.

I’d really like the gift of healthcare. Medicare for all, single-payer healthcare would remove so much of this awful process. That would be a gift.

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“Patient choices are severely limited by the current system,” says Donna Smith, who was forced into medical bankruptcy. She now lectures around the country on health care reform. “Even when you have insurance, you still fight. It’s a defective product.”

Donna Smith, 54, is well aware of the dire consequences of unpaid hospital bills. She was diagnosed with uterine cancer around the same time her husband, Larry, was diagnosed with coronary artery disease. They had insurance, but copays and deductibles mounted to the point where they were forced to sell their home and move into their adult daughter’s basement. Hospital, doctor, and pharmacy bills “wiped us out in a matter of months,” Smith says.

For their troubles, the Smiths received roles as subjects in Michael Moore’s 2007 documentary, Sicko, about the weaknesses of the American health care system. “Being in a Michael Moore film is not something you aspire to,” Smith says dryly when we meet in the cafeteria at Howard County General Hospital, where her husband is currently being treated. He has aged into Medicare “and now he can go anywhere he wants” for medical care, she says. Four years after the couple was forced into medical bankruptcy, Smith is working for the California Nurses Association as an organizer. She lectures around the country on the need for health care reform—and insurance companies continue to provide her with great material for her talks.

In an unfortunate postscript to her Sicko story, Smith was hospitalized over Labor Day weekend with chest pains. After determining that she was not having a heart attack, physicians at Howard County General Hospital released her on the condition that she return after the holiday weekend for a series of tests. However, her current insurer refused to authorize either the prescription ordered by physicians to alleviate the pain or their orders for an upper-GI scope and cardiac stress test until a third-party administrator had reviewed the case. “I said, ‘You mean I have four Johns Hopkins doctors telling me I need this medication and these tests, and an insurance company bean-counter is going to overrule that?’” The answer, unfortunately, was yes. “My HR department said they found a provision in the policy that says if medication is considered an emergency, they have to cover them. I will probably get the tests eventually,” she says, “but who knows where I will have them.”

For the rest of the article

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Recipients of the Physicians for a National Health Program’s 2009 Dr. Quentin Young Health Activist Awards, pictured in Boston on Saturday, October 24, 2009: Dr. Margaret Flowers, left, and Donna Smith. Both women were honored for their work to advance the cause for single-payer healthcare reform over the past year.

Donna Smith, founder of American Patients United, was one of the documentary subjects of Michael Moore’s 2007 film, SiCKO, and now works as a legislative advocate and community organizer for the California Nurses Association/National Nurses Organizing Committee. Donna is a member of PNHP, and has also presented Congressional testimony on medical bankruptcy along with PNHP co-founder Dr. David Himmelstein. Donna writes extensively on single-payer reform and is also one of the national co-chairs of Progressive Democrats of America’s Healthcare Not Warfare campaign.

Dr. Margaret Flowers of Maryland is PNHP’s current Congressional Fellow and has testified to Congress on single-payer reform. Margaret was also one of the single-payer advocates arrested in the Senate Finance Committee chambers in May 2009 when Committee Chair Max Baucus failed to include single-payer witnesses to any of his panels convened to discuss healthcare reform plans. Margaret is a pediatrician who has taken leave from practicing to pursue full time advocacy for single-payer.

Dr. Quentin Young presented the health activists awards to both Donna and Margaret during PNHP’s national meeting. Both Senator Bernie Sanders of Vermont and Rep. Anthony Weiner of New York were present for the awards presentation.

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Cross posted at mike and friends blog

By Donna Smith, American Sicko
Jenny Fritts was 24 years old. Jenny lived with her husband Sean for the past five years, and together they had a little girl named Kylee, 2. Jenny was seven-and-a-half months pregnant with her second child – a beautiful, baby girl.

Jenny is dead. Jenny’s unborn baby is dead. They died because they were turned away for appropriate care at a for-profit hospital because they did not have health insurance. Sean rushed Jenny back to another hospital when her symptoms became even more severe, and he lied about having insurance to get her in the door. She was placed on a respirator in intensive care, but she didn’t make it. She died. And so did her baby.

They become two more of the more than 45,000 Americans who die preventable deaths due to our broken healthcare system every year. Two more. Mother and child.

The time to stop this has long since past.

When our members of Congress are sworn into office, they raise their right hands and take the following oath, “I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties of the office on which I am about to enter, So help me God.”

We have a domestic enemy against whom we require defense now. More than 45,000 of us are dying every year because the enemy is advancing as the profits in the healthcare industry swell – for-profit insurance companies, drug manufacturers, for-profit hospital corporations, medical equipment makers and suppliers, financial services and Wall Street folks. Yep, they have their fingers deep into the healthcare arena too as the mortgage markets are not enough to feed the beasts of greed who market health savings and spending products and credit cards tied to insurance deductibles and co-pays and other out-of-pocket costs.

Oh, yes, capitalism loves the healthcare business. But in this business, the enemy’s advance means suffering and death. Like Jenny. Like her unborn child. And like the suffering happening in your neighborhood, your church, your kids’ school, and all around you.

Time to demand that our Congress step up to honor the oath of office they each took on our behalf to protect our Constitution and our nation. Send a letter to your U.S. Congressional Representative and to your two U.S. Senators demanding protection from this domestic enemy – the for-profit medical-industrial complex. Do it now. Do it today. Send a copy to the White House. Today. Next month might be too late.

This cannot wait. Congress is about to hand over a huge bail-out to the for-profit health insurance companies in the form of a mandate that we all purchase private health insurance (and they’ll still be able to delay and deny care ordered by our doctors). If this mandate passes into law, the for-profit giants of healthcare will become even wealthier and harder to unseat. Given billions and billions more in profit, the health insurance industry and the big pharmaceutical companies will be the domestic enemy that stops at nothing – our Constitution and the oath our elected officials take to protect it is our defense.

If we had a foreign enemy killing 44,999 more Jenny’s from Indiana every year, you can bet Congress would declare war on that enemy. Time to demand Congress do the same to defend us now. The American people are under siege in their own homes and their own bodies. Let’s get the profit motivation out of our healthcare access in America.

Let’s defend and protect our most valuable resource: our people. We still haven’t been heard. Our deaths, our home foreclosures, our bankruptcies, our struggles – not enough yet. We have to get louder. Congress needs to hear us loud and clear over the ka-ching of cash flowing into campaign war chests from the enemy – the for-profit healthcare industry giants.

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Donna Smith, American SiCKO, and Wendell Potter, former CIGNA executive turned whistleblower, at rally in Harrisburg, PA, on October 20, 2009. The rally was organized in support of Pennsylvania’s single-payer healthcare legislation and was co-sponsored by many state and national organizations advocating for healthcare system overhaul, including the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), the California Nurses Association/National Nurses Organizing Committee, Healthcare for All Pennsylvania, Progressive Democrats of America, Healthcare-Now, Physicians for a National Health Program, the Western PA Coalition for Single-Payer Healthcare, and the Pennsylvania AFL-CIO .

Donna and her husband Larry were bankrupted due to medical crisis even though they carried health insurance coverage, disability insurance and a small healthcare savings account.

Donna told Wendell, “I forgive you.”

Wendell worked as an executive in the private, for-profit insurance industry (for Humana and then CIGNA) until May of 2008 when he finally decided he could not play a part in the suffering that resulted from so many of the practices of the industry.

The crowd of more than 1,200 people cheered, as Wendell teared up, embraced Donna and said, “God bless you.”

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SAFE HARBOR FOR PATIENTS FROM MEDICAL DEBTS

Medical bankruptcy is a big problem and is growing. According to researchers at PNHP and Harvard University, illness and medical bills were linked to at least 62.1% of all personal bankruptcies in 2007 the most recent year data is available. Using identical definitions in both years, the proportion of bankruptcies attributable to medical problems rose by 49.6% between 2001 and 2007.

Most medical debtors had some health insurance, but many suffered gaps in coverage:

• 77.9% of the individuals whose illness led to bankruptcy had health insurance at the onset of the bankrupting illness; 60.3% had private insurance.

• 69% of debtor families had coverage at the time of their bankruptcy filing

• 60% of families had continuous coverage

• Only 0.3% of the uninsured went without coverage voluntarily, i.e. because they though they didn’t need it – most others couldn’t afford it.

Current health reform does not address this issue. None of the insurance reform bills that have passed out of committee in the House or Senate will solve the medical bankruptcy issue because they don’t provide adequate measures to control costs to consumers for medical services.

Without cost control measures in place, insurance rates, co-pays, deductibles and other fees will continue to rise. One serious illness often destroys a lifetime of work and savings.

Safe harbor provisions are an accepted way to protect people from catastrophic medical bills.

A “safe harbor” is a provision of a statute or a regulation that reduces or eliminates a party’s liability under the law, on the condition that the party performed its actions in good faith. Legislators include safe-harbor provisions to protect legitimate or excusable violations.

Eight states have adopted some form of protection for citizens against catastrophic financial collapse. In Texas, an exemption for homesteads began as protection for the wives and children of the early settlers in the event the man of the house was lured into a not-so-honest game of chance or decided he needed a few dollars more to continue a night out on the town. Wives and children of a deceased breadwinner were secure in their home(stead) and could not be removed because of some improper or manufactured claim of debt.

Americans should not have their lives destroyed because they became ill. It is time that states adopted safe harbor provisions for medical debts to protect families from the unscrupulous practices that have become all too common in the health care system.

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By Donna Smith

It’s time, fellow patients, that we put the legal responsibility for what is being done to us where it belongs.  In the stack of forms signed when we seek healthcare anywhere in our current healthcare system, we sign all sorts of forms giving consent for treatment and billing, agreeing to the assignment of insurance benefits and payment, and assumption of the financial and physical risks of seeking care.

Every single form patients sign protects someone else in the system – none of the forms are designed in any way to protect our health and well-being and certainly not our financial status.  We sit, sometimes in a state of physical and mental duress, and sign away rights with every single signature.

As we listen to this crafting of “insurance reform” and healthcare reform on a national level, we patients need to be smart and extremely protective of our own personal status, as it is clear that no one else is prepared to do so for us.

I am but one patient, and I am on day 11 of my own post in-patient hospitalization denials of medication and follow-up care recommended during my stay.  My insurance neither protects my health nor my financial well-being – and I know so well that I am one of millions of people who try to maneuver a system hostile to my best interests.  As consumers, we are disadvantaged so drastically that unless we begin putting these other interests on notice, we can expect more abuse and damage, not less.

This Congress and this President do not intend to protect us any time soon from the defective product that is for-profit, health insurance or from the personal legal risk we are asked to exclusively assume when we seek medical care in this nation.

My insurance company started by denying the medication I tried to pick up at the pharmacy on the way home from my in-patient hospital stay and now is actively blocking the follow-up screenings recommended by the hospital physicians.  I thought asking to get these tests done on an out-patient basis would be a responsible way to do this and would allow me to keep up an active work schedule while going through the process.  Briefly, I am a cancer survivor with an aneurysm in my thoracic aorta (the main blood vessel between my heart and lungs) that needs appropriate evaluation and some anemia that needs some diagnostic investigation.   These issues are troubling to me, and I don’t feel as well as I would like.  But I cannot get care right now.

So, I am putting the insurance company and providers on notice that I hold them all responsible for the delay.  If something dire happens, I am not the one at fault as I am being responsible in seeking appropriate care, carrying insurance and expecting these actions to result in something very different from what is happening now.

The legal definition of a defective product is:   “A product is in a defective condition, unreasonably dangerous to the user, when it has a propensity or tendency for causing physical harm beyond that which would be contemplated by the ordinary user, having ordinary knowledge of the product’s characteristics commonly known to the foreseeable class of persons who would normally use the product.”

Part of the legal definition of health insurance is: “Protection against loss by sickness or bodily injury, in which sense it is synonymous with accident and health, accident and sickness, accident, or disability income insurance.”

Interesting, eh?

As far as I am concerned, waiting for some half-baked health insurance regulation or reform to kick in sometime in 2013 is insufficient in the face of the direct assault on my personal security – both my physical and financial health.

I would like to see a Medicare for All system to blow up this whole reform mess for those who continue to abuse my rights and do so knowingly and at my peril – not their own.  But I suspect we’ll see something very different from the wealthy folks who sit in Congress and the President who isn’t yet internalizing the risk at which he is leaving his nations’ citizens.

So, for now, I will personally notice them.  In writing.  I purchase health insurance.  I try to be responsible seeking care.  And when I am denied and delayed as I am now, the risk of those failures to provide service and care will now be placed directly where the risk belongs – on the insurance companies and the providers who are complicit.

And should the worst happen to any one of us – if we should die because we are denied or delayed – we must leave with our loved ones a trail of legally enforcement communications if we are ever to truly challenge and change this awful system.  The loss of our own humanity is apparently not enough to compel our leaders yet.

If our lawmakers will not make laws that protect patients, we must take matters into our own hands and create and enforce accountability.  It’s time.  It’s past time.  Until we have a just healthcare system, we simply cannot just grovel for care and beg for payment plans and the like when our insurance leaves us bare for financial trauma.  This has been a one-sided and abusive business arrangement so far, and we need to protect ourselves.

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