Dr. Burpee: Using the ER as a primary care facility is incredibly dangerous

by Jess Kutch | Thursday, September 04, 2008

An article posted today on Alibi.com profiles Healthcare United activist Dr. Elizabeth Burpee and the Healthcare United campaign in New Mexico. In light of recent comments made by Sen. John McCain's healthcare advisor, John Goodman, on the availability of the ER for persons without insurance,  Burpee's story seems particularly relevant:

Elizabeth Burpee's daughter was trying to scream, but she couldn't because her tongue was swollen. In the pediatric ER two weeks ago at UNM Hospital, the girl was having a life-threatening allergic reaction to an antibiotic. Burpee is a doctor at the hospital, but that night, she was there as a mom. "I went out to get a nurse, and the nurse was too busy to come right away," Burpee says. UNMH was on code purple status, she says, which means a message was sent to all health care providers in the hospital saying the ER was crowded, the hospital was full and patients needed to be discharged as fast as possible so ER patients could get into beds. "That's a product of our failed health care system," Burpee says. "People have to use the ER as their primary care facility. That's a huge problem and incredibly dangerous."

Days later, she would be traveling with 28 nurses and doctors from New Mexico to the Democratic National Convention, where Burpee would speak about the ailing health care system in the United States. The group was part of the state's chapter of Healthcare United, an organization of doctors and nurses seeking a voice in the national debate about health care. Watching her daughter catch her breath after finally receiving the treatment she needed, Burpee marveled at the situation. "I was thinking to myself, This is crazy. This is stuff that I talk about, and this is happening to me right now.

Dr. Burpee and other Healthcare United activists spoke at a rally in Denver on Wednesday, August 27th in support healthcare reform. In addressing the audience, Dr. Burpee explained the importance of Healthcare United's constituency: "If you put a reform package together without the expertise of doctors and nurses, it would be disastrous," she says.

Read the full article: http://alibi.com/index.php?story=24471&scn=news

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How We Can Make Immediate And Positive Changes in Health Care

by Elizabeth Burki, Ph.D., MSN, BSN, RN | Tuesday, August 19, 2008

NOTE: This post was written and submitted by a Healthcare United Caregiver. If you'd like to submit your own blog entry for consideration, please e-mail Brad Levinson at brad@healthcareunited.org.

Most of us know that it would take approximately 10 years to bring new oil resources to market, no matter how much certain candidates promise that allowing offshore and wilderness drilling will reduce present day gasoline prices.  However, few of us realize just how long it will take to over-haul the present American health care "mess".  In reality, it will take years of negotiations and reorganization of enormous bureaucracies before we can realize definitive change.

In the meantime, so many people -- old and young -- are suffering from gaps in their health care plans’ (private, federal, state) drug coverage.  We need to consider what can be done early on in the new presidential administration to help our most vulnerable citizens.  I offer four suggestions that can be affected by simple voting and which can positively effect millions of Americans:

1) Allow the Federal government to negotiate with the drug companies for "best pricing" of ALL drugs paid for out of Federal and/or State Medicare and Medicaid plans;

2) Eliminate the "Doughnut Hole" in Medicare drug coverage:  For those of you who don't know about this, Medicare will pay for the first $2,250 dollars worth of medications.  The participant is then responsible for the next $3,600 worth of medication.  Then Medicare kicks in again and pays for 95% of drug coverage.

This cost is per person – there is no special "couple" benefit.  An elderly couple living on Social Security might have to pay out >$7,200/year to keep both partners on their medication when they fall into the Doughnut Hole.  For most people/couples on fixed incomes this "Doughnut Hole" becomes a black hole of crushing expense.  

At present, only those persons who are truly destitute can qualify for Extra Help, leaving those barely over the bare minimum income to struggle onward. For patients requiring diabetic meds or any other chronic disease medications, including cancer medications, this is a devastating financial pit in which to fall.  

We health care providers have witnessed our elders cutting pills in half; not taking meds at all; foregoing food or not paying utility bills to pay for medication; not getting prescriptions filled in the first place, etc., because they simply cannot afford hundreds to thousands of additional dollars for their medications.

3) Supplement the SCHIP program so that middle-income families without health care or insurance or inadequate insurance coverage can afford on-going care (monitoring, caring, testing, medications, etc.) for children with chronic diseases such as juvenile diabetes.  Many millions of our fellow taxpayers are without health insurance, especially those who are self-employed or employed in small business which are exempt from insurance requirements. These hard working Americans earn too much to qualify for Medicaid yet cannot afford the devastating expenses incurred when a child becomes seriously and chronically ill.

4) For adults with cancer or other devastating condition who are too young for Medicare and who have either no insurance or their insurance is limited, there needs to be a fall-back insurance program for catastrophic illnesses.  Going home to die because no one entity can cover the staggering cost of cancer care medications and treatments is the sad scenario facing middle-age patients who might make too much money to qualify for Medicaid but cannot afford chemotherapy agents that cost an exorbitant amount of money, let alone surgery and radiation.  Bankrupting a family to pay for the health care of a loved one violates, in my mind, the principles of justice on which our country was founded.

It is my impression that these issues can be addressed within the next Congress and dealt with in an "up-and-down" vote.  I hope that each of us, individually as well as in the collective will demand that our representatives at the state and federal level own up to their responsibility to protect the most vulnerable amongst us while simultaneously working to further the Universal Health Care benefits for all of us.

Elizabeth Burki, Ph.D., MSN, BSN, RN has been a clinician, case manager, professor, ethics consultant, and reseacher for 40 years.  During this time she has witnessed too many people, especially the elderly, middle-aged adults and children without insurance or without decent insurance going without appropriate, coordinated health care (medical -- including medication -- and dental) because of financial constraints.  She believes strongly that access to health care is a right, not a priviledge.    

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