With the explosions that killed 29 miners in West Virginia and spilled oil off the Louisiana coast, we saw intensive media coverage, congressional hearings on lax safety standards and calls for new federal action.
But you don’t have to travel to Appalachia or the Gulf Coast to see evidence of lax safety standards. Just walk into any hospital across America where every day, away from the media spotlight, patients die partly as a result of similarly inadequate safety standards. Despite enactment of the national health care reform law this spring, safety standards remain a national scandal.
Nurses and others who have advocated for comprehensive reform of our dysfunctional health care system have long said the main failings fall into three broad categories — access, cost and quality, the three areas that have dropped the U.S. below other industrial countries in how we care for our citizenry. Those are key barometers that we’ve long said would be best fixed by moving to a national system, such as expanding and updating Medicare to cover everyone.
Despite passage of the most comprehensive health bill in decades, the job remains unfinished. Despite some important regulatory interventions on abuses of the insurance industry, the insurers’ chokehold on the system remains intact. Most notably, the new law fails to rein in the predatory pricing practices on the giant insurers, exposed in California by Anthem Blue Cross’ outrageous planned premium increases or the routine denials of claims. California Nurses Association research documented that routine denials amount to more than one-fifth of all claims according to data the insurers themselves submit to the state.
Quality is another arena where the report card must read incomplete. That starts with safe nursing care. We can begin the repair process by enacting two follow-up reforms now in Congress:
- S 1031/HR 2133, which would, among other components, establish minimum ratios of nurses to patients for all U.S. hospitals, modeled after our enormously successful California law; and
- S 1788/HR 2381, which would promote nurse retention and reduce patient accidents and injuries by establishing safe patient lifting and handling policies.
We have reason to be proud of what the CNA-sponsored ratio law in California has accomplished. According to a study by University of Pennsylvania researchers published last month, post-surgical patient deaths could have been reduced by 14% in New Jersey and 11% in Pennsylvania, if those states matched California’s nurse-to-patient staffing ratios.
As Sen. Barbara Boxer (D-Calif.) said to a conference of 1,000 registered nurses from across the nation in Washington, D.C., May 12, “We know that nurse-to-patient ratios work, and it is time to enact them around the nation. California was the testing ground and it’s working.”Â
The president and his supporters insist the reform legislation is just a start. Its passage proved that Congress can pass major health care legislation, and we should complete that work with life-saving patient safety protections, then on to guaranteeing a single standard of quality care for all.Â