I am registered nurse who works in emergency medicine. I spend my waking hours connecting and caring for strangers. I face the risk of assault and contracting any number of illness and disease on any given work day. I chose this, however: I worked two part-time jobs, and buried myself in debt at the age of 30, to become a nurse.
Prior to the implementation of the Affordable Care Act (ACA), the great health care equalizer was the emergency room. President Ronald Reagan signed the Emergency Treatment and Labor Act (EMTALA) to ensure that hospitals who participate in federal reimbursements such as Medicaid and Medicare would provide a medical screening exam to everyone regardless of their ability to pay. I spent several years of my life in what I can only describe as depressing poverty; many times an emergency room was the only way to access care.
As a nurse, I’ve spent many hours caring for people who fall through the cracks. The mentally ill, those with addictions, the homeless and the working poor use hospitals to access help they so desperately need. We have staff that connects patients with resources; we assure those in the most need that because of the ACA we can assist them in obtaining coverage. With the passing of the Republican health care plan in the House – and its large cuts to Medicaid – what do we tell the people in the most need now?
I’m not sure how I can adequately put into words what it means to look someone in the eye when you know they have a life-threatening condition, and they explain to you their worry about paying for their care. It seems to me that in a civilized and advanced society where we’ve cured diseases and extended life, we should be able to find a fair and equitable system. Unfortunately, with a political climate that seeks to vilify the poor, it becomes almost impossible to hope for a middle ground.
The American Nurses Association, the American Academy of Pediatrics, the American Medical Association and the chief medical officer of Medicaid, Dr. Andrey Ostrovsky, have all vocally denounced the Republican health care plan as an attack on the poor and elderly. The AHCA also seeks to redefine what is a pre-existing condition, returning us to a country where you or your loved one could be denied health coverage for something as common as juvenile diabetes or depression. The AHCA would mean we roll back the clock to patients relying on the ER – the one place they cannot be turned away – when the management of a chronic condition becomes so costly and unbearable they no longer can put it off.
While this sounds melodramatic, it is hard to truly understand what it means to be that desperate for something as simple as adequate health care. To save money, the House of Representatives has elected to further burden an already burdened emergency system.
I know I don’t have the answers. Our current system is far from perfect, but it was an ambitious first step. The issue isn’t coverage; it’s access to health care, education and how people are using services. The ACA took us one step forward, but we need to keep improving our system rather than backing away from it.
A stronger investment in mental health services, long-term care, outpatient programs, tuition sponsorship and reimbursement for midlevel providers, such as physician assistants or nurse practitioners willing to specialize in family medicine or psychiatry, would allow for more access to care and reduce costs in the long run.
No political party owns the value of compassion. Care for others is deeply rooted in the human spirit. We are a collection of healers, and it’s time we started to act like it.
Shawn Reed is a local emergency room nurse and member of SEIU Healthcare 1199NW.
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