Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, October 25, 1993 TAG: 9312100281
SECTION: EDITORIAL PAGE: A7 EDITION: METRO
SOURCE: LORNA FACTEAU, R.N.
DATELINE: LENGTH: Medium
As the front-line deliverers of health care, nurses see the inequities and waste in health care today. As middle-income workers, we worry about our own health-care needs and what would happen if we get a catastrophic illness that could bankrupt our families or cause our insurance companies to drop our coverage.
We see the people with diseases that could have been prevented with education and changes in lifestyle. We see the absence of primary-care physicians in inner cities and rural areas. We see people using emergency rooms because they do not have a primary-care provider. We see the waste of the paperwork burden, the endless forms. In fact, the average nurse fills out 19 forms per patient.
Now that Clinton has fulfilled his commitment and proposed a health-care reform package that addresses the issues, the Virginia Nurses Association is pleased to support the plan and to urge its enactment by Congress.
By now, we all know that the plan provides for affordable health care for every American, without regard to pre-existing conditions or where people work. We see an increased emphasis on prevention, on childhood immunizations, on health education and on home health-care for the elderly. The plan also assures all of us that an outrageously expensive illness will not cause us to lose our life's savings.
The plan envisions a larger role for nurses in delivering health care, a recognition that is long overdue. For example, the plan permits advanced- practice nurses - nurses with two to four years of postgraduate training - to be reimbursed when they serve as primary health-care providers.
This means consumers can choose to visit a nurse for everyday health-care needs. More than 100 studies have found that health-care consumers are pleased with the primary care they receive from nurses, because nurses spend more time with them and focus more on patient education.
Giving nurses a more important role in our health-care system in not as extreme as it sounds. At present, advanced-practice nurses provide everyday health care in many inner cities and rural areas where there are not enough primary-care physicians. In 43 states, nurses can prescribe medicines. In nine states, they can admit patients to hospitals. Many health-maintenance organizations already rely on advanced-practice nurses to diagnose and treat patients.
The change proposed by the Clinton plan is that advanced-practice nurses can be reimbursed directly for their services, rather than having to be reimbursed through a physician. We estimate that this simple change in reimbursement policy - even if enacted independently of the rest of the Clinton plan - would save consumers billions of dollars, and give millions more people access to health care.
The nurses of America are getting ready to urge congressional support for health-care reform. Virginia alone has 68,000 registered nurses. We are enthused and want to convey that enthusiasm both to the public and to our professional colleagues.
We believe the president's health-care plan will provide countless benefits to our patients. Every person in this country will always have the security of knowing he or she has adequate health coverage. That is a lot of peace of mind.
We Americans are often cautious about changes in our institutions. For most of us, the health-care system serves us well. What we must realize, however, is that the escalating costs and lack of access for many Americans are problems that need to be dealt with now, before health care consumes an even higher percentage of our national income.
\ Lorna Facteau, R.N. is president of the Virginia Nurses Association.
by CNB