1. Newland, Jamesetta RN, PhD, FNP-BC, FAANP, FNAP

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Healthcare reform has been at the forefront of intense discussions on the national scene for several months. Legislators in Washington, D.C. are battling over a solution. Why are we as a nation so hesitant to create a healthcare system that has the potential to be more effective in promoting equal access to healthcare services for all U.S. citizens and help restrain the escalating cost of healthcare?

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Several factors force us to take a look at the condition of our current healthcare system as a mandate for change. Unemployment rates, the high cost of medical insurance premiums, and expensive prescription drugs, not to mention the growing uninsured and underinsured population, increasing numbers of chronically and mentally ill persons, and an inadequate workforce are only a few issues that point to the urgency of examining and seeking remedies in healthcare delivery. In the midst of all these healthcare problems, patients are experiencing poorer health outcomes and diminished quality of life.


The bottom line

What does all this mean for a patient who cannot afford to pay for a visit to a healthcare provider and, as a result, delays seeking care until the condition has significantly worsened? Do all these discussions ease the burden for a patient who cannot afford to buy prescription or over-the-counter medications needed to treat an illness? And how should the loyal employee who has not been given a raise in 2 years react when told he still has health insurance but he is now responsible for a $50 co-pay for each visit to a network provider and coinsurance benefits of 15% after meeting a $500 individual deductible?


The dwindling number of primary care providers (PCPs) is perceived as one barrier to improving access. Individuals, organizations, and legislators have put forth recommendations for consideration such as the establishment of a "medical home," increased support for medical education, incentives for physicians to choose primary care over specialty practice, elimination of government-sponsored healthcare plans with complete privatization of healthcare, and limitations on the scope of practice for nonphysician providers. The nursing profession has been offered a noninclusive, loan repayment plan for nurses entering the professoriate, scholarships for students choosing nursing as a career, and research funding to study the nursing shortage and related workforce issues.


The American Academy of Nurse Practitioners and six other NP organizations placed an ad in the July 20, 2009 special issue of Roll Call, a newspaper published four times a week during regular Congressional sessions.1 The paper represents the "people, politics, process, and policy on Capitol Hill" and provides the voice of and a voice to members of Congress.2 The ad was a letter to President Obama and Congressional leaders. This was the thought-provoking headline:


Q: Do you know that there are 125,000 solutions to the Primary Care Shortage?


A: Yes, Nurse Practitioners.1


Rise and be heard

Legislators supportive of NP practice and autonomy have been working diligently to make sure NPs are included in the language of bills relating to the medical or healthcare home, in opportunities for funding innovative programs to increase access to healthcare and particularly nurse-managed centers, and in educational incentives to increase training for PCPs. We can only hope that all members of Congress read or at least noticed the ad. As an NP, you can actively participate in healthcare reform efforts by responding to calls from your nursing organizations for legislative action. We are part of the solution!


Jamesetta Newland, RN, PhD, FNP-BC, FAANP, FNAP

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1. American Academy of Nurse Practitioners. Roll Call advertisement. July 20, 2009. [Context Link]


2. Roll Call. About Roll Call group. [Context Link]