1. Kepshire, Bob RN, MS, MA

Article Content

Whatever your political stance, one thing is for sure: Healthcare reform is on its way. We're all keenly aware of our nation's current economic climate. We've experienced unprecedented losses on both Wall Street and Main Street.

Figure. Bob Kepshire... - Click to enlarge in new windowFigure. Bob Kepshire, RN, MS, MA

One of the key strategies to help turn around the economy is healthcare reform. Research indicates that the United States spent approximately $2.2 trillion on healthcare in 2007-$7,421 per person. This spending is 16.2% of the U.S. gross national product (GNP) and nearly twice the average of other developed nations. Healthcare costs doubled from 1996 to 2006, and are projected to rise to 25% of our GNP by 2025 and 49% by 2082.1


Considering these stats, healthcare costs are crippling American businesses. As these costs increase, so do expenses for businesses. For example, "Healthcare [costs] at General Motors put the company at a $5 billion disadvantage against Toyota, which spends nearly $1,400 less on healthcare per vehicle."1 To turn around the economy and get Americans working again, employer expenses need to be reduced[horizontal ellipsis]and the low-hanging fruit is healthcare, viewed as the number one cost dragging down the American business machine.


Just how is reform going to take shape? Well, that's anyone's guess. There are numerous proposed plans, from mandated coverage through government subsidized health insurance to private-sector plans. But who's developing the strategy for reform? Is it the bureaucrats and special interest groups? Are those formulating the plans really engaged in what's happening on the frontlines of our hospitals? Do they have a clue what our busy EDs face every day? Do they understand that people don't have a true "medical home"[horizontal ellipsis]and that merely saying everyone needs access to primary care doesn't mean it will actually happen?


And just who, exactly, gets squeezed in the process? Are we going to start to re-invest in our healthcare facilities? How about tort reform? What about shifting the big profits away from the insurance companies? Let's take out the middle man and ensure that hospitals and clinicians get paid for the services they provide. Let's devise standards for hospitals that make sense, not ones that make it too complicated to care for patients and their families-the very reason we entered the nursing profession.


The onus is on us to provide the highest possible quality care. We need to be excellent stewards of the resources we're given. We need to embrace continuous quality improvement and patient safety. We need to think creatively and invest in technology. We can do it. Nurses have always risen to the occasion. Let's use the nursing "can do" approach to get engaged in the entire process of healthcare reform. We must stay informed and we must stay active in our professional organizations. It's time to voice our concerns to policymakers.


Reform is necessary, but we run the risk of getting a plan that drops the hammer on providers if we just sit on the sidelines waiting for it to happen. As healthcare professionals, we must be a big part of the debate, have a major hand in drafting the chosen plan, and participate in the ongoing decisions. It makes sense: We already know what the problems are, and we're the ones who'll be there to provide the care. So get educated, stay informed, ask questions, and make your voice heard. There's a lot at stake[horizontal ellipsis]and as healthcare professionals, we have much to offer.


Bob Kepshire


Consulting Editor




1. U.S. Department of Health and Human Services: The costs of inaction[horizontal ellipsis]the urgent need for health reform. [Context Link]