The Coming Collapse of the US Health Care System

IIt’s four in the morning and you wake up with severe chest pain. Your family calls 911 and paramedics arrive and diagnose a heart event. They informed you that they needed to drive you 45 minutes ago because two of your local hospitals were closed in the last few months. Even when you go to the hospital, the overcrowding happens and they inform you that there are no ICU beds available for you of which 50% of the beds in the cardiology department are “full” due to lack of staff. This nightmare is an all-too-familiar post-pandemic reality about healthcare delivery in our country. This is not the expectation the public has come to expect in terms of healthcare delivery in one of the world’s richest countries that has been at the forefront of healthcare innovation of the last century.

What has led to this post-pandemic nightmare is multifactorial. The pandemic has changed the way healthcare professionals are valued and the way they see themselves. During the peak of the pandemic, they were heroes who risked their lives to help their communities. But now things seem different.

About 7,000 nurses on strike in New York nurses strike is a symbol of dire situation. Nurses, who are essential to the vital functioning of all hospitals, are not only entitled to fairer compensation and benefits, but ultimately a safer staff ratio across all wards. patient care facility. The irony is that the strike will force these same health care systems to replace recruited nurses with temporary nurses from staffing agencies, further exacerbating the financial situation. and ultimately their profits. Until we invest in people and their value in healthcare, we won’t be able to see the light at the end of the tunnel.

Every day, we read about hospitals across the country losing millions if not billions of dollars each year. Hospitals are closing urgent care, obstetrics, paediatrics and other services to try to survive. One of the main factors causing this crisis is the lack of staff. Hospital staffing after the pandemic has decreased massively along with an increase in reliance on temporary on-site staff. Hospitals and clinicians no longer have regular staff that can build professional and patient relationships; instead, they depend on local staff with short-term contracts to provide those services. Vendors are there at all levels of the professional ladder from doctors, mid-career providers, nurses, respiratory therapists, and radiology technicians. This personnel model has led to many problems both professionally and financially.

At the professional level, the huge staff shortage and reliance on temporary staff have created a serious problem in the patient care sector. Hospitals and clinics have discontinued all critical patient services. It is not uncommon to learn that health care systems have closed Pediatrics, Psychiatry, Obstetrics and ICUs. Other healthcare systems have gone to the point of closing entire hospitals because of staffing problems. Another key factor in the crisis is that outpatient services have reduced hours and days. It is clear that these cuts in services have had a major impact on access to health care. Individuals lose the ability to get to appointments, x-rays, and tests in a timely manner. In many communities, it is the underserved that pay the most for prompt care.

Hospitals also had to close operating rooms due to staffing shortages, thus delaying both elective and emergency services. Critically ill patients admitted to the emergency department also spend hours or days waiting for inpatient beds due to a lack of trained staff even when beds are available. Even when they may be ready to be discharged, patients have to wait a long time to find skilled nursing and rehabilitation facilities because they are also affected by staffing shortages. The inability to transfer patients to appropriate facilities only increases the number of inpatient beds in the short term.

During a pandemic, it’s not uncommon for older service providers with health problems to retire instead of going to work. Individuals who have gone to work have worked long hours and have increased stress levels. After the pandemic, many of these individuals were not financially rewarded: they saw the COVID-19 relief money used to upgrade facilities, construct new buildings, and other rewards. for non-employees. This has clearly changed the relationship between bedside providers and hospital management.

Adding to this breakdown for many are city and state vaccine regulations. Many believe they have worked hard with limited resources and experience to fight COVID-19 and now appreciation is costing you your job because of your own ability to make health care decisions. friend. Another big problem is the shortage of individuals who want to become healthcare providers. Many individuals and families have observed how hard healthcare workers have to work and work while other professions and jobs can work from home.

One of the most important aspects of the change was the introduction of a large number of temporary workers during the pandemic that continues to this day. Temporary workers (often referred to as Locums) are a major contributor to staffing issues. When ordinary hospital employees learn about the financial rewards that venue providers receive, it only leads to more people asking, “why am I still working here?”.

Venue providers can receive two to three times the hourly rate and, in some cases, free housing, rental cars, and meal allowances. This is not a good model for worker satisfaction as an individual works through the pandemic with all its stress and is currently training an individual that will earn many times the salary. their base with additional perks with no loyalty to the establishment. In some parts of the country, local health workers may be walking down the street from the hospital. Staff from hospital A to hospital B then hospital C without having to travel.

An integral part of this discussion is the high pre-pandemic level of burnout and attrition among providers that further devastated the supply of available healthcare providers leading up to the pandemic. . Addressing this issue is integral to the continued supply of suppliers across the United States

The widespread use of sites also affects how and the quality of care is provided. In the complex environment of health care delivery over the past few decades, we have learned that the best care is provided by individuals who work in teams who care about issues. or specific problem. Good examples of this are the operating room and the ICU. Here, providers know each provider’s expertise and skills, as well as the procedures and guidelines needed to care for specific conditions. You can easily see how this will produce the best care. With short-term venue suppliers, the use of this system descends into a world where individuals do not know the principles, the location of supplies, the needs of each supplier, and what each individual needs. brought to the table. Also affected is the ability to run through simulation and learning scenarios because the employee is temporary. Many of us will see an increase in complications and poor outcomes over the next few years due to failures in the healthcare team.

The massive financial drain due to staff shortages and site utilization has resulted in many healthcare facilities reaching a point of financial instability. Daily reports of large quarterly losses by both internationally renowned and local hospitals where billions of dollars are being lost in an already operating industry with low profit margins will lead to the loss of close more establishments. This affects not only rural hospitals with low operating margins, but also larger urban healthcare facilities. The loss of such vital services in hospitals and related outpatient facilities will impact future generations’ care for our community.

So if all hospitals and healthcare facilities close, where will we get care? The answer is bleak. If we are hit by another pandemic, where will the care be provided, where will the beds be? This important financial issue will also affect other industries. Medical technology companies cannot sell advanced ventilators, monitors, and imaging equipment to facilities with no cash flow. Aging health infrastructure cannot be repaired, upgraded or replaced in this financial environment.

As the backdrop of this growing crisis, we wonder why this isn’t an important news story. Why are our local and national leaders addressing this issue?

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