By Joanne Warner
These notes are being written as I fly back from the marble halls of Washington, DC.
I was fortunate enough to be there this past weekend when the U.S. House of Representatives passed the Senate version of health care insurance reform and President Obama signed it into law.
The energy was palpable. Jubilation, fatigue and angst, depending on your world view and preferred strategies.
As a nurse and Dean of a great nursing school, I was jubilant. I humbly acknowledge that other well-reasoned folks have differing opinions, and many consequences of the new law are yet to play out.
I applaud this step, however, as a way of strengthening our health delivery system.
It provides access for 32 million more people, emphasizes primary care, uses comparative effectiveness data on various therapies and reduces dilemmas of preexisting conditions. The Congressional Budget Office analyzes these changes as deficit reduction efforts.
We should understand the societal context that defines this historic situation. Donna Shalala, former Secretary of Health and Human Services (1993-2001), has noted that two conditions are required for successful reform: (1) national consensus that there is a problem with our current health system and (2) national consensus around a solution for reform. Both were not present in 1993 when President Clinton attempted reform. In 2010, broad agreement abounds around the problem.
Partisan divide exists on the best solutions, but enough agreement (and negotiation and persuasion) facilitated passage of the bill.
We should think of this historic moment as health care "reforming" - like a progressive tense verb that indicates ongoing action.
After 13 months of partisan posturing, passionate agendas and courageous leadership, much more work lies ahead.
Vigorous conversations and debate will continue refining the implementation and intent of the bill.
Nursing ideas, models, examples and perspective are needed on the committees and commissions that will shape the future. Full implementation will take up to four years.
As this new law addresses insurance reform, more work is needed to reform the delivery system.
I made five visits to Oregonian congressional offices this weekend.
The agenda was to build relationships, explain priorities, thank them for their work and ask how I could be of assistance. One staffer said from a fog of fatigue and anticipatory excitement, "Help us message the reality of this complex bill and explain the good possibilities." It is that admonition that inspired my candor - part personal and part professional - about the good step this can be for the U.S. economy, health and sustained "national security" that relies on a healthy population.
I'm inspired for continued collaboration with policymakers to strengthen our health care system. After all - the theme of our school's 75th anniversary year is "Difference Makers."
Joanne Warner is Dean of the School of Nursing
