Wednesday, July 18, 2007

ENA Responds to President's Comments

The following is a statement from ENA President Donna Mason, RN, MS, CEN in response to comments made by President George W. Bush during a speech in Cleveland, Ohio, July 10, 2007.


On July 10, a primary barrier to health care reform in the United States was illustrated perfectly by President George W. Bush during a speech in Cleveland, Ohio. Unfortunately, the President didn’t offer insight into a solution; instead he demonstrated a complete lack of understanding as to how health care is delivered today and how near the breaking point our health care system has become.

In talking about the challenges facing health care in the United States, the president said:

“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

The issues facing health care in America are complex, but it is clear by this statement that the President isn’t even aware nor understands the fundamentals of the crisis.

Emergency departments are required by law under the Emergency Medical Treatment and Active Labor Act to accept, examine and stabilize patients with emergent conditions. But with wait times growing, the severe shortage of nurses, violence in emergency departments rising, and the ranks of the un- and under-insured so high, treating the emergency room like a primary care clinic, mental health clinic and an emergency room all at the same time is a recipe for disaster.

While emergency departments are committed to providing quality care for all patients, they are intended to treat emergencies, not to provide primary care services. Patients with diabetes, heart conditions, high blood pressure, mental illness and other chronic conditions need the care of primary care doctors and specialists to manage their conditions. They need to be treated before their conditions become life threatening. By suggesting that patients in America have access to health care because they can always go to the emergency department, President Bush not only over simplifies the problem, he ignores the true nature of the problems facing patients and hospitals alike.

A Centers for Disease Control and Prevention report this year showed a 20 percent increase in emergency department patient visits while the total number of EDs in the United States declined by 9 percent. At the same time, the average emergency department wait times are as long as six hours in some states with some patients waiting as long as 24 hours to be seen. When you combine this with the growing number of elderly patients, the ever present shortage of nurses, the nearly 200,000 fewer hospital beds and the tens of billions of dollars of unrecovered treatment costs every year, it is clearly a false and dangerous assumption that all Americans have access to health care because there are emergency rooms.

As president of the Emergency Nurses Association, I know that a solution to the current health care crisis will not be easy. We must build an infrastructure capable of treating a growing and aging population. We have to find a way to train the individuals representing the more than 147,000 qualified nursing school applicants that were turned away during the 2004-2005 academic year primarily because of the lack of nurse faculty to teach them. But most of all, we must admit the failure of the current market-based health insurance system and find a way to truly provide patients with access to care, access that actually prevents illness and injury before they become emergencies.
Posted by HypnoKitten at 10:38 PM
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