Walk #84: Utilization Review, Single Payer and Warm Napa Evenings...

Walk Duration: one hour....

I awoke at 4:30 am and drove the three hours to Napa to work today. Having been in this business for quite a few years now, I sometimes wear different hats. I do the social work sometimes. Today I was the Utilization Review Nurse.

I knew it would be a relatively good day when, while driving through the wilds of northern California, I came across a herd of Elk. Next to the elk were a dozen wild turkeys. The turkeys were all puffed up, looking like they were ready for a Pilgrims Thanksgiving dinner. The elk and the turkeys were sharing the same field. I took photos (to be uploaded later). I could have gotten closer, but I didn't want to spook the elk onto the highway. I like my elk alive and foraging--not dead; implanted into the side of a Buick.

I took a walk around the grounds of the hospital in the warmish evening. The first warm evening we have had. Dressed in shorts and a t-shirt--I thought about my day.

I've never been a UR nurse before. I spent my day talking to insurance companies. Talking to other nurses--except they didn't identify themselves as such--they announced on the phone they were Patient Care Advocates.

Yeah, right!

The other nurses (Patient Care Advocates) were friendly enough: They have impossible jobs. They are there to: 1. minimize stays at inpatient hospitals; 2. find reasons to deny payment of their client's hospitalizations; 3. Move the process along to get to cheaper ways of paying for their client's care.

My job was to justify the client's hospitalization. Of course, most UR nurses never meet the clients. Neither do the "patient care advocates". We read charts; go to meetings; have coffee and browse through care plans. A silly system.

Insurance companies recently started using the term: Patient Care Advocates after a bunch of bad publicity (showcased by Michael Moore) when deaths occurred after insurance companies (and their hired Nursey guns) refused care to some high profile patients. A name change was in order, so now they are Patient Care Advocates. Call it damage control.

I am an advocate of single payer health care. Socialized medicine. To be social is not a dirty word to me; in fact, I find it highly admirable to be sociable. Aren't we social creatures? Those who think that "socialized medicine" results in a lower level of care have never really chatted with a floor nurse. The profit motive is not what motivates a floor nurse. No!

Nurses don't give a rip what insurance plan you have. They are there to care for you! They are there to help! Are MD's as motivated by such pure public good impulses? I think so. So what keeps us from providing decent care to everyone?

I would argue that the lack of Socialized Medicine does such. It is time for a single payer plan in the United States. Medicare for all! Support HR 676! Tell Obama to quit ignoring the one solution that makes sense!