1. Freda, Margaret Comerford EdD, RN, CHES, FAAN, EDITOR

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Here in the United States we had an historic election in November 2008 and a presidential inauguration of remarkable proportions in January 2009. It's difficult for me to adequately describe the importance of what happened in this election from my viewpoint, but I feel the need to try, because the health of women and children across my country could be affected by this election.


I have always been uncomfortable with the fact that my country never considered healthcare a right for its citizens, but rather a privilege. As much as I love the United States, I have never been able to reconcile our ability to deny our people access to healthcare because they were poor, unemployed, or disadvantaged in some other way. As I've grown older and become even more aware of the dismal statistics in the United States for infant mortality compared to the rest of the industrialized world, I've spoken out in print and in presentations about this travesty, but of course nothing has ever changed. Once, a decade ago, Hillary Clinton tried mightily to change our healthcare system but was shouted down by the forces of those who would lose money because of universal healthcare coverage. Her proposed program was never adopted, and our system continued on as before, denying access to healthcare for millions of people. I've thought about this failure so often and wondered if it would ever be reversed, but generally I'd come to believe that the United States was simply stuck in its employer-based, insurance-industry-centric system and would be-for my lifetime at least.


Suddenly, 2 years ago, a new candidate for president of the United States arrived on the scene, and people became excited about change. One of his ideas was the fundamental necessity of healthcare for all (not quite the universal system advocated by Senator Clinton, but close). Maybe the past decade had made people weary of ever-escalating health insurance premiums. Maybe the citizens needed a decade to really understand the movement that Senator Clinton started. Maybe the ongoing war forced people in the United States to think about entirely new paradigms. Maybe it's just a time for change.


Now, unbelievably, we've elected a president who has made healthcare for all a top priority. Of course, the confounding factor is that President Obama was elected just as a major financial crisis gripped the country and the world, but the fact remains that he was elected with a platform of changing the healthcare system. Because of the financial crisis, I fear that his large and ambitious program for healthcare might have to be altered or downsized, but I remain amazed that the people of the United States elected someone who truly believes that healthcare is a right!! President Obama gave many speeches during the election invoking the memory of his mother's last months, when so much of her time was spent fighting with insurance companies who didn't want to pay for her cancer treatments. For whatever reason, he "gets it." Our new president also "gets" the essential nature of providing healthcare for children and pregnant women, and how that one part of his program can influence the health of our nation. Now I'm thinking that if the financial crisis gets in the way, maybe he'll only be able to accomplish mandatory universal healthcare for children, but still, what a change that would be!! I can hardly imagine the day when no parents in the United States have to watch their sick child get sicker because they can't afford to see a healthcare provider, or when immunizations aren't given because there's an office visit fee attached.


I'm looking forward to momentous changes in the future because of this election, but none more important than an entire change in our culture to recognize the inherent right of citizens to healthcare. This truly is a time for change.


Margaret Comerford Freda, EdD, RN, CHES, FAAN