Keisha S. Walker, RN, MSN
Senior Research Nurse
Johns Hopkins University, Baltimore, MD
Keisha S. Walker is a maternal child health nurse with 10 years’ experience. She has worked at in-patient and out-patient settings as a clinical nurse and manager. While working at women’s health clinics, Keisha provided care to patients who experienced numerous barriers to accessing health care, including lack of insurance coverage.
Keisha Walker, In Her Own Words:
We need to change the health care system especially for patients who do not have health insurance or are under insured. As a RN, it is very challenging knowing that I am unable to provide the same standard of care to each patient, not due to lack of trying but rather the numerous barriers within the current system.
I have observed vastly different follow-up care provided for women who have abnormal pap smear results, depending on whether they have health insurance. The insured woman's plan of care would be implemented immediately while the uninsured woman's care would be delayed. Although unspoken, both the uninsured patient and I know that she does not have access to health care because of lack of coverage or money to pay for out-of-pocket costs.
I have spent numerous hours attempting to coordinate care by locating services for uninsured patients. Too often I was frustrated with the fragmented health care system that does not offer adequate funding or a safety net for uninsured patients to obtain proper follow-up for an abnormal test result. Meanwhile, the patients would worry about developing cervical cancer as they waited for weeks or months to be seen by a health care provider willing to manage their care.
It is incomprehensible to me that in the United States there are two standards of care – one for those with comprehensive health insurance coverage, and another for those who are under insured or lack insurance. The current health care system allows for varying standards in affordability and quality of care. It also promotes health disparities. If Congress truly wants to address the problems in health care, then broad health care reform legislation that includes a public health insurance plan option must be passed now.