February 14, 2007, 6:29 pm

Maybe, Just Maybe It Can Work!


Hey! The Doublemint Twins became nurses!

This must be their “How to make a wrinkle in a bedsheet class!”

Either that or they made hospital corners every twelve inches back then!

What’s with the dark cuffs and shoulder insignia?

Some sort of military uniform?


Back in January, I wrote a piece entitled “Health Care is NOT an Entitlement“.

I still believe that.

But I have found a proposal for a national plan that might actually work.

It isn’t socialized medicine and while it is a national health care insurance, it is administered at the state and local level and not by a government agency.

I was looking for references for my issue paper: Health Care: Commodity or Right. I was looking for something that would support my position that national health insurance would never work in the United States.

I believe that health care is a commodity in that it must be paid for. But, there may be a way to actually do it and cover everybody.

And that means everybody.

With free choice of provider, hospital, medications and tests. With health care where it belongs, between the doctor (or nurse practitioner) and the patient. Period.

What happened to make me hopeful?

I found the website for Physicians for a National Health Program (PNHP).

I would suggest you check out the following pages if you are new to their proposal:

  • New To Single Payer? This gives a very succinct overview of what they consider to be important in a single-payer plan.
  • Then check out Frequently Asked Questions. Everything you could want to know, from what is covered to what will happen to salaries to how it will be paid for is addressed.

And answered.

But I wondered. What about nurses?

So I wrote a letter to the PNHP and asked about the projected effect on nursing salaries. PNHP staff member Dave Howell responded to my inquiry promptly.

This proposal has been out there for many years. Dave quotes from the 1989 proposal:

  • “Each hospital would receive an annual lump-sum payment to cover all operating expenses – a “global” budget. The amount of this payment would be negotiated with the state national health program payment board and would be based on past expenditures, previous financial and clinical performance, projected changes in levels of services, wages and other costs, and proposed new and innovative programs.”

Dave assures me that nursing salaries are a priority in this program. He also notes, again from the 1989 proposal, the effect on health care workers in general under this program.

  • Nurses and other health care personnel would enjoy a more humane and efficient clinical milieu. The burdens of paperwork associated with billing would be lightened. The jobs of many administrative and insurance employees would be eliminated, necessitating a major effort at job placement and retraining. We advocate that many of these displaced workers be deployed in expanded programs of public health, health promotion and education, and home care and as support personnel to free nurses for clinical tasks.”

Less administrative duties and more time for patient care.

Works for me.

And while I differ politically on many issues with the California Nurses Association/National Nurses Organizing Committee, they are the reason the salaries and the working conditions here in California are among the best in the nation.

They are working with the PNHP to get this proposal off the ground, and they would not allow nurses to get the short shrift.

This proposal was enough to make me look at my preconceptions.

I believe this program would work.

There is too much information for me to add here in one blog post.

Visit the site.

Check out the pages I have linked to.

Tell me what you think.

It made this hard core private-insurance supporter believe medical coverage for everyone is not only possible, but affordable.

You may be very surprised.


  • Anne

    February 14, 2007 at 9:05 pm

    Great links Kim! Now if only those over at Kevin MD would read this.

  • N=1

    February 15, 2007 at 9:08 am

    Hi Kim: Get familiar with HR676 “Medicare For All”. It’s sponsored by Rep John Conyers, is endorsed by the PHNP, by many unions, by many patient advocacy groups, etc. All sorts of links to single payers and univ. healthcare at UH. Let me know if you need help in finding any of it.

    The ANA hasn’t taken a stance, as least according to what’s missing on its Nursing Insider news release web page. Maybe it’s time to wake up the sleepy ANA?

  • JenCarroll

    February 15, 2007 at 1:21 pm

    Um, it sounds great… in fact I know it’s great, it’s the Canadian system:

    everybody’s covered, check
    patient retain choice of MD, hosp, check
    MDs retain autonomy, check
    moderate taxes, check
    costs controlled, check
    administered through state/local bodies, check
    global operating budgets, check
    MD fee-for-service OR salary, check (interestingly some of our MDs are trying to change this one)

    You want it? We got it. And it’s nothing like the rumours you all hear down south.


  • Dawn

    February 16, 2007 at 5:31 pm

    Sorry Jen, my taxes are high enough; I don’t need them raised any further, so some bureaucrat can tell me what tests/procedures they think I can have in oh, say 3 months from now, by which time I might be dead from lack of diagnosis.

    3 MRI machines in all of BC? I got that first hand from an MD who trained in Vancouver, but practices in Ottawa. He wasn’t too thrilled with that figure.

    Don’t get me wrong – I like Canada. But after experiencing socialized medicine first hand in the UK 20 years ago, I don’t want it here.

    Thanks for the links Kim. Once I get through orientation on the tele unit, I’ll hopefully have some time to read them!

  • NurseWilliam

    February 17, 2007 at 4:35 am

    The jobs of many administrative and insurance employees would be eliminated…

    Right there is a big hurdle. Insurance companies will fight this like a cat in a dark bag with a snake in it.

    I’d like to see sane healthcare and less insurance-driven practices as much as the next guy. As wonderful as this sounds, I am pessimistic that it will ever see the light of day in this country.

  • AlisonH

    February 17, 2007 at 11:56 am

    As a patient, reading those links, I can only hope.

  • JenCarroll

    February 19, 2007 at 11:57 am

    Sorry Dawn, 3 MRI’s in BC–your friend either is out to lunch or hasn’t updated his/her facts since finishing med school (and obviously had a long, long residency). A quick google search proves you wrongwrongwrong. Beaurecrats don’t make medical decisions, and tests don’t take 3 months. Did you hear that on Fox news?


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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