Perspectives on improving nursing's public image. 1980.

Abstract

HALF A CENTURY AGO it may not have been absolutely essential for the general public to be informed about nursing and its implications for health care. Today the situation has so vastly changed that this view no longer holds true. The public is called upon to aid in the decision-making process in health care by voting, organizing, and exercising influence on government, at the local, state, and federal levels. They require a certain awareness of nursing activities in order to make intelligent judgments about the expenditure of their tax dollars. Public funds already pay the lion's share, 40 percent, of health costs nationally, compared to 35 percent by the user and about 25 percent by private insurance plans. This makes the cost of health care not only a private concern but a public one, and increased public financing of health care is leading to governmental action across the nation. Among hospitals, pharmacists and pharmaceutical manufacturers, medical suppliers, and physicians, there is a growing effort toward building better understanding and relationships with consumers. Where there is public spending, there must be public understanding. Obviously, regarding nursing, this cannot be achieved overnight, but nurses must make a beginning in understanding the complexities of communicating information about their work and themselves to the public. Need for Nursing's Inclusion in Health Care Reform To even the casual observer it is increasingly obvious that the United States is in the very early stages of a revolutionary change in its health care delivery system. When a national survey asked, "Which health care system do you think would be the best way to provide adequate medical and health care for all people?" only one American in four, 25 percent, said, "the present system." Just four years earlier, 30 percent spoke up for the present system. The leadership of the traditional health care industry has also drastically declined in public confidence since 1966 according to an annual survey by Louis Harris and Associates. To most Americans these days, what is changing most in the health care field are costs. For the average urban American, the cost of health care has soared 240 percent since 1968 - faster than any other basic living need, including food, housing, clothing, entertainment, and transportation. One out of every eleven dollars Americans spend today goes for health care. At a time when maintaining a single hospital bed can cost up to $30,000 per year - and when the average cost of a day's stay in the hospital has risen to over $200 from $35 in 1963 - the entire industry is the target of reform. The progress of health sciences, which offers increasing opportunities for curing diseases and improving health, creates a natural demand for new health care services. Americans want a large and increasing part of these to be provided as a public service, available to all with minimum discrimination due to financial means. Progress in this direction is being made, but the objective has yet to be met to a satisfactory degree. Meanwhile a heavy strain has been placed on both the available services and public treasury, with the cost of health care increasing at a rate which cannot be maintained. In such conditions, politicians are the first to know that the same taxpayers who demand increased health care services will not be prepared to foot the growing bill unless they are convinced that, colleclively, they are obtaining an appropriately increasing amount of useful service. The mass media, particularly the various news media, are well aware of this situation and devote an impressive amount of space to the public debate on health care reform. There is no doubt that legislators at all levels, health care administrators, along with health care providers (of which nursing services constitute about 50 percent) will all be deeply involved in a major reform of the present health care structure under the watchful eye of the much concerned public. …