For one Iowa nurse who’s seen more than her fair share of problems with the entire health care industry, the efforts to undermine the ACA’s progress has been baffling.
“The ACA didn’t go far enough, we really needed to have insurance for everyone, a public option, available,” Mary Burke, a case manager nurse from Linn County, Iowa, told Starting Line. “But it did make a big difference, and it’s also made a big difference in the number of patients being served at state hospitals.”
But with the current administration, it feels like the entire Republican party has issued a war on the ACA, including senators from Iowa and other Midwestern states.
“The foolishness needs to stop with these ACA attacks,” Burke said.
But problems with the health care industry obviously pre-date Donald Trump’s presidency.
“I remember being shocked early on in my career when we were told that a treatment that a physician ordered was not approved by insurance – so this is something that has been going on forever,” Burke said. “Wait, the doctor ordered it, when did [insurance companies] become the physician? When did the insurance companies go to medical school? How can they deny this? It was a complete shock.”
But what came as a shock to a recent graduate, fresh into the health care field in the early 1980s, is now commonplace. As insurance profits continue to drive care in the U.S., there’s problems spread far and wide throughout the industry.
“There is no part of health care that I can think of that hasn’t taken some extreme hits in the last couple years, I mean really major, significant hits – research, education of health care providers, every field in health care, they’re no longer maintaining research databases, just everywhere,” Burke explained.
As a provider, Burke often takes part in conversations about how to solve some of these problems, but finds it hard to hone in on just one, or a few, issues.
“My brother is a tea-party guy, and he asked me what I thought the three biggest issues in health care are … ” Burke said. “That’s like asking me if I’m more worried about the fire in this corner of the house or that corner of the house – the whole place is burning down.”
If the American health care industry is a house on fire, Burke believes insurance companies’ profit motive is the open gas can in the garage – which was just waiting to be set ablaze.
“This has been kind of a gradual erosion of coverage, along with a recent explosion in cost. But it’s really taken a huge hit in the last couple of years,” Burke said. “There’s a complete lack of compassion.”
Burke also discussed her experience in the state of Iowa, watching as resources have been depleted with lacking investments.
“The continued strangulation of university budgets and med schools, the impact that’s had on producing high-quality physicians who aren’t struggling under horrendous amounts of student-loan debt is going to be huge down the road,” Burke explained. “Especially as the baby boomers keep getting older, that’s going to have a really big impact.”
There was always pushback in Iowa from Republicans on the ACA. They went a step further when Governor Terry Branstad privatized Iowa’s Medicaid program, which has led to frustration amongst patients and health care providers.
“Privatization of Medicaid is a crazy,” Burke said. “I think folks are missing that they’re trying to privatize Medicare now, and everyone seems to be oblivious that that’s going on.”
It’s another piece of unfulfilling investment, and Burke said hospitals are now really struggling to provide enough quality care.
“The state hospitals are primarily affiliated with the university, so they have basically don’t have any resources from anywhere,” Burke explained, recalling a specific case. “I have a patient who is diabetic who needed to see any endocrinologist for almost a year before we could get her an appointment; and that’s just waiting for an appointment for someone who has full health insurance.”
With all of these challenges in the way, Burke said that state hospitals are now overburdened with a backlog caused by the private insurance “stranglehold.”
“BlueCross BlueShield won’t even negotiate prices. They won’t come to the table, they pass out their forms of what they’re going to pay and there’s no negotiating that,” Burke explained. “If they weren’t so huge and all-powerful, there would be some negotiation.”
Looking to the upcoming election, Burke is hoping to see a more progressive plan put in place that will sure-up funding to hospitals and medical schools, and one that will move toward universal coverage.
“I do think a public option needs to be enacted; I don’t care what it looks like,” Burke explained. “I have friends and family whose quality of life has gone down drastically because of private insurance, so let’s give people away to get care without it.”
By Josh Cook
Photo by Hush Naidoo