The New York Times recently reported on Health Reform Private House Parties. At this particular party, the participants easily sided with the angels: health care is a right, insurance should cover everything and coverage should be available from government and businesses. There, that was easy. Bet they had a nice time.

Partygoers were not asked for solutions and the devil is always in the details, so let’s use my favorite – flu shots.

First, the New York Times reported that party participants quickly agreed that “…health care was a right…” It makes me wonder; if health care is a “right,” what of “responsibility”?

- If I have a “right” to flu shots to help prevent flu disease, do I have a “responsibility” to get them to protect myself, reduce my medical care costs, improve economic productivity and protect others around me?
- If I don’t get the shot, infect others and cause them to be ill, am I responsible for the cost of their care?
- If others I infect miss work, am I responsible for the cost of temporary workers or losses incurred by their employer? Am I responsible to the government for the loss in taxable productivity?
- What if they die as a result of the flu I transmit to them? Am I culpable?

Second, participants also agreed “…that insurance should cover ‘everything,’ not just some services….”
- If a flu shot is covered and I choose not to get one, should I be required to pay for any doctor visits and medicines I need?
- Should my employer have the right to charge me for the temporary help that might need to be hired to replace me on the job?
- Should Uncle Sam have the right to tax me for earnings I would have made if I had been on the job?
- Should the cost of something so reasonably priced be covered for everyone? Really, I mean everyone? Even the wealthy who can well afford the cost?

Third, participants agreed that “…coverage should be readily available from the government, as well as from employers….” They agreed that individuals and businesses should have to pay a “small health care tax” to fund care.
- Who are they kidding, “small health care tax?” Have they looked at cost projections lately?
- And what about non-coverage barriers? Coverage is only one barrier to care. Ask those in rural areas, anyone not fluent in English or medically literate.

And yes, I’m still harping on flu shots. The season is not nearly over and there are plenty of doses left to protect the nation from the $87.1 billion – or more – that flu could cost us this winter.¹

1. Molinari NA, Ortega-Sanchez IR, Messonnier ML. The annual impact of seasonal influenza in the US: Measuring disease burden and costs. Vaccine 2007;25:5086-5087.

Like many Americans, I am still trying to wrap my mind around the shifts and changes wrought in our country on November 4, 2008. We will all be at it a while, I think. One dimension haunts me as a nurse: we elected a president who calmly stated “I think health care is a right”.

As a young nurse I repeatedly tried to understand why education, fundamental K-12, was considered a given in this country, yet health care was something one not only had to negotiate for but indeed was being systematically subjected to the vagaries of markets, profit motives, shareholder demands, and the overt “rankism” of our society. (more…)

As working professionals with decades of experience in health care, we face several workplace challenges, including co-workers from different (often younger) generations and retirement plans crumbling in this era of economic downturn. As mothers we face the dynamics of child birth and the hair pulling dilemmas of child raising. But it is as baby boomers who are part of the sandwich generation, that I think we are experiencing hurdles more difficult than contemplated. For me, front and center has been the need to confront care planning and end of life decisions for family members living hundreds of miles away. (more…)

Most of us today spend more time planning a party or buying a car than we do planning our healthcare. Granted, it is not as pleasant to create a plan for our healthcare as it is to picture ourselves behind the wheel of a new Mercedes or BMW, but the stakes are certainly much higher. And, chances are great that if we are proactive and make decisions before we need medical attention, if and when we do need care, our outcomes will be better. While not a sure-fire guarantee of a positive result, when you are invested in an outcome chances are better that your outcome will be a positive one.

Whether by design or not, the passage of HIPAA and the Patient’s Bill of Rights at the turn of the Century kicked off a series of events that has begun to cause a shift in the level of responsibility many of us are taking for our own healthcare. Continued support for HIPAA and HIPAA-like laws and regulations will likely continue this trend. HIPAA clearly spells out certain patient rights in their health information. Among them are your rights to obtain and inspect a copy of your medical records and to request a correction of inaccurate health information. Among a patient’s rights as spelled out in the Medicare Patients’ Bill of Rights are the right to choose your healthcare provider (remember when your Primary Care Physician used to be assigned by some healthcare plans?) and the right to fully participate in all decisions related to your healthcare.

Hospitals have taken these concepts a step further and have created their own Patients’ Bill of Rights that give patients the right to know if your providers are in training, request a second opinion or change physicians, receive a copy of your bill and have it explained to you, and the right to financial counseling as well as others.

In the legal profession, we have seen a shift in the concerns and claims brought to us by clients. For example, in the past year alone, we have counseled several clients who had complaints about the content of their medical record. In two of the cases, the patients had brought their records to the providers and asked for clarification and some type of change since they disagreed with factual statements in the record. When the providers refused, the patients sought legal counsel. While we don’t see this as a growing area for legal services, we do see it as a way to educate and inform both patients and providers. More importantly, we see this as a positive sign that patients are paying attention to the details of the law that impact them and are acting on it.

Exercising greater responsibility in healthcare planning and decision making not only benefits the patient, but also makes the provider more accountable. The end result is higher quality of care and lower costs – something we can always use more of!