The challenges facing incoming President Barack Obama and Congress are tremendous, but Americans are making it clear they want healthcare to be a high priority on the national agenda.
In a national survey released Jan. 15 by Kaiser Family Foundation and the Harvard School of Public Health, 43% of respondents said they view reforming healthcare as a top concern, ranking it third behind improving the economy at 73% and fighting terrorism at 48%.
We asked staff nurses from the DC/Maryland/Virginia region how they would advise the new president to improve the U.S. healthcare system.
What healthcare issue do you think the Obama administration should address first in 2009?
On the campaign trail, President Obama talked about disease prevention as opposed to disease management. That said, I think his administration should address the issue of poverty-related illness. Many families in this country are unable to afford healthy food, live in a clean environment, or seek proper medical attention for minor illnesses. This issue needs to be addressed as soon as possible so we can invest in less expensive disease prevention as opposed to costly disease management.
– Mojisola Lucky Peregrino, RN, CCRN, PCCN
Telemetry Unit (3SA)
Franklin Square Medical Center
The first thing comes to mind is making cancer research and cancer screening a priority. We need preventive screenings so we can cut costs and extend lives and advance our hope for a cure. If we can’t find a cure, maybe we can lengthen the quality of life.
Putting effort and money and attention into research should be a priority. We learn that in nursing school in Public Health 101 – it’s prevention.
Especially now, when hospitals and institutions are measure by outcomes, it’s imperative to address the nursing shortage. In the end, it affects me at the bedside and the care I can give. As the shortage continues, in the end, it’s the patients that suffer.
Justine DeWitt, RN, BSN, OCN
Blood/Bone Marrow Transplant Unit
Georgetown University Hospital
I believe that the most pressing healthcare issue for the Obama administration to focus on in 2009 is the philosophy of healthcare in America. I believe that preventive, well-care treatment should be a priority for our public healthcare dollars. Preventive healthcare is often much less expensive, and produces a much greater improvement in quality of life as compared with end of life care. Childhood immunizations, smoking cessation, dietary and exercise programs, mammograms, pap-smears, prostate exams, blood pressure screens, etc. are all good examples of preventative healthcare which should be available to all Americans.
Linnea Cheseldine, RN, BSN, PCCN
Intermediate Care Unit
Hope and change. This has been President Obama’s platform. Delivering campaign promises and fulfilling dreams to the American people is the next step. Aside from the obvious economic challenges, the new administration is faced with reforming issues in healthcare. Hopefully one of the first items on his agenda will be to evaluate strategies geared toward balancing expenditures and quality and increasing coverage for preventive screening. Strategies related to value-based purchasing of healthcare, such as The Physician Quality Reporting Initiative (PQRI), payment incentives, and transparency of performance, will help to curtail the escalation of Medicare expenditures and improve the quality of care we are all entitled to.
Lois M. Kemple, RN, MS, CNS
Oncology Nurse Navigator
Union Memorial Hospital
People are the most fundamental component in a functioning, productive society. It makes sense that a society would ensure the well being of its constituents so the society continues to flourish. Healthcare is perhaps the most integral variable in our societal equation, and the incoming administration needs to establish a healthcare system where everybody has the ability to access care. A system founded on universally based ethical principles will yield greater successes over time.
Mike DeFranco, RN
Johns Hopkins Bayview Medical Center
I know Obama is very focused on providing healthcare for the uninsured. But by 2012, there’s going to be a huge shortage of nurses. Everyone deserves medical care. However, what is he going to do to make sure we maintain the current RNs and attract new nurses to the profession?
Marie White, RN, BSN
Labor and Delivery
Holy Cross Hospital
Silver Spring, Md.
The Obama administration can prove to be a force for positive change through the recognition of the value of prevention. Our healthcare system has traditionally focused on treating individuals, families, and communities once disease or dysfunction has been identified.
This is a poor utilization of healthcare dollars and human capital. In order to improve our nation’s health and spend our nation’s resources most effectively, we must put greater emphasis on efforts to keep people healthy.
Prevention services provided in both clinical and community settings include immunizations, disease screenings, policy making/implementation, early start programs like breastfeeding and physical activity programs, and services that apply to large populations. Early detection and screening is the best prevention.
Investing in preventative services is essential if our country is to decrease the cost of healthcare and improve the health of its citizens.
Rebecca D. Mance, RNC-OB, BSN
Labor and Delivery
Inova Fairfax Hospital
Falls Church, Va.
Providing safe, quality patient care is the heart and soul of every nurse. With the state of the economy, increasing numbers of Americans are facing decisions about whether to buy food and pay the rent or spend money on medication and healthcare. The rate of unemployment has risen, and many families are now in bankruptcy. President Obama’s administration must focus on healthcare reform that provides accessible and affordable healthcare for uninsured or underinsured American families.
Christine L. Byerly, RNC-NIC, BSN
Senior Clinical Nurse II
University of Maryland Medical Center
The Obama administration should make accessibility to healthcare one of the first issues it addresses. Two areas affecting accessibility are insurance and reimbursement. Too many people lack insurance or do not have enough of it. And, reimbursement impacts everything from the number of healthcare providers in practice to whether they will accept new patients. Better access would allow more attention to be focused on wellness and prevention, which would create a healthier America.
Jay Brennan, RN
Washington Hospital Center