Thank you for your recent article: “The states go marching in” on Feb. 15, (p. 6). It solidifies my concern not only as a citizen but also as a healthcare provider in regards to the current healthcare reform law. As you pointed out, there are a number of states in opposition to the recommendations being offered, so much so that they are in the process of taking legal action. As Rebecca Vesely stated, “Most of these state pre-emption bills were filed just after the new year.” This further concludes, in my opinion, how passionate we have come in opposition to the reform. The ideas contained in the reform law have not even been implemented, and the states feel the need to take immediate action. Ms. Vesely also has exposed the inconsistency with the legislative programs. How can the government guarantee funding federal program mandates for one state and not another? How can one not feel their constitutional rights are being impinged upon when one is required to purchase healthcare or at risk of being fined a percentage of their income? At the same time, I am extremely concerned about the reimbursement issues that will come into play in my own community hospital. I am also concerned about the domino effect that it will have on patient care as well as staffing and job security. I do appreciate the efforts being taken by different states to effectively reform programs at the state level. These programs inherently want to support the individuals and their care without additional and extraneous strains on the taxpayers and/or business. BadgerCare Plus Basic in Wisconsin is a basic health plan that most healthy people would enjoy for a premium of $130. Oregon and Utah both want to expand the exchange programs that would encompass the work force and insurance programs. Thank you for acknowledging their efforts. I am quite sure, given the proper support, most states would be able to clean up, enhance or do away with cluttered programs that are no longer effective. This, in turn, would not only lend a hand toward the financial burdens, but also support the autonomy of individuals and the states. Ms. Vesely pointed out that “news broke that Anthem Blue Cross of California, a WellPoint subsidiary, planned to raise rates on the individual market by up to 39%, setting off a firestorm in Washington and in Sacramento.” This should send a firestorm throughout the country. This shows once again the greed and willingness to push the limits by some individuals/organizations. No matter what rules, policies or recommendations come into play, someone will always want to manipulate the system or work around the rules. I don't think that anyone with compassion or a conscience denies the fact that we need healthcare reform in this country. Unfortunately, care and caretakers come with a price. If we as a country don't seriously consider every aspect of each level of reform, we are destined for failure. Even if every intention is good, the massive change being generated through this law is setting us up for chaos and financial ruin. I would like to thank your publication for exposing positive and negative elements of this reform that we as a country are facing.
Theresa ThetfordNursing studentUniversity of Texas at El Paso