Driving Home The Message On Health Care

Felicia Bycenski says she believes state legislators are getting the message about the Commonwealth’s health care system and its deteriorating condition.
We can only hope she’s right.


Bycenski, nurse manager in the emergency department at Noble Hospital in Westfield, was one of many of those on the front lines of health care who went to Boston last week in an effort to drive home the fact that there is a crisis in health care that requires some immediate attention.

The event, coordinated by the Mass. Hospital Assoc., was called Advocacy Day. Caregivers like Bycenski, many of them supported by their CEOs, went to Boston to let all lawmakers, but especially those who represent their districts, know just how precarious the state of health care delivery is in Massachusetts.

This wasn’t the first time health care providers have descended on the State House to press their case, and it won’t be the last. Bycenski told The Healthcare News that the only way reform will happen is if legislators can see the real-life ramifications of decisions like the one to cut 50,000 people from the Medicaid program MassHealth Basic on April 1.

That cutback — part of a wider effort to close the state’s $3 billion budget deficit — left those individuals without health insurance. As a result, many could not longer afford prescriptions, and most of them had to resort to emergency rooms to receive needed care.

Bycenski told Westfield-area legislators about one man, a diabetic, who could no longer afford his medication. He showed up at Noble’s emergency room door with a blood-sugar level of about 400, four or five times the norm.

She also related the story of a woman stopped taking her blood-pressure medication because she couldn’t afford it. Her ankles were so swollen, she could barely walk. “She told me that it was a choice between buying food or medicine, and that week, she had to buy food,” said Bycenski.

And then, there was the story about the man who tried to stretch the medication he was taking to thin his blood by cutting the dosage in half. He wound up having a stroke and requiring expensive medical treatment.

While the stories are somewhat different, they have common themes, Bycenski told legislators, and together they provide a powerful message: when health care benefits and programs are cut to help reduce the deficit, there are prices to pay.

The individuals cut from the Medicaid program paid an obvious price, because their health and well-being was directly affected. But all those who receive health care services are impacted, said Bycenski, because there will be longer waits for care in the emergency room and longer waits for beds for those who need them.

And, if things don’t improve, more hospitals may be forced to close because they can no longer operate in an environment where they are either giving away care or receiving far less from payers than what the treatment costs. In Western Mass., where the hospitals are fewer and farther between, any closings would bring dire consequences.

Bycenski was part of a large contingent of administrators and caregivers from Noble that made the trek to Boston last week. Noble President George Koller has been very outspoken about the fact that he believes the system is broken and needs fixing. He often gets frustrated in his efforts to get this message across to the governor and the legislators, and he can’t be blamed if he thinks his comments are falling on deaf ears.

But he, and Felicia Bycenski, and others across the state know that they have to keep pressing their case — otherwise, the message might get lost.

Stories about people cutting their medication in half to make it last longer are heartbreaking, but there is a bigger picture. Those anecdotes are mere symptoms of a health care system in danger of collapse.

To keep that from happening, legislators need to listen to those stories and understand that they are part of a vicious cycle that needs to be broken.