January 17, 2009, 3:12 pm

Change We Can “Live” With

Dear Mr. President,

Well, it’s here.

The campaign has been waged, the victory scored. Tuesday will mark the beginning of a historic era in our country’s history.

You now know the minute details of what faces this country; things you could not know while campaigning and probably wish you didn’t know now.

We, on the other hand will now find out if promises made can be promises kept. Some will be. Some won’t be. Some can’t be.


“Change” was the theme of your campaign. I’d like to throw out some ideas for change we can “live” with.

Change that can help every single American.

Change that can save the health care system in this country.


At the risk of sounding like a Frank Capra movie, I believe America is the greatest country on Earth. I believe it. You believe it. So, even though I did not vote for you, we have one major belief in common.

Given America’s greatness, why is our health care system so fragmented, so focused on illness, so underfunded?

So sick?

There is no one answer. You may be President when the system improves or it may take you starting the ball rolling and a successor to complete. But, there are ways to begin looking at the system now to make it better.

This is what I believe:

  • Every American should have access to the same quality health care no matter where they live, whether they are employed, whether they are healthy, whether they are sick.
  • Health care is a need, not a right. Rights are not purchased (life, liberty, the pursuit of happiness)…Rights are fought for. Needs are purchased. Health care will require funding and adequate payment to those who provide it.
  • The focus of any health care plan needs to be….health! This is the definition of primary care. Regular check ups. Immunizations. Screening tests. Public health is also the definition of primary care.
  • Public health is so much more than just making sure people have a doctor handy. Public health means working on the infrastructure. Decent housing. Good schools. Jobs. Good stores. Stable neighborhoods that invite businesses to invest.

This is what I believe:

  • Anything our government touches becomes mismanaged, misused, misfunded and bloated to high heaven.
  • I live in California, don’t try to tell me otherwise (and this is a Republican talking!).
  • Ergo, health care should not be managed by the government. Health care must be managed at the community level with input from physicians, nurses, other health care disciplines and lay citizens.
  • Drop insurance.
  • Employers pay a percentage of tax for the number of employees they have. Tiny business? Less taxes paid. Big corporation? More taxes paid. It’s got to be less than what employers are paying now.
  • Every individual worker pays a 2% flat tax for health care. Poor? You pay less. Rich? You pay more. But, this is all you pay. Ever. No co-pays, no medication costs. Just your fair share of taxes. On welfare? Then 2% of your welfare check is kept for health care needs. Yep, you pay, too.
  • Add this to monies already spent for Medicare and Medi-Cal. You can cover every person in America and those who can’t pay are covered by those who can. We are doing this already.
  • This is the plan of the Physicians for a National Health Plan – it’s already been worked out and debated and supported by California nurses. Check out the site. Why re-invent the nearly invented wheel?

Things we need to do now:

  • Change our focus to primary health care and not big-bucks disease management.
  • Study other countries’ systems. Learn from their mistakes. Learn from their successes.
  • Make medicine and nursing professions that attract the best and the brightest. It does not come cheap. Anything worth having never does.
  • People are your best investment in health care. Make it worth the time and effort to become a doctor or a nurse.
  • You can’t provide primary care without primary providers, nor can you expect someone to be willing to work for the same (or less!) wages provided to the local waste-management worker after 12 years of education leading to over $100,000 in debt. Let’s get real.

Mr. President, you are obviously able to communicate with the American citizen, or you would not be where you are today. Please:

  • Let Americans know that they are responsible for their health. Not the US Government. We each make our own decisions leading to good or bad health in the long run. What the government can do is provide the infrastructure that gives people the choice to make correct health decisions. That gives them neighborhoods that are safe and where businesses can thrive. Some will come crying to you that they are victims in the health care arena, that they should not have to pay for whatever reason. Don’t let them. Stand firm.
  • Make it clear that health care is not an entitlement. Make sure the patients know that they will be paying for their health care and that they are expected to pay for their health care. With that responsibility comes the knowledge that the health care community is accountable for the care they provide. That is no change from what we have now.

So, Mr. President, I wish you luck and will pray for your success in the office you have won, because your success is my success, and that is bipartisanship at its best.


Kim McAllister, RN


  • […] Change We Can “Live” With // Emergiblog At the risk of sounding like a Frank Capra movie, I believe America is the greatest country on Earth. I believe it. You believe it. So, even though I did not vote for you, we have one major belief in common. […]

  • kinggeorge

    January 17, 2009 at 10:59 pm

    I like the ideas Kim, hope someone is listening.

  • Medicblog999

    January 18, 2009 at 11:00 am

    Nice post Kim,
    The solutions all sound familiar over here in the uk. I’m not saying the National Health Service is perfect (far from it) but I can’t imagine what it must be like to need a surgery, have chemo, or need a medical admission for a chronic complaint but not be able to afford it. The statement made at the conception of the NHS still holds as fast today as it did in the 1940s. : ” Healthcare, free for all,at the point of delivery”.
    I hope president Obama, brings everything you hope for. I’ll be watching his inaguration with great hope for the U.S

  • Maureen

    January 18, 2009 at 2:09 pm

    Wow Kim, maybe YOU should run for office! I am so impressed by your post that I feel I don’t have anything worthy to add. I too am a republican didn’t vote for President elect Obama, but I wish him success and I support him as my president. Healthcare is broken, I don’t know how quickly it can be fixed, but it MUST be, and at least you have suggestions, a plan. I truly hope someone listens.

    Thanks for another great post. You always restore my faith in the medical profession, which after the week I have had is no small feat!

  • k

    January 18, 2009 at 2:28 pm

    Nice post – you may want to repost at change.gov.

  • Medix311

    January 18, 2009 at 9:34 pm

    Great post! I have to agree with damn near all of it. And I suggest the same as K, go on over to change.gov and way in.

  • missbhavens

    January 19, 2009 at 9:31 am

    I dig it. I dig it.

  • Julie

    January 19, 2009 at 1:52 pm

    Excellent post and great ideas. I support them.

  • Healthcare Today

    January 19, 2009 at 9:13 pm

    Change We Can “Live” With // Emergiblog…

    An open letter to President Obama on what I think is important as we look to modify our health care system….

  • Griffin3

    January 21, 2009 at 7:47 am

    Good ideas, but, I don’t understand the bit about [1] anything government touches becomes a bloat-mare, and [2] funding the whole thing with a 2% flat tax, added onto medicare/medicaid. How do you propose doing that without the gov’t sucking half the money down some over-paperworked black hole?

  • Nurse K

    January 22, 2009 at 7:11 am

    Make it clear that health care is not an entitlement.

    Good luck there, sistah. You just said you want everyone to be on government health care and be forced to pay a tax to pay for it (a very small tax relative to the amount of money needed to pay for it). That’s called an “entitlement”.

    Good luck keeping costs down with unlimited access and no co-pays. LOLOLOL.

    Stupidest idea I’ve ever heard, sorry.

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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