Bedside Nurse - Nursing Round-Table

U.S. Healthcare in a Glance

•    The percentage of adults with no health insurance is the highest on record, 17.3 percent of adults as of the third quarter of 2011. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. (Gallup, Politico, Nov. 11, 2011). By January, 2012, the percentage of unemployed was up to 17.7 percent.
(http://fdlaction.firedoglake.com/2012/01/24/number-of-uninsured-americans-steadily-increasing/)

•    Factoring out those 65 and over, eligible for Medicare, and young adults up to 26, now eligible to remain on their parent’s coverage as a result of the Affordable Care Act, the numbers are even higher. 19.9 percent of 26-64 year olds are uninsured, up from 18.1 percent in mid-2010.Further, the number getting health coverage from their employer continues to fall, now down to 44.5 percent in the third quarter of 2011 (Gallup, Politico, Nov. 11, 2011).

•    Total number of uninsured Americans- 49.9 million in 2010, up from 49 million in 2009 (U.S. Census Bureau, CNN/Money, Sept. 13, 2011). An additional 29 million Americans were underinsured in 2009, up from 16 million in 2003, an increase of 80 percent (Health Affairs, September, 2011)  

•    About half of unemployed and underemployed U.S. residents do not have health insurance and 56% are delaying necessary care because of concerns about cost.  Among those who said that they or another family member have delayed medical care because they could not afford it: 63% skipped dental care or checkups;  46% skipped a recommended test of treatment; 40% did not fill a prescription; and 18% reported problems receiving mental health services. (NPR/Kaiser Family Foundation survey, Dec. 12, 2011)

•    Between 2003 and 2010, premiums for employer-sponsored health insurance increased by a nationwide average of 50%.--  62 percent of Americans now live in a state in which health insurance premiums equal 20 percent or more of median earnings for adults younger than 65. In 2003, 13 states had annual premiums that comprised less than 14 percent of the median income. In 2010, there were none. Average annual premiums for family coverage were $13,871, with the average annual employee share at $3,721 in 2010, up from $2,283 in 2003. (Commonwealth Fund, Washington Post, Nov. 16, 2011; San Francisco Chronicle, Nov. 17, 2011)

•    Under a study of high income countries, sicker adults in the U.S. stood out for having cost and access problems. More than one of four (27%) were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1 percent and 14 percent of adults in the other countries. In the U.S., 42 percent reported not visiting a doctor, not filling a prescription, or not getting recommended care. This is twice the rate for every other country but Australia, New Zealand, and Germany. (Commonwealth Fund, Nov. 9, 2011)

•    On life expectancy, between 2000 and 2007, more than 80% of U.S. counties fell in standing against the average of the 10 nations with the best life expectancies in the world. Some US counties are more than 50 calendar years behind – meaning they have a life expectancy today that nations with the best health outcomes had in 1957. Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind Honduras, El Salvador, and Peru. Four of those counties have the lowest life expectancies for men, all below 67 years, behind Brazil, Latvia, and the Philippines. Nationwide, women fare more poorly than men. Women in 1,373 counties – about 40% of US counties – fell more than five years behind the nations with the best life expectancies. Men in about half as many counties – 661 total – fell that far.  Black men and women have lower life expectancies than white men and women in all counties. (Institute for Health Metrics and Evaluation (IHME) at the University of Washington, June 15, 2011)

•    In a global survey of inequality in healthcare for children, the US ranked just 22nd in material well being for children, behind even economically struggling Greece. (Unicef study, December, 2010)

•    Between 2003 and 2007, the average maternal mortality rate – defined by deaths that occur within 42 days of childbirth – rose to 13 deaths per 100,000 live births, approximately double the low of 6.6 deaths per 100,000 live births recorded in 1987. Today, the United States ranks 41st in the world for maternal mortality, one of the worst records among developed countries. "Near misses", complications so severe that a woman nearly dies, increased between 1998 and 2005 to become common – at one woman every 15 minutes. African American women are three to four times more likely to die of pregnancy-related death than white women. States in which poverty rates exceeded 18% had a 77% higher rate of maternal mortality than states with lower rates of poverty. Over the last seven years, federal spending for maternal and child health programs has been reduced by 10%. (Guardian, UK, July 5, 2011)

•    More than one in four U.S. emergency departments were closed in the past two decades, forcing the nation’s poor and elderly to seek care in fewer, more crowded facilities. The number of emergency rooms in metropolitan and suburban areas fell 27 percent to 1,779 in 2009 from 2,446 in 1990. (Bloomberg News, May 17, 2011)

•    Illness and medical bills are linked to 62 percent of all U.S. personal bankruptcies. The proportion of bankruptcies attributed to medical bills rose by nearly 50 percent between 2001 and 2007 (Physicians for a National Health Program, 2009).

•    In California, the only state that makes such data public, the seven largest private insurers rejected 26% of claims in 2010. Typically, the rejections came from payment disputes between the insurers and providers, such as doctors and hospitals, but often that resulted in patients and families getting stuck with massive bills in a system that does little to control costs. Outright care denials are all too common from insurers, which have developed a laundry list of lingo to justify denial of care, such as transplants, even when recommended by the patient's physician.

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California Nurses Association/Institute for Health and Socio Economic Policy, Jan. 28, 2011

Of Taxes and Real Entitlement

Posted:  January 30, 2012
By: Carl Ginsbeurg, Protest In The USA Blog

Robin Hood rides to France.   French President Nicolas Sarkozy has followed through on his promise to put before parliament a financial transaction tax – calling it a “Robin Hood Tax” –  of 0.1% on stock trades to commence in August, according to reports.   Absent from the tax: bond sales.  Sarkozy also proposed raising  the basic consumption tax (VAT)  by 1.6 percent, to 21.2 percent, and upping  by 2 percentage points the taxes paid on financial profits.   His proposed targets of new revenue:  an increase in construction of low-income housing and creation of an “industry bank” to make cheaper loans to small and medium companies.

The Enduring Demise of the Austerity Doctrine.   The National Institute of Economic and Social Research, a British think tank, reports that four years after the Great Recession began, Britain is nowhere close to regaining its lost ground in terms of growth.   New York Times columnist Paul Krugman writes that that failure undercuts any argument that the austerity doctrine – prominent in elite circles in both Europe and the US for the last two years – will address economic demise and gross inequality  it perpetuates. 

Britain has been pushing “expansionary austerity.”   But, asks Krugman, “How could the economy thrive when unemployment was already high, and government policies were directly reducing employment even further?”  State and local governments in the US, have slashed spending and employment which, Krugman maintains, “has been a major drag on the overall economy. Without those spending cuts, we might already have been on the road to self-sustaining growth; as it is, recovery still hangs in the balance.”

Why not a “living wage”?  In New York, key Democrats have introduced a bill to raise the state’s minimum wage to $8.50 an hour, a 17 percent increase.   The Empire State now joins Delaware, reports the Times, which  recently passed a minimum wage increase, and raises are in the mix in  California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Missouri and New Jersey.

New York City’s Mayor Michael Bloomberg supports the Dem’s proposal; however,  Gotham’s chief  executive – whose personal wealth is estimated at $20 billion —  beat back a living wage proposal of $10 an hour after his re-election   “It is impossible to live in this city on $15,000 a year,” Micah C. Lasher, Mr. Bloomberg’s director of state legislative affairs, told the New York Times.    Working at $8.50  an hour full-time grosses a worker $17,680 a year.

Had the national minimum wage kept pace with inflation over the past 40 years, it would be at $10.39 now, according to the  National Employment Law Project.  Says Paul Sonn, the Law Project’s legal co-director,  $8.50 an hour “really is not enough for New York’s cost of living and New York’s economy.”   Not by a long shot.

Technology’s great tradition.  Among those attending the World Economic Forum in Davos was Google’s Executive Chairman Eric Schmidt.  He was talking up social media and related technologies.  Schmidt first came to the Davos event 15 years ago.  “At Davos the conversation is really about economic growth and the reality is that technological advancement benefits those who are educated but endangers jobs that are routine and automatable….This has been true for two hundred years with technologies,” said Schmidt.  With estimated wealth of $7 billion, Schmidt is the 136^th richest person in the world. 

Attention: Wall Street parents!  The cost of private school in New York City is breaking the $40,000 per year barrier, according to a recent report.  That’s just tuition.  Add-ons include spring training in Florida for sports.    Over the past 10 years, the median price of first grade in the city has gone up by 48 percent.  The New York Times reports that unlike public schools, which have faced severe cutbacks in the face of dwindling state and local revenues, private schools seem only to add courses, such as  languages.   “Offering Mandarin is a way to prepare students for the 21st-century world we live in,” said Trinity School’s headmaster.  Trinity has three theaters, six art studios, two tennis courts, a pool and a diving pool.

The percentage of students receiving financial aid has not increased alongside tuition. At the schools for which financial data was available,  18.5 percent of students received financial aid, the same figure as a decade ago.  

Oh where or where will Tim Geithner go?  With the announcement that Treasury Secretary Timothy Geithner is to leave his post at the general election, speculation as to his destination is afoot.  Wall Street would be a solid guess.  Bill Moyers and Michael Winship reminded readers recently that  Jack Lew, President Obama’s new chief of staff used to work for Citigroup, as did Clinton-era Treasury chief Robert Rubin. Bill Daley, who Lew replaced, labored at JPMorgan Chase, “where he was maestro of the bank’s global lobbying and chief liaison to the White House,” write Moyers and Winship. Daley replaced Obama’s first chief of staff, Rahm Emanuel, who once worked as a rainmaker for the investment bank now known as Wasserstein & Company, where in less than three years he was paid a reported $18.5 million.  

Geithner will be playing catch up.  Average income for the richest 400 families in the US in 2008 was an $270 million, according to David Morris.  Had these tribes actually paid the statutory tax rate of 39 percent, Morris points out,  an additional $500 billion in revenue would be raised over 10 years.  

What they do pay, writes David Cay Johnston, is a whole lost less.  “The federal tax burden on the richest 400 has been slashed,” he writes,  “thanks to a variety of loopholes, allowable deductions and other tools. The actual share of their income paid in taxes, according to the IRS, is 16.6 percent. Adding payroll taxes barely nudges that number.”

‘A Nightmare on Wall Street’: New Video From Nurses Says Time to Hold Wall Street Accountable to Hea

By: RoseAnn DeMoro, Executive Director National Nurses United

If there is one enduring message from the past year, it is that the days of silent suffering are over for the millions of Americans who continue to face a daily struggle to survive while Wall Street high rollers have yet to be called to account for ruining our economy.

The Occupy movement has transformed the status quo, and built an experienced army of activists who will be heard from again and again.

Similarly America's nurses who spent much of 2011 helping to revive the call for meaningful action against Wall Street to demand restitution for the economic ruin are planning a year long campaign to continue to press for real reform.

We're starting with the premiere of a new video ad, "A Nightmare on Wall Street:"

The ad depicts an imagined encounter between a Wall Street banker and the victims of financial misdeed and the government's too-big-to-fail policies -- carried out at the expense of Main Street's small businesses, students, unemployed and elderly.

It's a fictional nightmare for the banker juxtaposed against an every day nightmare for the tens of millions of families enduring job loss, priced out of needed healthcare and educational opportunity, facing the loss of their home, and staring at a bleak and uncertain future, all while the 1 percent continue to enjoy their 50-foot yachts, corporate jets, and vacation homes.

With the video, we have a message for Wall Street. It's time to pay back for the damage you have wrought. A meaningful tax on stocks, bonds, derivatives, currencies, and other financial instruments could harvest up to $350 billion every year to help reframe the economy and heal America.

Many world markets already have such a financial transaction tax. The European Union is widely expected to pass a continent wide FTT this year.

With the help of National Nurses United members -- who held protests last year on Wall Street, outside the White House and Treasury Department, at dozens of Congressional offices, brought the message into Occupy protests coast to coast, and joined with international labor, environmental and non-government organizations to press the issue at the G-20 summit of world leaders in France, it's on the agenda again in the U.S.

Don't be misled by temporary blips in jobs numbers -- this crisis is real and enduring. With 18.5 million vacant homes and foreclosures apace, 3.5 million homeless and one in two Americans at or near poverty, America's nurses are sounding an online alarm.

Without a commitment to substantial new revenue, this appalling demise will continue with grievous consequences. In their hospitals and communities, America's registered nurses are seeing the very tangible results of an America engulfed in poverty and insecurity -- stress-related illnesses, mental and emotional collapse, suicide.

The nurses are not alone. In a recent national poll, 85% of primary care physicians and pediatricians identified "low household income" as a negative effect on health in more than half their patients. "Low access to adequate health insurance" measured the same.

Yet, the 1% grow richer. Their average annual household income is more than $1.5 million and average net worth in the tens of millions. Compensation pools at the seven biggest U.S. banks totaled $156 billion in 2011, a 3.7% increase over the previous year's record-breaking number.

The time is now: taxing Wall Street transactions is the starting point for a national recovery.
In addition to the ad, National Nurses United (NNU) has revamped an innovative website www.ProtestIntheUSA.org to help provide information for the movement of the 99 percent.

Visit the site are sign our Petition to Support a Real Financial Transaction Tax on Wall Street and to upload details and videos about protests in which they are involved.

Let's bring an end to the American nightmare, and genuinely restore the American dream.

Follow RoseAnn DeMoro on Huffington Post here