ANA Protests Narrow Focus of Bush's Health Care Proposals, Calls For Comprehensive Health Care Reform
Association also urges Congress not to slash Medicaid funding
Silver Spring, MD - Responding to President Bush's remarks regarding health care during his State of the Union address last night, ANA President Barbara Blakeney, MS, RN, noted that while the administration should be commended for refocusing on the issue, the president's proposals place too much emphasis on the concerns of employers, small businesses in particular, and not enough on protecting consumers from undue risk and financial burden.
"At a time when a record number of Americans lack any kind of health insurance at all, and while plans are underway today in Congress to pass a budget bill that proposes to cut Medicaid by $22.6 billion over 10 years (with 80 percent of the savings resulting from Medicaid beneficiaries forgoing needed care), President Bush's State of the Union proposals to rein in what he characterizes as the 'rising costs of entitlements' add insult to injury by asking the American people to shoulder even more of the cost and the risk," said Blakeney. "ANA finds the narrow focus of this plan unacceptable and irresponsible."
Pointing to President Bush's proposal to offer tax incentives to help small businesses and individuals get the same health care advantages as people working for big business, Blakeney noted several shortfalls, including the omission of the 45 million Americans who are uninsured.
"While it is important to offer incentives that will help small businesses and their employees, along with expanded portability of health care coverage for individuals," Blakeney noted, "this plan ignores other aspects of the broken health care system that are badly in need of fixing."
With regard to President Bush's proposal offering additional tax breaks for the use of health savings accounts (HSAs), which promise to reduce employer health care costs while shifting more of the responsibility for health care selection and spending onto individuals, Blakeney noted that such high-deductible plans actually discourage primary and preventive care, raise out-of-pocket costs and ignore individuals and families who do not already have health insurance.
"While ANA agrees with the need to rein in skyrocketing health-care costs, these cuts should not shift the burden of payment onto the middle class, and they should not come at the expense of the poor, the chronically ill, the elderly and the uninsured," Blakeney noted. "Moreover, the proposals should not erode state laws that already require insurers to cover such preventive health care services as mammography screening, maternity care, mental health services and home health care."
A key concern of ANA is that HSAs further undermine the system and weaken the nation's social safety net by taking away key health protections that millions of Americans already have.
"What we're seeing is a shift away from health insurance as we know it, under a system where we all share the risks, to a piecemeal plan that leaves it up to individuals to pick their own coverage and shoulder more risk," said Blakeney. "And while this approach may work for the young, healthy and affluent, it does not benefit persons who suffer a catastrophic illness or injury, become chronically ill or lose their health insurance."
As evidence, Blakeney pointed to research that has shown that persons who select high-deductible plans, either alone or paired with HSAs, are significantly more likely to avoid, skip or delay health care because of higher out-of-pocket costs than are people who have more comprehensive health care plans.
Another concern for ANA is that HSAs would increase the burden on the nation's already under-staffed, overextended health-care delivery system.
"As the nation's largest group of health care providers, nurses are on the front lines of patient care every day," Blakeney noted. "And, as nurses, already we are seeing hospital emergency rooms pushed to the breaking point because they represent the only recourse for persons who do not have health insurance. With HSAs, I fear we will see not only more of the uninsured clamoring to get into the ER, but also more individuals who have inadequate health coverage - people who have delayed or forgone much-needed care, in some cases until it is too late, because they can't afford to pay such high out-of-pocket costs."
As an alternative to incremental, market-based approaches that have proven costly and ineffective, ANA proposes a refocusing on more comprehensive health care reform such as that offered in ANA's Health Care Agenda - 2005. This report, released last June, further reaffirms the association's 15 years of support for a restructured health care system that ensures universal access to a standard package of essential health care services, and lays out a comprehensive strategy for government, industry, consumers and health care providers to follow in achieving these goals. (See www.nursingworld.org/readroom/anahca05.pdf for details.)
"In this era of catering to the wealthy and the well-connected, the last thing America needs is more health care 'entitlement' cuts on the backs of the middle class and the poor; instead, we should opt for a more humane approach: securing universal health coverage, which pools the risk among all individuals, and preserving - instead of gutting - the nation's Medicare and Medicaid programs," Blakeney noted.
"As ANA's Health Care Agenda - 2005 illustrates, ANA believes access to comprehensive health care is a basic human right that should be guaranteed to everyone in our nation. That is why we remain committed to working with the administration and with Congress to ensure this right becomes a reality."
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The ANA is the only full-service professional organization representing the nation's 2.7 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.