By Jennifer Larson, contributor
October 17, 2012 - As the November 6 election approaches, campaigns are kicking into high gear to get out the vote. Presidential debates are discussed at the water cooler, political commercials have taken over our televisions, yard signs and bumper stickers are everywhere, and campaign promises are posted all over Facebook and Twitter.
In fact, by the time the election rolls around, many voters begin to feel campaign fatigue, but experts say that you shouldn’t let that prevent you from lining up at the polling place.
“As a civic duty, everyone should make it their purpose to get out and vote, if at all possible,” said Jerome Mayer, associate director for federal government affairs for the American Nurses Association (ANA). “It’s one of the most solemn responsibilities we have as citizens.”
The impact of health reform on the election
Two of the main issues in the presidential election revolve around the state of the nation’s economy and the Patient Protection and Affordable Care Act, or ACA. The ACA is not actually on the ballot, but the two main presidential candidates have different positions on the landmark health reform law, which was passed in 2010 and then upheld by the Supreme Court in June of this year.
In fact, a team of authors wrote in the October 10 issue of the New England Journal of Medicine that the economy “dominates most voters’ thinking in terms of their priorities for choosing a candidate” but “health care is playing a greater role in this presidential election than in many other recent ones.” They noted the two main presidential candidates’ views have never been so “diametrically opposed” on health care issues as they are this year.
“The views of President Barack Obama and Republican presidential nominee Mitt Romney differ on whether the 2010 Affordable Care Act (ACA) should be implemented or repealed, whether Medicare and Medicaid should remain in their current forms with their current level of commitments, and whether the availability of abortion services should be further restricted,” wrote Robert J. Blendon, ScD. John M. Benson, MA, and Amanda Brulé, MA, in a special report titled “Understanding Health Care in the 2012 Election.”
They also noted that, in a close election, those positions could make the difference.
“No matter who you vote for, you are entitled to your position,” said Deborah Nickitas, PhD, RN, editor of the journal Nursing Economic$ and a professor of nursing at Hunter-Bellevue School of Nursing with Hunter College and City University of New York. “But for nurses, who are on the front lines of health care, if this Affordable Care Act goes away, it’s going to impact greatly the delivery system in, I think, very negative ways. For children, for young mothers and for our elders--the most vulnerable populations will suffer if this is repealed.”
Suzanne Wells, MSN, RN, president of the American Academy of Ambulatory Care Nursing (AAACN), said, “We have all already pushed up our sleeves and come to the table to begin to determine what the future is going to look like….The election has the opportunity to change that direction and that is a concern.”
The ACA is certainly not perfect, said Deborah Burger, RN, co-president of the National Nurses United, which preferred a Medicare-for-all type of scenario. “But there are good provisions in the Affordable Care Act,” she said, referring to provisions such as removing the ability to deny people coverage based on pre-existing conditions. “And nurses and our organization will continue to fight to improve it.”
Burger noted that it’s easy to get the impression that your vote won’t count in a presidential election, particularly if you don’t live in a swing state. “But it does matter,” she said.
Beyond the Oval Office
The presidency is not the only office at stake. Every seat in the U.S. House of Representatives is up for grabs this year, as they are every two years (there are 435 seats). Candidates are vying for 33 U.S. Senate seats, as well, and voters in 11 states are set to choose a governor on November 6.
Additionally, there are several ballot measures in a number of states, some of which directly involve health care issues. For example, Arkansas, Massachusetts and Montana all have ballot measures that would authorize the use of medical marijuana.
Some ballot measures and amendments also deal, either directly or indirectly, with the Affordable Care Act. Several states have ballot measures that would affect the establishment of any type of state-run health insurance exchanges, as envisioned by the ACA. For example, in Missouri, a ballot measure up for the vote dictates that an exchange could not be created except by the legislature or an initiative. Florida has a ballot measure that would prohibit any penalties from being levied upon individuals who don’t buy health insurance to comply with the federal health reform statutes.
Meanwhile, voters in Alabama, Wyoming and Montana are voting upon amendments or legislative referendums that would outlaw mandatory participation in any health system. As an example, Montana’s Legislative Referendum 122 would give residents the authority to choose what health insurance they prefer--if they prefer to purchase any at all.
Burger encourages nurses to read about their state ballot initiatives in advance of the election, and suggests looking at the voting records of all the candidates “so you can see if someone is actually voting your values,” she said.
Wells agreed that it’s important to educate yourself.
“Don’t make decisions based just on sound bites,” she said. “Be an informed voter and feel that you’ve done your due diligence in investigating the candidates and their positions before going to the polls.”
If you are uncertain about a certain measure, check with your professional organizations--for example, the ANA or your state association or specialty association--for more information, suggested Nickitas.
“Nurses have a responsibility not only to stay informed and to participate as voters, but also to inform others around them how our health policies are improving or preventing the delivery or access to quality, affordable health care,” she said. “We have to make sure our families and friends and all those we have contact with understand.”
Mayer noted that the ANA is working to encourage its members to get involved in any elections that affect them. It doesn’t necessarily have to be the presidential election; it could be an election for the local school board or city council or a state representative.
“You can make a difference,” said Mayer. “Find a cause, and find a candidate who stands for your cause and support them.”
Additionally, nurses can volunteer for a campaign and get to know a candidate, who may in turn be able to ask you for insight on health care issues.
“It’s all about relationship-building at those stages,” Mayer said.
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