Friday, December 12, 2008

Universal Healthcare Making Nurses?

From today's Huffington Post: Maggie Mahar on Healthcare Reform
(Bold italics added by this nurse)

...Will Universal Coverage Create More Nurses?
Gruber cheerfully assumes that if we just invest $100 billion a year in universal coverage, the money will quite naturally flow where it is needed to create "high-paying, rewarding jobs in health services" that will add value to the economy. "Most reform proposals emphasize primary care" he explains, "much of which can be provided by nurse practitioners, registered nurses and physician's assistants. These jobs could provide a landing spot for workers who have lost jobs in other sectors of the economy."
Here, he ignores two realities. First, the guy who loses a job in Detroit--or on Wall Street--is not going to be in a position to become a nurse without a few years of training, if then. Nursing is a demanding profession that requires a keen intelligence, a cool head, physical stamina, and empathy. Not every former investment banker would make the grade.
Secondly, and more importantly, because the pay for U.S. nurses is relatively low--and working conditions in our chaotic health care system are poor--we have a very hard time filling the nursing positions that we have today.
As I reported not long ago, while the U.S. lays out substantially more for doctors, drugs, devices, and medical procedures than every other developed country in the world, there is one exception to our medical largesse: the "salaries of [U.S.] nurses are roughly equal to salaries in other countries." In addition, salaries for nursing school professors are often lower than the salaries we pay nurses. As a result, nursing schools have had great difficulty recruiting teachers.
Meanwhile, given the high rate of medical errors in our hectic healthcare system, nurses find the job exceptionally stressful. "I was just too afraid that I would kill someone," one former New York City nurse told me.
As Dr. Val points out over at "getbetterhealth.com," nurses are not lining up to provide primary care services in our healthcare system "for the same reasons that physicians aren't too keen on it: the pay is low, the workload is grueling, and there are other career options that offer better lifestyle and salary benefits."
So while universal coverage would create greater demand for skilled nurses able and willing to provide primary care, it would not create greater supply. One would think that, given the fact that Gruber is a board member of the Massachusetts Health Insurance Connector Authority overseeing Massachusetts effort to provide universal coverage, he would be aware of the shortage of registered nurses in that state.
As of 2006, federal government estimates show that Massachusetts had 5,000 fewer nurses than it needed. In 2010 it is projected that 10,000 positions will be empty, and five years after that Massachusetts will be looking for 16,000 nurses.

Mitzi here: 16000 nurses for one state? Where will they all come from, if not Detroit or Wall Street? Although the thought of a Wall Street investor in a suit cleaning up vomit or giving medication to a combative Alzheimer's patient is very intriguing. Especially if "he's" a "she" in Manolos.

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