Cleveland school nurse headed to combat hospital in Iraq

School nurse Diane Adloff got a new assignment this school year. A major with the U.S. Army Reserves, she was ordered to prepare for deployment to Iraq, where she will work as a community health nurse at a combat support hospital.

In her civilian life as a nationally certified school nurse, Adloff already has a big job with the Cleveland Public Schools, where she’s been since 1989. Her duties include working with adults, including English language learners, at the Max Hayes Vocational School. At the Ben Franklin School, she serves nearly 800 preschoolers through eighth-graders, including a fair number of special education students. She tenaciously advocates for the children under her care, her colleagues say, writing individual healthcare plans and 504 plans to ensure their safety in school.

“As times have changed to mainstreaming medically fragile children,” she says, “I found myself in the role of assuring that up-to-date care plans, treatments and staff instruction were in place.”

When she got her orders, Adloff prepared her school clinics for a replacement nurse. She carefully put all the necessary data on discs for her successor.

“School nursing is not a ‘Band-Aid’ profession,” she says, explaining that nurses need an array of skills, including self-assurance, to walk the line between educational and medical goals for their students. “I find my profession in the schools rewarding and challenging, and would never want to have picked another area of nursing.”

From her unit’s combat support hospital in Brooklyn, Ohio, Adloff was transferred for deployment to a hospital in Taunton, Mass. An Army reservist since 1991, she has three grown, married children and three grandchildren, the youngest of whom will be walking and talking before she gets home, making her departure more difficult.

“At age 57, this is certainly a new adventure in my life,” she says, adding that she hopes to “make a difference for the people I will serve.”

Single-payer system could cure healthcare’s ills

At the AFT convention in July, delegates adopted a resolution endorsing a single-payer system and other solutions to the healthcare crisis, and rejecting any further shift of costs and risks to individual Americans.

Declaring that access to healthcare is a right, not a privilege, the AFT has pledged to support a national single-payer system as a way to prevent cost shifting and to pare down administrative expenses. Other endorsed solutions include employer mandates, wider eligibility for Medicare and Medicaid, and responsible state initiatives.

The resolution also warns that free-market approaches to healthcare, such as health savings accounts, “would lead to even greater fragmentation of a ‘system’ that is already dysfunctional due to its lack of coordination.”

So, what is single-payer national health insurance? According to John Abraham of the AFT’s research and information services department, it’s a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

One reason for interest in the single-payer model is that the United States now has a crazy quilt of financing and payment for healthcare that relies on public (Medicare, Medicaid and Veterans Administration) and private insurers alike. The current yearly cost for healthcare in the United States is nearly $2 trillion, or about 15.5 percent of the gross domestic product.

Private, for-profit insurers spend lots of money on overhead, sales and marketing—things that have nothing to do with patient care. Doctors and hospitals are forced to hire large administrative staffs to deal with different procedures from each insurer. What’s more, profit-taking by vendors also removes money from the current healthcare system.

According to the Physicians for National Health Insurance, about $350 billion per year could be saved by rolling the administrative functions provided by insurance companies into one administrative agent.

A single-payer system would:

■ Be financed in part by eliminating private insurers and recapturing their administrative costs.

■ Ensure that all Americans are covered for medically necessary services, including physicians, hospitals, prescription drugs and medical supplies.

■ Pay physicians a “fee for service,” according to a negotiated schedule, or pay doctors a salary through a health maintenance organization or HMO. Hospitals would negotiate an annual global budget for operating expenses. Expansion and medical equipment purchases also would be managed by regional health planning boards, eliminating the “medical arms race.”

■ Replace premiums and out-of-pocket costs with taxes. Overall costs would be controlled by a combination of negotiated fees, global budgeting and bulk purchasing.

Other options for achieving systemic healthcare reform include:

■ A national law requiring that employers either provide a legislated set of benefits for all employees or pay the cost of an equivalent plan into a state or regional fund that provides the benefits for workers.

■ An expansion of Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP) to cover all Americans.

To see this AFT resolution on healthcare, go to www.aft.org/about/resolutions/
2006/healthcare_system.htm.

Online activists stop healthcare attacks

It was a textbook Capitol hill battle. On one side were high-powered lobbyists working the U.S. Senate for a bill that would have let insurance companies—instead of state officials—decide what benefits healthcare plans must offer. On the other side were people like Brenda Wallace, a Wisconsin school secretary, who joined thousands of other AFT “e-Activists” in urging her senator to stand firm against the lobby.

The bill under consideration would have taken away state authority to require insurers to cover cancer screening, prenatal and baby care, diabetes supplies and maternity care. Also in jeopardy were state requirements for mammography coverage, mental health care, prostate and colorectal screenings, and post-mastectomy hospital stays.

When the votes were counted, the e-Activists carried the day. They generated more than 6,000 letters, and the bill was defeated last spring on a 55-43 procedural vote.

“Typically, I’m not a really political person, but I think the [e-Activist network] is great,” says Wallace.

The network, available through the AFT Web site, gives a concise analysis of important pending legislation, quick and easy ways to contact your representatives, and follow-up on how each lawmaker voted.

You can join the AFT e-Activist network by visiting www.aft.org/e-activist.

HIV/AIDS materials

Healthcare professionals can find practical information about HIV/AIDS in America—including facts on bloodborne pathogens, universal precautions and a Centers for Disease Control and Prevention network—at www.aft.org/topics/aids-in-america. The site is updated regularly, so check back.

AFT affiliates also can obtain printed resource packets, including a pocket guide to AIDS/HIV resources (pictured below), from the union’s human rights and community relations department at 202/879-4434.

For patients and the public, you can download and reproduce free copies of a new AFT pamphlet that gives a basic overview about the HIV/AIDS epidemic in America. The three-fold pamphlet, available at the Web site in pdf format, details the scope of the crisis, the importance of HIV/AIDS awareness, key terms, ways to get involved in fighting the problem and more.