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Healing Our Healthcare System


by Randi Weingarten
President, American Federation of Teachers 


I have yet to see a perfect piece of legislation, and the Patient Protection and Affordable Care Act (ACA), often referred to as Obamacare, has real flaws. But even at this early stage, its accomplishments are important. Millions of previously uninsured people have gained healthcare coverage; the law has begun to rein in healthcare costs; consumers are starting to realize savings; patients have greater access to preventive care; and carrots and sticks throughout the healthcare industry are spurring moves to improve quality. But key elements of the act have yet to take effect, and this is a vital period to realizing its potential. 

Randi Weingarten at ACA rally

Randi Weingarten at a rally in support

of healthcare reform. Photo by Michael Campbell.

The ACA has been threatened with extinction since its inception. The U.S. House of Representatives recently held its 36th unsuccessful vote to repeal the act, and House Republicans have denied the appropriations necessary to fully implement the law. Many governors have refused to establish insurance exchanges central to the law and to expand Medicaid in their states. These efforts amount to what Washington Post columnist Ezra Klein calls “cutting off your nose to spite Obama.”

But it’s not just elected officials who have an interest in the success or failure of the law. We all have a stake—whether through gaining access to affordable care, controlling healthcare costs to free up funding for other priorities, or knowing that emergency rooms will be for emergencies—not for patients who have no other options for care. It’s time to get the law right, not tear it apart.

Nurses and other frontline healthcare workers are uniquely qualified to identify what’s working for patients and communities in America’s health system—and what’s not. The AFT is one of the largest unions of registered nurses and other healthcare personnel in the United States. Our members support proper implementation of the ACA in order to make affordable, high-quality healthcare available to all, and they are working on a number of fronts to enhance patient care. 

The deliberate understaffing of nurses to save money adversely affects patient health and safety—and AFT Healthcare members have identified it as their top professional concern. Nurse staffing shortages are a factor in 1 out of every 4 unexpected hospital deaths or injuries caused by errors. The additional costs associated with patients who develop complications due to understaffing are greater than the labor savings. We’re fighting for safe-staffing legislation, and AFT Healthcare affiliates in Connecticut, New Jersey, New York and elsewhere have used the union contract as a tool to correct staffing problems

Politics and profits should never be elevated above patients.

AFT Healthcare members in Oregon and Vermont have championed the use of teams of healthcare personnel, doctors and managers to identify areas in need of improvement and to take action to address them. Such teams have successfully helped lower operating costs while making improvements to the quality of care. 

Nurses belonging to the Washington State Nurses Association just this month won a case before the state Supreme Court affirming nurses’ right to take breaks during shifts that can last 10, 12 or even more hours. They fought for nine years to ensure safe, high-quality care for patients in Washington state and to set a precedent for other states.

The AFT’s teacher members see the inadequacies in America’s healthcare system, as well. One of the key issues for Chicago teachers who went on strike last fall was the need to increase the number of school nurses to provide adequate care for students. And teachers in Cincinnati have worked with the school district to ensure all students have access to health services right in their schools.

In February, we took a historic step toward giving nurses a stronger voice on issues affecting their profession and their ability to provide high-quality patient care. The 34,000 registered nurses in Montana, Ohio, Oregon and Washington state who belong to the National Federation of Nurses affiliated with the AFT, joining more than 48,000 nurses and thousands of other healthcare workers. This is particularly important now, in this time of transition, when America’s healthcare industry is rapidly changing and the ACA is being implemented.

I am proud to represent dedicated healthcare professionals committed to the ideal that politics and profits should never be elevated above patients.