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The Return of Nurse Ratched – because we fear strong women

By Barbara Glickstein

September 8, 2017

Poured my coffee and grabbed The New York Times Weekend Arts section to see what’s happening culturally this weekend to make plans that would provide balm for my soul.

 

I turned to page C3, Arts, briefly and this headline jumped out at me: “Netflix Acquires Series on Nurse Ratched”  a Netflix series from Ryan Murphy, the creator of the horror series “American Horror Story”, Sarah Paulson will be the star of the show. It will focus on the the character Nurse Ratched in Ken Kesey’s 1962 novel “One Flew Over the Cuckoo’s Nest”. It was adapted as a film in 1975.

 

I asked myself, why now?

 

It’s 2017, the President of the United States has been widely called out for his objectification of women – he has a tendency to criticise them for their looks – and he makes sexist remarks. This administration is back peddling on policy issues that directly impact women from access to equal pay, parental leave, and reproductive justice (to name just a few issues on a long list).

 

So Netflix is producing a 2-season 18 part horror series based on the female character, Nurse Ratched. “Ms. Paulson will play the title character, tracing her evolution from low-level nurse to the manipulative tyrant who terrorizes mental institution patients in Ken Kesey’s 1962 novel.” In the film, her nickname was “Big Nurse”.

 

In the film adaptation (and in the book) Ratched is depicted as a powerful and threatening woman who emasculates and belittles men on the unit she commands full control over. Ratched also holds absolute power over the male and female staff. She makes them do what she wants.

 

One message: When this woman is in charge. Fear her to the fullest degree.

 

The book, “One Flew Over the Cuckoo’s Nest” was written in 1962, a period of social turmoil, the Civil Rights movement and Second Wave Feminism.

 

I guess the backlash on women moving forward, nurses working towards full scope of practice is still as threatening now as it was in 1962.

 

We have our work cut out for us. But we already knew that. I’ll be tuning in as a feminist nurse media analyst.

 

I didn’t even touch on the portrayal of people living with mental health issues and how we still can’t talk about it or provide access to care.

 

Barbara Glickstein
Barbara is a founder of the Center for Health, Media & Policy, as well as a nurse, media guru & activist in New York City. She is the chairman of the board of Project Kesher and a consultant to many health care organizations and creative projects. Barbara tweets and 'grams @blickstein.

Today’s Scorecard on the HELP Committee Hearings

By Carole R. Myers

September 7, 2017

Senator Lamar Alexander (R-Tennessee), working with Senator Patty Murray (D-Washington), scheduled four bipartisan hearings on stabilizing the Affordable Care Act (ACA) individual markets which are also known as exchanges. The first two of the hearings were held this week and two more are scheduled for next week.

 

Five Governors testified today before the Senate Health, Education, Labor, and Pension (HELP) committee, following the five state Insurance Commissioners who testified yesterday. At the end of the day, there was consensus on one potential fix, a growing consensus on another suggested remedy, and an impasse on a third option.

 

Consensus: The five Governors who testified advocated for the continuation of CSR (Cost Sharing Reduction) payments to insurance companies to cover the cost of out-of-pocket expenses, including co-pays and deductibles, for the lowest income individuals enrolled in the individual market plans. The only disagreement was whether the HELP committee should push for a one year assurance of funding or a multi-year plan.

 

Growing consensus: State flexibility was promoted across-the-board. Specifically, section 1332 waivers pertaining to certain ACA provisions were promoted. There was a coalescing around several specific procedural changes (e.g., shortened approval process, “me too” applications, allowing Governors and Insurance Commissioners to apply for waiver instead of state legislators, etc.). Views were mixed on whether waivers would apply to only procedural issues, leaving ACA consumer protection some coverage provisions intact, or if protections and coverages could be modified under the waivers.

 

Discord: Governor Haslam (R-Tennessee) led the charge in requesting federal money for establishing reinsurance plans as a means to reduce premium costs. He and the other Governors indicated there is insufficient time for the states to get reinsurance plans up and running for 2018. Senator Alexander pushed back, indicating he could not pass a bill that included funding for a federal reinsurance plan.

 

Stay tuned for next week when healthcare stakeholders testify and state flexibility is discussed.  You can listen to the hearings live or on-demand (https://www.help.senate.gov/hearings).  Hearings will be held next week on September 12 and 14 at 10 am EDT.

 

Carole R. Myers, PhD, RN

September 7, 2017 9:00 p.m.

Carole R. Myers

A Refreshing Start on What Truly Made America Great

By Carole R. Myers

September 6, 2017

 

Photcredit:Library of Congress

I just listened to the opening comments of Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) as they kicked-off the first of four hearing of the Health, Education, Labor, and Pension (HELP) committee hearings over the next two weeks on stabilizing the individual marketplaces.  It was refreshing and encouraging to hear an emphasis on “coming together” and “finding common ground” (remember when this was more common?).  I will be watching to see if the call for bipartisanship is realized.

The challenges are great.  Eighteen million Americans, 6% of all Americans, are enrolled in marketplace plans. The impact of market instability is real and painful to Americans across the country.  Proposed premium rates for 2018 in Tennessee include 21-42% increases because of uncertainty regarding ongoing reimbursement to insurance companies to offset the discounts provided to the lowest income individuals for out-of-pocket costs, including copayments and deductibles.  These reimbursements paid by the federal government, called Cost Sharing Reductions (CSRs) are not bail-outs as they have been characterized by President Trump.  These are justifiable reimbursements to insurance companies for discounts for the poorest marketplace enrollees.  If federal CSR payments are stopped, the insurance companies will recoup cost by increasing premiums for other enrollees.  This is not sustainable.

Another sign of distress is the decline in the number of marketplace plan per counties across the U.S.  Senator Alexander reported that initially only 4% of counties had just one insurer.  This number is now 50%.  Time is another major challenge.  The HELP committee must forge and pass a legislative solution and this policy solution must be approved by Congress by September 27, 2017 to stabilize the individual markets for 2018 as annual enrollment begins.  Americans can do extraordinary things when they have the will and work together.

You can watch live HELP committee hearings via https://www.help.senate.gov/hearings .  Hearings will be held September 7 at 9 am EDT and September 12 and 14 at 10 am EDT.

 

Carole R. Myers, PhD, RN

September 6, 2017 12 noon

 

Carole R. Myers