Okay. You did your part. You spoke with your friends, colleagues, and patients about the importance of health care in the November election. You told anyone who would listen about how this new Congress and president have an opportunity to reshape our current “sick care” system into a true healthcare system aimed at providing high-quality, affordable health care for all. Or maybe you didn’t and wish you had.
I’m here to tell you that you have another chance. Your insight and your voice are needed more than ever to help educate the many new legislators coming to Congress, who want to know what you know about the healthcare system. Fast. Because healthcare reform is going to be one of the enormous challenges facing the 111th Congress in 2009.
Even if you consider yourself a novice on the issue of healthcare reform, I can almost guarantee that because of your frontline experience as an RN, you know more about the reality of the system’s failings than does most any person with whom an elected official could speak. We nurses witness daily how a chaotic, fragmented, and costly healthcare system endangers the health and safety of our patients and creates overwhelming barriers to care.
As I travel the country on behalf of ANA, elected leaders approach me, asking, “Is the healthcare system really as bad as my constituents tell me?” They seek validation of heartbreaking stories voters share about problems encountered in trying to get proper health care for themselves or their families. I have to tell the truth. “Yes, it’s that bad.”
Cost is, indeed, a major barrier to needed care. With job security faltering along with the U.S. economy, we see more people losing their employer-sponsored insurance because their employer either can no longer afford to offer coverage or has shifted so much cost onto the employee that coverage is no longer affordable. Or the individual loses his or her job and its accompanying benefits.
In 2008, nearly half of the public reported someone in their family skipping pills or postponing or doing without needed medical care due to the cost of care. Alarmingly, many of these people have insurance; these are the “underinsured.”
We know these things are a reality for millions of people in the United States and, frankly, it’s a disgrace. As nurses, where is our outrage? Sometimes I think nurses literally could flood Capitol Hill with the tears we weep in our cars, driving home from yet another heartrending shift of preventable mental or physical suffering. Tears not only of sadness but of anger, because we know it doesn’t have to be like this.
It’s within the power of President Obama and the new Congress to move the country’s healthcare system in a new direction. It’s within our power to motivate, educate, and persuade our newly elected leaders to drive meaningful reform. We need to make sure that people—and not profits—come first. We need to ensure affordable access to essential healthcare services for everyone in this country, so American families aren’t put in the position of choosing whether to fill their prescriptions or fill their gas tanks.
Nurses have many of the answers that policymakers are looking for right now. I understand that all of us are very busy people—we have jobs, families, and a lot of responsibilities. Many people depend on us.
I also know that the future of this country—the direction it will take, the priorities our leaders pursue—is also ultimately our responsibility. So when your elected representative asks, “Is it really that bad,” you can answer, “Not if you help us change it!” Congress faces a daunting challenge, and senators and representatives will need to muster all their political courage to do the right thing. It’s up to nurses to provide our continuing strong support and encouragement, as well as our experience and expertise.
An organized national strategy to restructure the healthcare system to provide health security for all? That would be “change we can believe in.”

Rebecca M. Patton, MSN, RN, CNOR
President
American Nurses Association