Today, the Senate will reconvene to vote on... something. They're not even sure what, exactly, but... something.
Why, after all their oh-so principled sneers about how "Nancy Pelosi said we had to pass it to find out what was in it!" and "It was rammed down our throats!", are they so bound and determined to not only actually do the very things they complained about, but doing it on fire going 120 miles per hour through a hospital zone.
This, of course, is a rhetorical question. There's no doubt as to why they're doing it- because they have to get a win for the President, a man whose valuation of personal fealty above all else has so debased the Republican Party that its leaders lay prostrate before him, unashamedly cowering rather than to stand up for decades of "values" they supposedly held. I think a lot of us recognized long ago exactly how "supposed" those values were, which would be hilarious if it weren't so disgusting because of the effect it'll have on our fellow Americans.
So, as an emergency department nurse running for the House of Delegates here in central Virginia, I think it's high time I explain once again exactly how everyone will be affected by Trumpcare, even if think you've got great insurance, a perfect job, and can ride out whatever may come down the pipe in the way of disruption to our healthcare system. I discussed this in a similar article about a month ago- and that missive, along with a hell of a lot of hard work and agitating by folks across the country, including an enormous number from this very website, helped buy us a reprieve.
But I’m here today to bring you this story again, because those wavering votes in the Senate need to be reminded how this will affect everyone. I promise you, those Senators who're voting think that there'll be enough folks who won't be impacted by Trumpcare, so that these career politicians can save their jobs; they're deluded, of course, but that's what they believe. And y'know what? Letting them pull the trigger on that might make sense "politically" to us, because the backlash to that will be immediate and unstoppable.
But there will be so many real people hurt by the legislation they want to pass- including not just the folks impacted by coverage loss, but all of my brothers and sisters in emergency services- I'd rather give those Senators a "win" by standing up against Trumpcare, and keep that hurt out of our communities, then have to watch so many suffer from them committing political suicide.
So! If you want a relatable way to explain this, that you can take back to share with as many people as possible- and aimed at those wavering Senators, your friends, and family- it's included here below. I don't care if it's your MAGA-hatted uncle, your politically uninvolved friend, et cetera; they need to know exactly how this reckless and incredibly ill-conceived bill is going to affect them personally, even if they have great insurance and good primary care provider. Because then they need to take that heat back to every single Senator and Congressman in the country.
We all get to wade waist-deep in this upcoming scheisse-fest. And to help explain how, we're going to use the emergency room as an example, since the ER is one of the few places in medicine where everyone (regardless of class, creed, color, religion, economics, etc) is likely to go at some point. It's also the one place that everyone truly starts out as equal- or, at the very least, as close to it as possible.
The moment we’ve all feared is here, and Trumpcare passes, and becomes the law of the land. Since we just denied millions of people health insurance, making them unable to get reliable primary care and preventative services, I've got great news for all my colleagues in emergency service! You just became the primary care provider for upwards of ten to twenty percent of the entire country! And that's not just the nurses and doctors in the ER, but firefighters, EMS, and even law enforcement- they have to deal with it a hell of a lot more than you'd think, and they are absolutely included in our umbrella of emergency services, and will have to deal with this fallout.
But that's okay; you've got great insurance. So you’ve got no problem! But, oh no! Your nine-year old daughter falls off her bike at 5:45pm on a Friday afternoon and slices a three-inch laceration into her chin that's bleeding profusely. Your family doc is done for the day, so guess where you have to go? Ahh, yes, the ER!
Do you like Disney World? Great! Because it'll be just like that, minus all the rides and attractions. Yup, just a giant bill and lots of waiting. And waiting is what you'll do, because all of the people I mentioned before, the ones Trumpcare has forced into the ER- they've been waiting ahead of you for several hours already! Get comfortable in that shoulder-to-shoulder waiting room.
Ahh, but you've patient consoled your daughter for several hours, and finally get back to a room. Great! Well, lacerations are time consuming to deal with, so expect the provider to put it off to last, after they finish (necessarily!) with any patients that are having acute problems and may decompensate while they're doing the suturing. And that's IF they don't decide to consult with Plastics, since this is a facial laceration and doing it poorly will result in a scar that'd make Harry Potter jealous.
And if they do a Plastics consult, then that cash-register noise you just heard was the hospital billing department, who are grinning and rubbing their hands together in excitement. Since the Republicans decided to repeal the "personal responsibility", "no free rider" act from Obamacare that stipulated everyone had to have health insurance, lest their income tax refund be penalized, the hospital has to make up the money from folks who either can't; or, yes, even refuse to pay! I know you'll share the hilarity of Republicans being so reflexive on having to destroy anything associated with Barack Obama they’ll even destroy their own party’s platform; you'll find it especially funny when you get your bill in the mail!
Ahh, you say, whatever- I can maybe handle that, and you're just trying to scare me... if anything was really wrong, or if I called an ambulance, I'd still get straight back into the ER, seen quickly. This ain’t a third-world country.
Well, let me tell you about that! Because, unfortunately, I've got bad news for you; your mom just slipped and broke her hip! This is depressingly common, ground-level falls are one of the most common morbidities among folks over 65. Luckily, though, you were there with her to see it happen, so you could call 911 immediately. In just a few short minutes, that rescue squad will show up at your door!
Ooooh, but small problem. The local volunteer rescue squad has another empty building call. See, the county you live in relied heavily on their volunteer crews before Trumpcare was passed, but now that it's the law of the land? They worked them so hard they burned them out! And since they couldn't reimburse them training, meal, or uniform costs, the state, in a last ditch effort to get more volunteers, attempted to kneecap the training and certification requirements for EMTs (THIS IS NOT A JOKE, THIS ACTUALLY HAPPENED IN VIRGINIA). But we managed to take all of these well-meaning, community minded volunteers and burn them out by asking them to do a full-time job for no money, no training, and no support.
So, the call goes to a paid crew of firefighters and EMTs. Now, unfortunately, that paid crew may have to range over an area of a couple hundred square miles. So it might take 'em awhile to get there! Hip fractures are notoriously painful, so do your best to keep your mom comfortable while the ambulance is on the way.
Almost a couple hours after you called 911, finally! You arrive in the ER, and go straight back to a room to get seen. Oooh- wait. Nope. No, you're going to triage. Yes, yes, I know; your mom broke her hip, but have you seen the ER today? There are six other ambulances in queue when you pulled in. Why don't we see if your mom can sit in a wheelchair for a little bit, or possibly a hall bed or triage bed, if they've got one available.
Then you'll get to see the maestro for the entire department- the triage nurse! Though she or he is overworked and inundated, they know precisely what your mom is going through, and are gonna do their best to put an IV in her, and then grab one of the docs and beg them to give her something for pain- ibuprofen, or maybe toradol if they're lucky. If they know it's going to be a long wait, though, she might be lucky enough to get a shot of dilaudid, and since she's been in pain so long, it's going to take a hefty dose to quiet it.
And on that note, congratulations! Along with her broken hip, she's also acquired an opiate dependency! That's right, most narcotic addictions start in exactly this fashion- it's not "junkies" who're getting hooked on painkillers, it's normal folks like you and I. And not only that, but you'd be stunned to find out the average age of a new onset narcotic addiction isn’t in the teens… or twenties… or thirties… or even forties! Nope, in fact, older Americans are one of the most at-risk groups! Oooh, and remember, too, those "junkies" weren't always so- they started out "normal" too, and now your mom is well on her way to joining them!
When your mom is finally seen, she'll get more pain meds, x-rayed, et cetera, but then she'll at least get to a hospital inpatient room, and be able to relax, right? Oof. Sorry about that. If she doesn't need surgery emergently, she'll be boarding in the Emergency Department, because the inpatient beds are all full. Possibly for days, in fact; but don't worry! Even though the ER staff is incredibly overworked, they'll do their level best to provide for your mom.
In fact, the nurses, techs, EMTs, and doctors will burn themselves right the frick out trying to take care of your mom. Her nurse will skip lunch, skip breaks, even ignore a screaming bladder, just to make sure that hip fracture pain stays quieted (along with the other four to seven patients she or he is looking after). That nurse'll work twelve or sixteen hours straight ("Can you just stay for an extra four? We're so backed up, and had two call-outs. Please!") because they know people need help, are suffering. And as a consequence, that nurse will also be hard t work exhausting themselves emotionally and physically, destroying personal relationships, ruining their home life, all because they're not willing to let your mom be the one to suffer for this Trumpcare nonsense, anymore than she already has.
And we nurses aren't alone in that; EMTs are in this with us, too. And doctors. And police officers. And firefighters. We're not going to ask for help for us; hell, no! We're going to keep shouldering these loads for the people who need our help. Why, we had a firefighter in our community not long ago that attempted to commit suicide rather than have to ask anyone else for help. Asking other people for help when there are so many that need YOUR help is a deadly sin in emergency services, much to my incredible dismay. I've seen people turn to drugs, become addicted to narcotics, just to take the edge off to get them through another day. It's okay, see- they don't have a problem, they're just trying to make it to another day of helping people. A percocet here or there isn't going to hurt, right?
There’s a point when hard work and perseverance in the face of incredible odds isn’t enough to hold the line. This is what Republican legislators are counting on to bail them out on this POS bill. They're counting on the heroes that live among us to save their asses- give them cover from having to actually govern. Give them the cover they need to pass this massive tax cut for the rich, at the expense of all the rest of us.
They'll tip their hat to my brothers and sisters in emergency services, broken and battered, and say "Hah, without you guys the Democrats' worst prognostications would've totally come true! Thanks! Oh, and sorry; can't approve that .5% tax increase on cigarettes. I know it would've paid for all your training and equipment, but I got lobbyists to answer to. See ya!"
And we'll just take it; nod and keep working. Because we don't complain. We just work; work until we can't do it any longer.
This is what I realized in the wake of last November's election. These were the stakes. I was going to watch a bloated, POS bill like Trumpcare get actually slammed down our throats, because we have a Congress in Washington, and House of Delegates in Richmond, full of career politicians, who are completely out of touch with their constituents. Completely. And if we were going to have to bear the brunt of these political games and shenanigans that the Republican Party wants to play, then it wasn't going to be because I didn't stand up and fight. Fight with every single fiber of my being; fight for the folks who'll lose their coverage. Fight for the folks who'll try desperately to make up the difference in care provision. Fight, shout, holler, and scream, as long as there's a single breath in my body, for people who are ignored or abused and yet soldier on in the face of unimaginable odds.
Thank you- and join me today in blasting this and other stories to Senators like Heller, Capito, etc.
Kellen Squire is an emergency department nurse from Barboursville, VA, running for the Virginia House of Delegates in the 58th District of Central Virginia this fall.