01.19.13
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We Need a Real Economy

NNU’s RoseAnn DeMoro joins national panel on call to eradicate U.S. poverty

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Rebroadcasting Tuesday, January 22 through Thursday, January 25.

Smiley is calling on President Obama to convene forthwith a White House Conference to Eradicate Poverty. 

TELL THE PRESIDENT #PovertyMustEnd. Sign the letter http://bit.ly/U4Zyi1

“We have to have an economy – a real economy. What do we have now? We want our jobs back. We want our pensions. We want our healthcare. We want to raise standards for everyone in America.  We want a civil society….Where’s our country?”

These questions, posed by National Nurses United Executive Director RoseAnn DeMoro set the stage last night as TV and radio host Tavis Smiley convened a group of eight individuals for a landmark national broadcast promoting his goal of a “Vision for a New America: A Future Without Poverty,” .  

Panelists included included former House Speaker Newt Gingrich, Rep. Marcia Fudge, who chairs the Congressional Black Caucus, Professor Cornel West of Columbia’s Union Theological Seminary, Prof. Jeffrey Sachs, of Columbia’s Earth Institute, public education advocate Jonathan Kozol, Professor Marianne Chilton of Drexel University, and NNU’s DeMoro.

The Inauguration this year coincides with the national holiday celebrating Martin Luther King, Jr. who Smiley termed “the greatest American we have ever produced.”  The broadcast from George Washington University in Washington, D.C., shown live on C-Span will be re-broadcast in half-hour segments on Smiley’s PBS program  over four evenings, January 22-25.

Smiley is calling on President Obama to convene forthwith a White House Conference to Eradicate Poverty.  

Vision for a New America
Broadcaster Tavis Smiley, left, with former House Speaker Newt Gingrich and NNU Executive Director RoseAnn DeMoro

‘Poverty a crime against humanity in the world’s richest country’

“It is a crime against humanity that the richest country in the world has such poverty,” said West.  He praised King for his “decency and dignity” and questioned whether his memory was “appropriate for presidential pageantry.”

West was referring to the planned use of King’s personal bible in the presidential swearing in ceremony on Monday.  “What would Dr. King say about the poverty here now while not one Wall Street executive has gone to jail?” asked West.  

“I represent registered nurses in the unions across this country,” said DeMoro.  “They are of the finest tradition of Martin Luther King. They are about humanity. They don’t make distinctions among patients. They don’t care if you are rich or if you are poor or if you are black or white or if you’re a man or a woman.  You’re their patient.”

Nurses, said DeMoro, “protect you. They fight for you. And what they are finding because of the profits in the healthcare industry and the most inept system in the industrial  world – the American medical system – is that patients are being pushed out. The children are coming in with malnutrition. Sometimes the only lunches they get is when they go into the emergency room. The shame that basically our decisions makers and Wall Street have brought to our country is presented to nurses on every shift and every hour in the hospitals in this country.”

Nurses, DeMoro added, “don’t stop fighting with their hospitals to care of their patients because they see people who haven’t had cancer screenings, people who basically can’t afford their medications, as the drug companies make $60 billion in profits as well as hospitals where $52 billion in profits. That’s billions and trillions of dollars sitting in the reserves of the wealthy and our children starving and people are presenting with almost near death.”

Vision for a New America
RoseAnn DeMoro calling for single payer healthcare and a Robin Hood tax to help fight poverty in the U.S.

“But what the nurses have done,” she added, is say, ‘I’ll fight for them in my hospital but I’m also going to fight for them in the streets.’  

The single payer solution

One solution for both the healthcare crisis and poverty, DeMoro said, is a single-payer healthcare system.  “ It would cover everyone. The insurance companies would be gone. We could have cost, quality and access and the ability to be a civil society. If we had a single payer healthcare system, we could generate almost three million jobs, which would actually serve to stimulate the rest of the economy so you’re building and actually taking care of the people of America.”

Sachs shared an estimate that it costs the U.S. $750 billion to sustain a for-profit healthcare system.  “The rich have gotten their way.  The corporations have gotten their way.  We have the least social mobility in any industrial country,” he said.

Income inequality and poverty have come to define the American landscape in thick strokes.  In the last generation, since 1989, Smiley told listeners, 49 of 50 states have experienced stepped-up income inequality and 43 states have seen poverty rates go up.   The number of Americans in official poverty is now approaching 50 million, Smiley has reported, and nearly half the U.S. population is living at or near poverty, he has said.
“We are incapacitating ourselves,” said Sachs, who heads the Earth Institute at Columbia University.  He called for investment in infrastructure and decried a political system in which “we have two parties of the rich.”  

“The White House,” said West, “is addicted to power.  Where is the love and justice? We live by the rule of money.  Everything is up for sale.  Big money versus quality of morality.”  

It is a world, Kozol reminded, “straight out of Charles Dickens.”   He added hat “charity is not a substitute for justice.”  Kozol thanked both teachers and nurses, reminding that both workforces are comprised of women and he acknowledged their extraordinary dedication.  

The Robin Hood campaign to tax Wall Street

DeMoro highlighted a major campaign promoted by NNU for a Robin Hood tax, now supported by more than 125 organizations – labor, religious, consumer, health advocates and others, embodied in The Inclusive Prosperity Act, sponsored by Rep. Keith Ellison (D-MN).

It says to Wall Street, “you’re going to pay your fair share in this country.”
Sachs is among many public figures speaking out in support of the Robin Hood Tax, whose annual revenue would address the nation’s impoverishment with good jobs and decent retirement, quality education and healthcare and more.  

“Influential Americans are buying into the Robin Hood Tax,” said  Smiley.

“It’s simply a tax on Wall Street,” explained DeMoro, just “50 cents in the case of stock on a $100 trade. We all pay sales tax on everything we buy. This is saying to Wall Street that you have gotten such a pass.”

Gingrich, citing the “big boys” of Wall Street – the Federal Reserve, the big banks and those behind Dodd Frank – for escaping scrutiny and raiding the Treasury.  He said, “There has been no serious investigation about what happened to the money.”  

“It’s good to hear Newt talk about breaking up the banks,” DeMoro noted.

Kozol described how poverty deprives American children of their full potential and called for full support of public education.   “The only tried and proven exit from destitution of their parents  is terrific, expensive public education,” said Kozol.  

To him, class size matters—the “most significant factor in the pedagogic world.”  Yet public school class sizes are soaring, to 40 high schoolers per room in L.A., according to Kozol.   “It is a crime against the innocent,” he declared.

Prof. Chilton, an expert on early childhood conditions, said that one in four children under six years old is suffering from food insecurity in the U.S. today, with serious healthcare consequences—“a major crisis.”  She argued for support in the form of food stamps and the Women Infant and Children program (WIC).  “They work and make us a better country,” concluded Chilton.

How do you make poverty a priority?”    Smiley asked Rep. Fudge. She
concurred that “none of us has done enough to address poverty.”  

“Silence is betrayal,” said Fudge. “I am on the Agriculture Committee that oversees food stamps.  We cut food stamps by $16.5 billion over the next decade.  Some of my ‘colleagues’ were not satisfied.  They wanted to cut more!!” 
‘If everyone was unionized, we’d have Wall Street on the run. Labor unions play a particularly critical role in society, said DeMoro.  “The American labor movement is behind Social Security, one of the greatest programs that keeps us out of poverty.  The President cannot cut care to the most vulnerable people in our society.  Medicare, it’s such a critical program—also pushed by the American labor movement.

 

GET INVOLVED:

Rebroadcasting Tuesday, January 22 through Thursday, January 25.

Smiley is calling on President Obama to convene forthwith a White House Conference to Eradicate Poverty. 

 

“The other thing the American labor movement does is raises all boats.  It set living wages for people, benefits, pensions. If everyone in this country was unionized, we would have Wall Street on the run.,” she said.  

“There is a concerted effort as part of the neo-liberal agenda to vilify teachers, vilify anything public,” said DeMoro.   “The greatest institutions we’ve ever had have been public institutions.  The corporations have been in control and this country is a disaster.”

She critiqued those who have placed bipartisanship above principle. “We compromise on the things that are fundamentals. We can compromise on tactics but people will have to draw a line in the sand. Learn that from the labor movement and the building trades … .  get the cement, fill in that line and we say this is a line that you do not cross.”

DeMoro endorsed Fudge’s statement “that you’ve got to push. We’ve got to push. We’ve got to create a movement in this country. Occupy was a moment. Occupy needs to start up and keep going and needs to bring millions and millions of people with it. We are organizing a movement. It’s in the streets. It’s in Congress and it’s across the world and we’re not going to stop.”

“People have to engage,” DeMoro concluded.   “We can’t entrust our democracy to a bunch of people in Washington, D.C., who are getting paid by some very expensive lobbyist on the side.  We have to take control of our democracy, to participate in democracy.  Don’t discount America.  Take control.”

By: Carl Ginsburg, NNU

 

01.18.13
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Living and Working as a Nurse in Boston

One of the oldest cities in the United States, Boston is home to some of the best hospitals in the country. Some of the best nursing jobs in Boston can be found at Massachusetts General, Brigham & Women’s, Beth Israel Deaconess, the Massachusetts Eye & Ear Infirmary, New England Baptist Hospital and Dana-Farber Cancer Institute, which are all well-rated by US News and World Report, and all are ranked #1 in the United States in at least one specialty by… Continue reading →

01.18.13
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Obama Directs CDC on Research

The Centers for Disease Control and Prevention will be free to do research on the impact of guns on health, President Barack Obama said on Wednesday when he announced a comprehensive set of recommendations for stemming shooting-related deaths and injuries.

CDC researchers have collected statistics on firearm-related deaths but have been barred from conducting in-depth studies since 1996, when then-Rep. Jay Dickey, R-Ark., led the drive to strip the agency’s budget of $2.6 million, the amount spent that year on research into guns. Dickey also successfully inserted report language into the Labor-HHS-Education appropriations bill that said: “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Since then, that prohibition has been renewed annually in spending bills.

Federal officials, concerned about the political ramifications, interpreted the language as a signal to steer away from doing the kind of research that the CDC used to provide. One of the articles that drew protests from the National Rifle Association was a New England Journal of Medicine study that found that people who lived in homes with a gun were nearly three times as likely to die of a homicide and nearly five times as likely to die of suicide than people without guns.

Obama said Wednesday that his lawyers have assured him that such research does not amount to advocacy or promotion, and he signed a presidential memo directing the CDC, the National Institutes of Health and other agencies to conduct it. A senior administration official said that the CDC will begin work immediately on research exploring the causes and prevention of gun violence, and that the White House will propose in its fiscal 2014 budget request that Congress provide $10 million for the CDC to support that research, including investigating whether there is a link between shootings and violent video games or other media.

The administration also will seek an additional $20 million to expand the CDC’s National Violent Death Reporting System, which was created in 2002 to collect de-identified data from 18 states on gun-related deaths, including the type of gun used and how it was stored. The information is gleaned from death certificates, police reports and coroner or medical examiner reports.

Dickey has since repudiated the idea that federally funded researchers should not investigate gun-related deaths. In an opinion piece in The Washington Post last year, Dickey and former director of the CDC National Center for Injury Prevention and Control Mark Rosenberg wrote: “It’s vital to understand why we know more and spend so much more on preventing traffic fatalities than on preventing gun violence, even though firearm deaths (31,347 in 2009, the most recent year for which statistics are available) approximate the number of motor vehicle deaths (32,885 in 2010).”

In an interview Wednesday, Rosenberg said he expected researchers to begin working with data from such departments as Justice and Education. They will try to answer questions about what raises the risks of dying from gun violence. He called Obama’s proposal “a very important start,” likening it to the planting of a tree that requires many years to grow. “The best time to begin was 20 years ago, but the second best time is now,” he said.

“When the NRA threatened the science, they scared researchers away from this field, so today we don’t know what works,” Rosenberg added.

Also on Wednesday. Democratic Reps. Edward J. Markey of Massachusetts and Carolyn B. Maloney of New York said that they and 31 cosponsors would introduce legislation to codify the president’s executive order and end what Markey called “an irrational and counterproductive ban.”

The push by the White House to pursue gun-related research is part of a detailed, four-part plan that includes proposals to reduce problems tied to mental illness. (See related story, CQ News, Jan. 16, 2013).

The proposal also clarified that no federal law in any way prohibits doctors or other health care providers from reporting their patients’ threats of violence to the authorities, or talking to patients about gun safety.

CDC National Violent Death Reporting System

By Rebecca Adams, CQ HealthBeat Associate Editor, Rebecca Adams can be reached at radams@cq.com.

01.18.13
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Walt Whitman

Although better known as an influential American poet, essayist and journalist, Walt Whitman also worked as a nurse during the Civil War.               More information Traveling with the Wounded: Walt Whitman and Washington’s Civil War Hospitals Meeting the mother man: rediscovering Walt Whitman, writer and nurse. The Wound Dresser by […]

01.18.13
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Clara Barton

Clarissa (“Clara”) Harlowe Barton was born on December 25, 1821 in North Oxford, Massachusetts and is best known for founding the American Association of the Red Cross in 1881. In May 1839, she became a school teacher and spent the next several years teaching children in Oxford and North Oxford.  In 1845, she founded a school […]

01.17.13
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One big way to reduce poverty – expand Medicare to everyone, no cuts to Social Security or Medicare

Follow NNU on DailyKos: National Nurses Movement

With poverty rates spinning perilously out of control in the U.S., it’s time to send an unmistakable message to Congress and the White House as they prepare to resume the ongoing obsession with the deficit:

End the silence on poverty, don’t make poverty worse through cuts to Social Security or Medicare, and address a principle cause of poverty with a permanent fix to our dysfunctional healthcare system.

That’s one prescription recommended by RoseAnn DeMoro, executive director of America’s largest organization of nurses, National Nurses United.

DeMoro is one speaker on an impressive panel presentation on poverty tonight in Washington, titled “Vision for a New America. A Future Without Poverty.” Organized by nationally syndicated broadcaster Tavis Smiley, it’s being broadcast on CSPAN at 6:30 p.m. EST, and also live streamed.  

In a week in which a shocking new report on U.S. life expectancy rates was published, which has a disproportionate impact on the poor, DeMoro notes, this is a good time to draw the links between income, healthcare, and Social Security and Medicare, perhaps the two most effective anti-poverty programs ever enacted in the U.S.

Census Bureau data puts the official poverty rate at 15 percent, 46 million people, and at 22 percent for children under 18. Some have speculated the real number is two to three times that amount.

Not that you would notice listening to the debates inside the Beltway where too many politicians are focused on spending cuts, not addressing the daily shortages of  food, shelter, healthcare, and jobs faced by a large swath of our nation.

Nurses, DeMoro is likely to point out tonight, see the correlation of low incomes and deteriorating health status every day in hospitals and clinics across the U.S.

Consequences that are evident in a report released last week by the National Research Council and Institute of Medicine which found the U.S. ranked last in life expectancies among 17 affluent countries.

All those other countries have some form of a national healthcare system, like our VA or Medicare program. No gold medals for us in this international competition, except in how much we spend and waste on health care as a result of our profit-focused private system.

Sadly, the Affordable Care Act has not eradicated the problem, especially when it comes to rising healthcare costs, as apparent in the double digit premium hikes private insurance companies continue to demand.

0512_SNA_M18_2082
NNU RN, in mask promoting Robin Hood tax on Wall Street speculation that would raise hundreds of millions for healthcare and anti-poverty programs, calling for Medicare for all at Chicago rally last year

No surprise then that medical bills are the leading cause of two-thirds of personal bankruptcies and other medical woes directly linked to poverty related factors that nurses witness regularly.

These effects include:

  • premature and low weight babies and other widespread nutrition problems from *hunger and malnutrition that can lead to disease and even organ failure
  • children with high levels of stress and anxiety
  • heart attacks in younger and younger men
  • rampant unaddressed mental health problems and emotional disorders
  • poor dental care with more patients with severe dental problems ending up in the ER, and
  • scores of patients who routinely skip needed medical care because of the cost until they end up in emergency rooms with major untreated diseases that may then be too late to heal.

Patients like the widowed woman in a Midwest state whose diabetes led to foot and leg wounds that became severe because she could not afford constant treatment. Finally admitted to a hospital, she faced the Sophie’s Choice of amputation or lengthy, more expensive long term care. She chose amputation because it was cheaper. No that’s not a story out of the Middle Ages or a Civil War battlefield, it’s modern day America.

Permanent disability would not have been needed had she been able to wait a few more years. The NRC/Institute of Medicine study found the U.S. catching up to other countries only when people are later in life. Because of Medicare.

Upon signing the Medicare law in 1965, President Johnson cited the long history in the U.S. of “bill after bill (being)  introduced to help older citizens meet the often crushing and always rising cost of disease and crippling illness.”

Before Medicare, a story told in this video, barely half of seniors had medical coverage, Within five years, 97 percent did.

A similar story can be told about Social Security. Before that law was enacted in 1935, only 15 percent of workers had private pension plans, and many American seniors were mired in poverty totally dependent on their sons and daughters.

Now, reports the Center on Budget and Policy Priorities, Social Security provides two-thirds of the income for recipients over 65, and more than 90 percent for one-third of seniors.  Only 10 percent of seniors are below the official poverty level, without Social Security more than half would be.

That’s the context in which the “deficit scolds,” as economist Paul Krugman calls them, are targeting Social Security and Medicare.

It is the working poor who must work longer and those who would be thrown back into poverty, especially women who have historically earned less than men and built less of an income base that determines amounts of benefits, who would be most harmed by such cuts as raising the eligibility age or slashing benefits.

The proposal, floated by President Obama and others to shift Social Security benefits to a “chained” Consumer Price Index by itself could cut monthly benefits for a typical single woman by $56 at age 80, says the National Women’s Law Center.  

A comprehensive program to combat poverty in America is long overdue. It should start by insisting on no cuts in Social Security or Medicare, and move on to a permanent fix of our healthcare system by upgrading Medicare with full funding and an end to the creeping privatization, and expanding it to cover everyone.

Originally posted to National Nurses Movement on Thu Jan 17, 2013 at 10:53 AM PST.

Also republished by In Support of Labor and Unions.

01.15.13
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Care Coordination: Opportunities for Nursing

Coordination of care is not a new role for nurses, but it has never been fully appreciated. As nurses, we coordinate patient care and ease the transition from hospital to home, often preventing readmission to hospital and improving the quality of patients’ lives. Finally, this vital role is being seen as a valuable one, not just in terms of patient care, but in financial terms for nurses who perform this essential service.

The Medicare fee schedule is set to change in January of 2013. It contains new codes that will have a great impact on care coordination, which is typically performed by nurses in a physician-supervised setting. Currently, reimbursement for non-face-to-face visits is lumped under payment for face-to-face visits. Both physicians and nurses have argued that the current codes are insufficient, as they do not account for communication with persons other than the patient, home visits or conveyance of patient information over the phone, common practices which are not adequately addressed under the current codes.

“Specifically, this HCPCS G code would describe all non-face-to-face services related to the TCM furnished by the community physician or qualified nonphysician practitioner within 30 calendar days following the date of discharge… The post-discharge TCM service includes non-face-to-face care management services furnished by clinical staff member(s) or office-based case manager(s) under the supervision of the community physician or qualified nonphysician practitioner” (Centers for Medicare and Medicaid Services, 2012).

Required elements for post-discharge transitional care management include:

  • communication with the patient/caregiver within two (business) days of discharge (communication by phone, electronically or face-to-face)
  • medical decision-making of moderate to high complexity
  • to be eligible to bill for the service, there must be a face-to-face visit with the patient within 30 days of the transition in care or within 14 (business) days following the transition in care

What does this mean for nurses? Nurses provide an essential service and should be reimbursed for this service, according to the American Nurses Association. Care coordination activities are often performed by RNs and have been shown to reduce patient costs, improve outcomes, prevent readmission to hospital and increase patient satisfaction. This move by the CMS increases the likelihood that nurses may soon be able to directly reimburse for these services. This may create the need for new nursing jobs to fill the growing need for nurses skilled in this area, particularly as the population is aging rapidly and more elderly individuals are living in the community.

As physicians will be able to bill for services performed by nurses who provide transition services, this will encourage the growth in jobs in this area. “Although the rule does not allow separate billing for care coordination, some private insurers likely will use the codes to reimburse providers directly for the service…[reimbursement policy] could expand the RN job market and raise recognition for nurses” (Nurse.com, 2012).

Sources:

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DMEFace-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013. Centers for Medicare and Medicaid Services, 2012.

CMS rule creates reimbursement opportunities for RNs. Nurse.com, November 15, 2012.

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