Health Care Reform

NPs Can Make a Difference

by Corrin Knebel, NP, and Leslie Burgel, NP

As Election Day approaches, all voters — particularly nurse practitioners — should have a strong understanding of each candidate's health care reform platform. Although politics may not affect your skill, knowledge or compassion when treating patients, they may affect how you develop treatment plans for your patients. For example, you might find yourself needing to choose cheaper medications that may not work as well because patients cannot afford health insurance. Politics may also have an impact on the future efficiency and quality of health care and the ability of practices to become financially successful.

The Cost of Health Care

The key problem with the United States health care system is not the quality of care, but the tremendous cost of care. Health care costs are reaching landmark highs. In fact, we spend more on health care than any other nation.

In 2006, national health expenditures reached $2.1 trillion, which averages to $7,026 per person or 16% of the nation's gross domestic product. Based on estimations made by the actuarial office at the Centers for Medicare and Medicaid Services, health care expenditures will reach $2.7 trillion by 2010 and $4.3 trillion by 2017.

With numbers like these, the upcoming election has become fertile territory for renewed discussion about health care reform. Points that require consideration are how any changes will affect patients financially and how NPs will be affected in daily practice.

The Proposals for Change

Information about each candidate's platform is readily available, but here we highlight a few proposals that directly affect providers.

Barack Obama proposes a reward system for providers who achieve performance thresholds on physician-validated outcome measures for preventive care. He would spend $10 billion on health information technology to reduce medical errors, and he supports programs that encourage team care through models that create a medical home.

Obama intends to allow U.S. residents to purchase medications from other developed countries, to increase the use of generic drugs in all health plans and to prohibit pharmaceutical companies from keeping generics out of the market. Finally, he seeks to strengthen antitrust laws to prevent insurers from overcharging providers for malpractice insurance.

John McCain proposes reforming Medicare and Medicaid to allow payment for more preventive services. He considers health information technology an opportunity for health care providers to practice across state lines and therefore promote competition. He proposes paying "a single bill for high-quality disease care" and says that every provider should be accountable and responsive to patient needs.

McCain seeks to increase pharmaceutical competition through reimportation of drugs and faster introduction of generic drugs. He also supports reforms to eliminate lawsuits directed at providers who follow clinical guidelines.

The NP's Responsibility

Although this is only a brief summary of the candidates' proposals for health care reform, it shows the potential impact of your vote on your practice. Optimistically, a vote for either candidate will mean that changes will be made to advance the quality of health care for all and to help relieve providers who are currently struggling to do so. NP

Corrin Knebel and Leslie Burgel are adult nurse practitioners in Columbus, Ohio. Knebel works on the orthopedic unit at Grant Medical Center in Columbus, and Burgel works on the transplant unit at Ohio State University Medical Center in Columbus.