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Voices From The Nursing School By Maria Silveira My nursing colleague, “S,” has a 50/50 chance of inheriting Polycystic Kidney Disease from her father. At the age of 28, through genetic testing, she will find out if she has the gene that will inevitably cause her body to develop cysts in her kidneys, liver and other organs. There is no cure, so why would she get screened? And more immediately, if she has the gene, will she be dropped by her health insurance company for having a pre-existing condition? S’s situation is relevant to the bill the senate unanimously approved HR 493 last week; a bill entitled the Genetic Information Nondiscrimination Act (GINA). As the title suggests anyone who has a genetic test and finds out they carry genes that may cause them to develop a disease later in life, can’t be discriminated against. Your genes are now protected against discrimination in the same way you can’t be discriminated against for your age, gender, race, religion, etc. Neither your employer nor health insurance companies can use your genetic test results against you, for example by firing you or declaring that you have a pre-existing condition and dropping your health coverage. While I find this a step in the right direction for treating long-term health outcomes and protecting patient privacy, I’m left wondering why we are allowed to discriminate against people once they develop a disease. I’m beginning to think that healthcare is a right. As a nursing student, I am taught not to discriminate against patients for any reason. I advocate and care for each patient equally and I don’t ask about their insurance status. As healthcare providers we strive to provide the highest quality of care to everyone who comes through the doors of the hospital, but the healthcare system prevents us from doing so in a multitude of ways. Some often quoted problems are: a shortage of providers, lack of insurance, fragmented services, high cost of medications, poor continuity of care, and language/cultural differences. By now, everyone knows we are in a healthcare crisis in the U.S. and as a nursing student I believe the solution is to ban discrimination against sick people. We all deserve basic healthcare and discrimination is a result of being under- and un-insured. We should treat everyone equally, by allowing them the same access to care and excellent quality of care. The best way to do that is a single-payer healthcare system. If everyone pays into the system then we can afford to treat everyone. If patients have healthcare coverage, then they can focus on staying well by getting timely healthcare and spend less time worrying about whether a medication is covered by the formulary or whether they need a pre-authorization to receive healthcare. We will not deny care to an individual with a chronic disease because it is too expensive to treat. We will not discriminate based on cancer, inherited diseases, or congenital disorders. Back to S’s story, so she wanted the genetic test for polycystic kidney disease because her father needed a kidney transplant. The bad news is, she isn’t a transplant candidate because she carries the gene for the disease. The good news is, her brother doesn’t have it and he is a good match. For now, S is lucky, she’s young and healthy enough to keep working as a nurse in the emergency department. Her health insurance company can’t discriminate against her – yet. She will develop polycystic kidney disease and when she is too sick to work she will have a hard time finding a health insurance policy that will cover her. The solution for our patients, friends, family, colleagues and ourselves is already here, we have a bill, SB 840, in the state of California and HR 676 is a federal bill. As students and American residents we are all in this healthcare system together and as voters and constituents we have the power to change the system into a fair one. Everyone in, nobody out! NS4universalcare.blogspot.com
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