Healthcare Policy

Undocumented Immigrants, the law, and healthcare

By | Health, Healthcare Policy, underserved populations | One Comment

A high school Valedictorian in Texas announced that she was an undocumented immigrant this week, sparking a debate about who should and should not be enjoying the benefits of residency in the US.  Larissa 20160423_blp901Martinez stated the following:


Lovely, brilliant Valedictorian

“By sharing my story, I hope to convince all of you that if I was able to break every stereotype based on what I’m classified as — Mexican, female, undocumented, first generation, low-income — then so can you.” 

My maternal grandparents are from Italy.  My mother is a first-generation American.  I was the first person in my family to go to college, which happened later in my life because my parents didn’t really see the benefit.  After all, my father never graduated high school, and no one in either of their families had been to college and they turned out just fine.

Naturally, in our changing economic climate that was a mistake.  However, back to the undocumented part… When my grandparents came here it was much easier to become a legal resident of the US.  My grandfather was so unbelievably proud to become an American Citizen, after the long and grueling process of naturalization.  He only spoke Italian when he arrived, and worked at low-paying jobs doing manual labor.  He learned English.  He studied, he sweated, and he passed the test after 12 years.

Larissa says that she and her mother have been trying to become a citizen for seven years, and that the US Immigration system is broken.

I am going to make comparisons here.  Preparing for the tomatoes.  tomatoe-thrown

While the US Immigration system is probably broken, the Mexican Immigration system is equally as convoluted and full of red tape.  I cannot just walk into Mexico with my children and set up housekeeping, as Larissa’s mother did.  News stories I read about her family stated that they ‘fled’ to the US; from an abusive, alcoholic father, apparently. It seems to me that it was probably not necessary to illegally enter the US for that reason. I will assume that Larissa’s mother wanted an American life for her children.

In 2011, the Mexican government enacted a ‘softer’ law about undocumented immigrants to Mexico. Up until then, this was the law:

  • Under the Mexican law, illegal immigration is a felony, punishable by up to two years in prison.
  • Immigrants who are deported and attempt to re-enter can be imprisoned for 10 years.
  • Visa violators can be sentenced to six-year terms.
  • Mexicans who help illegal immigrants are considered criminals. 
  • The law also says Mexico can deport foreigners who are deemed detrimental to “economic or national interests,” violate Mexican law, are not “physically or mentally healthy” or lack the “necessary funds for their sustenance” and for their dependents.

Sick and poor undocumented people are not supported by the Mexican government.

So, when Larissa’s family arrived in the US, the law in Mexico was pretty harsh.  Had I done the same thing with my children, I would have been imprisoned for two years and charged with a felony, then deported. The law has since been changed to an administrative and financial penalty, and it is possible to obtain Mexican residency unless you are sick or poor. Larissa’s family was poor.

illegal-immigrants3Having said all that, am I in favor of deporting all undocumented immigrants? No, of course not.  I am in favor of naturalizing them; they already live here and contribute to the economy.  As a matter of fact, they have historically contributed to Social Security and never collect the benefits.  Of course, there are people who work “Off the books”, but the large majority actually contribute to all payroll taxes via a false Social Security number. And this is not the fault of their children, who know no other life.illegal-immigrants-pay

However, if they commit crimes against other people, I am in favor of instantly deporting them.  Not in a year, not after a prison term that we pay for.  That very moment. Mexico can keep her problem children. They have high standards for Americans emigrating to Mexico.

Let’s get to the healthcare part! 🙂

The Affordable Care Act specifically prohibits undocumented immigrants from purchasing health insurance through the marketplace.  Undocumented immigrants can sometimes get coverage through an employer.  They can purchase private health insurance, which is expensive.  If they are a college student, they can purchase a student plan through a university.  These are usually cheap.

Also, a 2012 federal law provides temporary work authorization and relief from deportation to undocumented children and young adults who arrived in the U.S. before turning 16. It’s part of the Deferred Action for Childhood Arrivals law, known as DACA. Undocumented immigrants who qualify are eligible. Since we really cannot blame kids for the actions of their parents, I think it is a good concept. In California, undocumented immigrants may be allowed coverage under Medi-Cal if they have DACA status.

I see no problem with undocumented immigrants buying health insurance through the marketplace.  More people = lower prices according to our government.  Also, these folks currently seek primary care in Emergency Departments all over the US because they have no insurance.  11 million undocumented people can clog up a lot of ED’s.  Let’s make them pay for insurance like everyone else, and stop using the ED as a PCP’s office.

While I do not have the answer to the problems we have with undocumented immigrants, I would say that Larissa probably made an error when she did this.  Many people will see it in a negative light.  She is still in the country illegally.  I hope Yale knows her immigration status, and that she is prepared to get a student visa.  She is a smart kid, so she probably thought of this.

However, great job on those grades, girl! I hope you are a great neurosurgeon.

And we don’t need that wall.



Share this post with friends!
Want More? Click below to follow us!

Why would a rape deserve a 6 month sentence on any planet?

By | Advocacy, Events, Healthcare Policy | One Comment

Brock Allen Turner.brockturner

Some would describe him as a promising Stanford student, and competitive swimmer.

I would not.

I would describe him as a 19 year old sexual predator who attacked a 23-year old woman, then got off with a six-month sentence because of a judge who isn’t fit to grace the bench. I would also describe him as a young man who is unable to admit when he has done something wrong, and who blames the victim of the sexual assault he committed for the whole scenario.  He plans to start a charity to combat the ‘campus drinking culture’ instead of the rape culture in which he was an active participant.  If not for two Swedish Grad students, he might have left a young woman naked, unconscious, and alone next to a dumpster; like the disposable object he thought she was.  judge-persky

He took an intoxicated and vulnerable young woman from a party and turned her into an inanimate receptacle for his sexual desires.  He obviously did not seek her permission to do so, and had his attorney emotionally violate her in court.  As if this young woman hadn’t gone through enough, the attorney efficiently assassinated her character on the stand. He placed the focus on the fact that she dared drink to intoxication, which is legal. He diverted attention from the fact that Brock Allen Turner engaged in sexual activity with her while she was unconscious, which is illegal. The attorney asked if she had a habit of cheating on her boyfriend, as if that is even in the same ethical universe.  As if she were consenting to relations with a man who violated her unconscious body.

And dared to say a year later that this young woman consented to sex next to a dumpster.

At what point are we going to stop victim blaming and start teaching our sons that sexual assault is unacceptable? When are we going to stop defending wrongdoing on the part of our sons? At what point do we say, “Son, you have done something so absolutely wrong that I am not defending you with my money. Get a public defender”?

At what point will we stop condoning the assault of young women because they have had too much to drink? At what point will we stop thinking: “She Asked For It” ?2952e1cebda59cd2468e3df296a630a2b262969b724e8e85d109f688701d23dc

There is a petition to recall this judge. Click here if you want to sign it.

Disgusting. Morally Bereft.  Heartbreakingly Sad.






Share this post with friends!
Want More? Click below to follow us!

Fox News SLAMS Nurse Practitioners. How quaint.

By | Healthcare Policy, Nurse Politics, Nursing, VA Nursing | 10 Comments

How do you know an organization knows NOTHING about a subject? Click the big text and watch this video:

VA takes heat over plan to let nurses treat vets without doc supervision

These people are insane.  Twenty-one states have given the GIFT of primary care to their residents by allowing NP’s to practice independently.  The veteran population has so far been denied the choice of a nurse practitioner as a primary care provider, and the VA is said to have long wait times.  This is the obvious solution, and a choice I applaud the VA for making.  And Fox News makes a skewed report that makes it look like *I* will be practicing primary care at the VA next month? “Nurses will have their roles expanded”.  No.  Highly trained Nurse Practitioners will be allowed to practice at the level twenty-one US states say they are able to practice.  And now Veterans are ‘settling for a nurse’.

Really, Fox News? Really?VA-health-care-scandal-590x442

Be clear, the VA is taking no heat from me on the subject.  I am a VA employee and I do not agree with some of their policies, but this one is spot on. I am a veteran and a nurse, and I would be totally OK with a nurse practitioner taking care of my primary care needs at the VA.  As a matter of fact, I am now going to make it a point to register for VA health care. They take my insurance, and it would be extremely convenient to see someone in my building for primary care. Less sick time, less travel time, less wait time.  Everyone wins, especially me.

Even if you are opposed to Nurse Practitioners privately practicing in standalone clinics, the VA is a wonderful environment for NP’s.  There are all kinds of resources, and a physician is a phone call away.  All specialties are represented, and the VA Nurse Practitioner can get patients in to see specialists when necessary, with seamless continuity of care. Patients get their medications from an in-house pharmacy, and the VA Pharmacist has access to the patient’s medical record if there is a question about the dosage or choice of a particular drug.  This is the perfect situation for Nurse Practitioners; they are able to practice to their greatest ability, and they have backup.  Everyone wins – Especially the patient.STLHealthcareSystemLogov2

What people do not seem to understand is that the VA is actually held to way HIGHER standards than the private sector. We are taking care of our veterans, to whom we owe our very lives, so this is appropriate. It may take you 3-4 months to get in to see a new Primary Care Physician in the private sector.  The VA is required to get the new patient seen within thirty days.  Not only that, but if we are unable to get patients seen within thirty days, we run the risk of being dragged through the mud on Fox News.  In the private sector, nobody would be looking and the media would never be told about it. That is the difference between wait times in the private sector and the VA.  Public knowledge.

3e487c3Yellow Journalism at its finest.

I have seen ‘surveys’ of veterans who say they want care outside of the VA on the news.  I want to meet these people and see how random the surveys were.  As stated, I work for the VA.  I have so far had one patient say they wanted to go outside the VA for their healthcare.  The rest of them generally say something along these lines: “I know that I hear a lot of bad stuff about care at the VA, but i’ll tell you, they have always treated me great!” I have scheduled veterans who have insisted on driving four hours to our VA Hospital for a procedure, rather than having the procedure done close to their home because they TRUST the VA. 

Odd how that happens.

Thank you, Secretary McDonald for allowing us to further improve VA healthcare by providing even greater access to primary care.  Our veterans deserve it.  Thank you for utilizing Nurse Practitioners to help veterans get the best care anywhere.








Share this post with friends!
Want More? Click below to follow us!

Let’s talk about…… Nurse Practitioners and Double Standards

By | Education, Healthcare Policy | 6 Comments

Click this picture to register for our event in DC after the safe staffing rally.

Let’s say you are a medical student. You go to ISYS (I Stole Your Stethoscope) University. You pay your tuition and attend your classes.   You are expected to show up for your clinical experiences on time or early, prepared, and ready to go. Your school arranges them, and Physicians are compensated for your instruction. Then you are in Residency and you are paid to work and learn. And the facility actually bills for your time, and the Supervising Physician bills for hers.

Now let’s say you are a Nurse Practitioner student. You go to SMYS University. You pay your tuition and attend your classes. You are expected to spend untold hours locating a Provider to precept you, and possibly begging them to have you. You may be completely unable to find one; in which case, you will automatically fail. If you find one, awesome! If not, doom! Total crapshoot.

What is the difference here?Investment-in-Healthcare

The Supervising Physician is paid to teach.  The Supervising NP is not.  We have single handedly solved the mystery surrounding the difficulty of finding NP preceptors. It took us thirty seconds.

It is possible that we need to change this model.  We need NP’s. They are good, solid critical thinkers, and excellent within their scope of practice. Hospitals can afford to better staff their services when NPs are part of the provider pool. They are a lifesaver in a financial sense.  There are good outcomes with Nurse Practitioners as well as Physicians.  NP’s make a difference here and abroad. We can see they are especially necessary when events like the #JuniorDoctors strike happen.  Physicians and NP’s are both absolutely essential.

Both Physicians and NP’s are constantly pressured to see more patients, document more stuff, take less time, and make more money for their organizations. This is not a scenario in which it is optimal for anyone to take on a student.  However, the Physician will be paid to do it, so there is some incentive. The NP has to do it out of the kindness of his heart; and take on liability and extra work for the privilege.  I am all about students.  I do my best to give them a great experience, and if I were in that situation, I might not take students either.  No incentive, added liability and extra work? What could go wrong?

This seems to be a symptom of the disease pervasive in nursing….. “Dumped Upon” Syndrome.  This happens because it is the status quo, nobody else wants it to change, and we are allowing it to happen.  We want to help, our hearts are in the right place, and we take on ridiculous amounts of work for no added

Because we are a profession of Martyrs.

Perhaps together we can fix this mess.





Share this post with friends!
Want More? Click below to follow us!

Spreading the Gospel of Ratios

By | Advocacy, Events, Healthcare Policy, Nursing, professional, Unity, Workplace Safety | 4 Comments

ZDoggMD, representin’.

Huh. Who knew staffing ratios were a big deal?
Oh, right. WE DID.

Nurses everywhere have taken up the call—staffing ratios impact the care and safety of our patients, and keep the profession from burning out and getting hurt on the job. Even a certain Dogg knows it. (See Z-DoggMD’s AMA here.)

(ZdoggMD is on fleek in our Staffing Ratios Matter shirt. Get one here.)

We’re waking up and ready to destroy the current paradigm: doing more with less. SHENANIGANS, Y’ALL. All chronic understaffing has done is increase the rates of morbidity and mortality, and decreased professional satisfaction—which means fewer nurses stay at their jobs…which means fewer nurses are at work…which leads to more injury and infection. Instead of the Circle of Life, it’s the Spiral of Disaster.

Let’s tell our administrators, CEOs and legislators what we know to be true. Are we cool with staffing ratios that endanger patients, decimate the health care worker population and and ultimately increase cost of care? NOPE.


Kelsey R. of She knows what’s up!

Here’s what you can do:

  • Tell your health care friends, teachers and students about how unsafe staffing levels increase the number of adverse patient events, up to and including death
  • Also mention that it can increase the number of workplace injuries
  • Invite them to join us in Washington on May 12, 2016
  • Or, attend a state capitol event on the same day
  • Share this press release with your colleagues, coworkers and friends:
  • Get the Staffing Ratios Matter Shirt & rock that thang! It’s the Little Shirt that Could. It’s everywhere, and it’s back on sale. Order here.
Share this post with friends!
Want More? Click below to follow us!