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Public health nurses talk about reform |
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| Written by Arley Hoskin | |||
| Sunday, 31 May 2009 23:00 | |||
 Area public health officials describe the high number of uninsured Americans and the lack of preventive health care as two sides of the same coin."If a woman doesn't have insurance she's not going to go for her yearly mammogram, she's not going to go for her yearly Pap smear," said Sharon Shewmaker, RN, a nurse with the Jackson County Health Department. There are more than 45 million uninsured people in the United States, but issues with access extend beyond the uninsured. Shewmaker has been with the health department for 15 years. She said access to care remains a huge issue for the insured as well as the uninsured. "A lot of people are working two jobs; when do you have time to go to the doctor for maintenance?" Shewmaker asked. Those who do find time to schedule doctor visits are sometimes surprised by what their insurance providers will, or rather will not, cover. "Some of the insurances are not paying for well child visits and (parents) are not realizing it until they go to the doctor and accumulate a $300 debt," Shewmaker said. Jackson County Health Department provides well child visits and immunizations, but some parents do not realize that until it is too late. "A lot of clients don't even realize what their health departments can do for them. They don't realize what services are offered," Shewmaker said. Plugging people into programs that already exist is one of several steps to improve health care in the U.S., said Lougene Marsh, director of the Johnson County Health Department. "There are really three things that drive our health care system, one is quality, one is cost and one is access," Marsh said. "All three of those areas are things that a true health care initiative will have to address." Rosemary Howlett, BSN, ARNP, RNC, Wyandotte County Health Department's division head for maternal and child health, said she wants to see health reform that focuses on prevention. "I would like to see our country focus much more on preventative measures such smoking cessation, early prenatal care, planning healthy pregnancy, proper diet and exercise, and just healthy lifestyles in general," Howlett said. "We don't spend nearly enough on the beginnings of life and far too much on curative efforts instead of preventative efforts." Opinions about whether future health initiatives should be funded through a single payer universal system or individual health savings plans vary. Howlett said she could not speak for Wyandotte County Health Department, but personally she believes a single payer universal system will work best. "In adopting any kind of universal system there are going to be challenges, and there may be some concessions on the part of the insured. And how our country would address those I'm unsure," Howlett said. Marsh said as an individual she too leans toward a single payer universal plan. "That is probably a strategy that could and should be considered," she said. "Politically that is a very difficult approach to advance on." Not all public health nurses describe universal health care as the best approach. "I don't think universal health care is the answer, but insurance is so high," Shewmaker said. Shewmaker said she advocates for regulations on insurance and pharmaceutical companies. "Everything is so expensive," she said. While not everyone agrees on one solution for America's health care woes, most agree that nurses will be a part of the solution. "We do a lot of patient teaching, no matter where it is, no matter what it's on," Shewmaker said. Marsh said nurses can do more than just teach about healthy lifestyles. "All of us in the health care field need to model those healthy lifestyles," she said. "We have to kind of walk the talk." Howlett agrees. "We need to model what we preach and that's not easy," Howlett said. "It's such a small minority of Americans that get proper exercise or eat the proper numbers of fruits and vegetables in a day. ... Those healthy lifestyle choices are just critical for long-term health."
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