There are many in our own camp who declare the HCR bill to be a victory for corporate America. Many believe that single payer is the only way to truly reform our health care system. Others say the current HCR bill is meaningless without a public option. As someone who devoted my life to a career in health care, I think it's really, really important to distinguish health care from health insurance. What we just accomplished was a modicum of health insurance reform. If we want to reform health care, I suggest focusing on the following instead.
1. Nursing Shortage
According to a report conducted two years ago by the Health Resources and Services Administration, The nursing shortage is considered critical in more than half of the U.S. Unable to fill positions, 90% of long term care facilities do not have sufficient staffing to provide even the most basic care and home health agencies are being forced to refuse new admissions. The nurses who remain are overworked, underpaid, and undervalued. The number of unfilled nursing positions across the country is expected to reach 1.1 million by 2012. If you want to improve health care, we need to examine why nurses are leaving the field, strengthen the infrastructure, develop retention programs, and give them the respect, salary, and voice they deserve.
2. Local Budget Cuts to Higher Education
Seems like one solution to the nursing shortage would be to promote the heck out of nursing schools. But nursing programs across the country have had their budgets slashed repeatedly over the last 10 years, so much so that many junior colleges no longer even offer accredited nursing programs and state universities have long waiting lists for classes. Waiting times have been reported to be as long as two years.
3. Fewer Physicians to Choose From
In today's world of litigation, tort reform, and skyrocketing malpractice insurance rates, many physicians are being forced to amend their services, take early retirement, or shut down their solo practices altogether. Ob/GYN has the highest number of casualties with 25% of physicians no longer offering obstetrics care as part of their practice. With malpractice insurance rates quadrupling in many states, physicians are being asked to pay more per year than they actually make.
4. Access to Facilities
In the '80s we saw the rush of private investors taking over a large chunk of facilities across the nation. The Rick Scott's of the world got together with their buddies and decided that health care was a great financial investment. So they began buying up hospital after hospital, merging some with others, and permanently leaving doors closed on others. Which ones? Mostly the charity ones. Health care became a high stakes investment managed by a bunch of lawyers and few medical experts (except the token ones who also served in Congress). With companies like Humana, Galen, Columbia, Hospital Corporation of America all coming together to form a conglomerate that included 166 hospitals and 112 outpatient centers across half the U.S. (and England, too) they were prime to do whatever they wanted, marginalizing standards of care for ROI all the way. With strategic facilities kept closed, people really were at the mercy of getting health care only if they could afford it.
Interestingly enough, in 2006, HCA underwent another merger that allowed it to become a private company once again. Who were the investors? Affiliates of Bain Capital, Kohlberg Kravis Roberts & Co. and Merrill Lynch Global Private Equity, and HCA founder Dr. Thomas F. Frist, Jr. Isn't that interesting.
With fewer facilities to choose from, fewer practicing physicians, a critical nursing shortage, and fewer people entering the field, my question is this: Who is going to care for all the millions of people now able to enter the health care system? Answering these questions is how we're going to fix health CARE.
1. Nursing Shortage
According to a report conducted two years ago by the Health Resources and Services Administration, The nursing shortage is considered critical in more than half of the U.S. Unable to fill positions, 90% of long term care facilities do not have sufficient staffing to provide even the most basic care and home health agencies are being forced to refuse new admissions. The nurses who remain are overworked, underpaid, and undervalued. The number of unfilled nursing positions across the country is expected to reach 1.1 million by 2012. If you want to improve health care, we need to examine why nurses are leaving the field, strengthen the infrastructure, develop retention programs, and give them the respect, salary, and voice they deserve.
2. Local Budget Cuts to Higher Education
Seems like one solution to the nursing shortage would be to promote the heck out of nursing schools. But nursing programs across the country have had their budgets slashed repeatedly over the last 10 years, so much so that many junior colleges no longer even offer accredited nursing programs and state universities have long waiting lists for classes. Waiting times have been reported to be as long as two years.
3. Fewer Physicians to Choose From
In today's world of litigation, tort reform, and skyrocketing malpractice insurance rates, many physicians are being forced to amend their services, take early retirement, or shut down their solo practices altogether. Ob/GYN has the highest number of casualties with 25% of physicians no longer offering obstetrics care as part of their practice. With malpractice insurance rates quadrupling in many states, physicians are being asked to pay more per year than they actually make.
4. Access to Facilities
In the '80s we saw the rush of private investors taking over a large chunk of facilities across the nation. The Rick Scott's of the world got together with their buddies and decided that health care was a great financial investment. So they began buying up hospital after hospital, merging some with others, and permanently leaving doors closed on others. Which ones? Mostly the charity ones. Health care became a high stakes investment managed by a bunch of lawyers and few medical experts (except the token ones who also served in Congress). With companies like Humana, Galen, Columbia, Hospital Corporation of America all coming together to form a conglomerate that included 166 hospitals and 112 outpatient centers across half the U.S. (and England, too) they were prime to do whatever they wanted, marginalizing standards of care for ROI all the way. With strategic facilities kept closed, people really were at the mercy of getting health care only if they could afford it.
Interestingly enough, in 2006, HCA underwent another merger that allowed it to become a private company once again. Who were the investors? Affiliates of Bain Capital, Kohlberg Kravis Roberts & Co. and Merrill Lynch Global Private Equity, and HCA founder Dr. Thomas F. Frist, Jr. Isn't that interesting.
With fewer facilities to choose from, fewer practicing physicians, a critical nursing shortage, and fewer people entering the field, my question is this: Who is going to care for all the millions of people now able to enter the health care system? Answering these questions is how we're going to fix health CARE.
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