This article from the Wall Street Journal talks about the increasing shortage of physicians in the U.S. and how it looks as though it will only get worse. To make matters worse, many people believe that the new healthcare reform act will cause more people to consume healthcare resources, thereby increasing the need for healthcare professionals even more.
"It will probably take 10 years to even make a dent into the number of
doctors that we need out there," said Atul Grover, the AAMC's chief
advocacy officer.
Obviously an increased need for healthcare professionals will benefit the healthcare staffing industry. However, many measures need to be taken to ensure the shortage doesn't grow to severe. Even though healthcare reform will positively affect the healthcare staffing industry, too severe of a shortage will hurt us all as a country. Unfortunately, the healthcare reform bill did not go far enough in addressing the growing need for healthcare professionals.
Proponents of the new health-care law say it does attempt to address the
physician shortage. The law offers sweeteners to encourage more people
to enter medical professions, and a 10% Medicare pay boost for
primary-care doctors.
This map is a great visualization of the shortage of physicians across the country.
Of course, how this legislation is carried out will determine the exact changes we all see and feel. There are several sources around the web that have posted summaries on some of the most immediate changes the healthcare reform legislation will make.
To me, the biggest question here is about the cost and potential tax increases we will all face as individuals and businesses. According to this interactive tool from the Washington Post, neither my premiums nor my personal taxes will increase due to healthcare reform. The really good news is that my premiums were expected to rise between 10-15% before "Obamacare," so I'm going to see this as being positive.
For businesses, it now appears that not providing health insurance to your employees will earn you a penalty. It will be interesting to see if this legislation changes the classifications or definitions of employees as to when insurance has to be provided. However, most large companies already provide insurance for all of their internal employees and offer it as a benefit to their field staff who meet qualifying hours. Therefore, there should be no impact to most healthcare staffing agencies in this regard. For new and small healthcare staffing companies (under 50 employees) there is even better news. Not only will these companies avoid potential penalties for lack of employee insurance provisions, they can qualify for stipends to provide insurance to their employees. This will offer tremendous assistance to start-up companies who otherwise couldn't offer coverage.
Unfortunately, big businesses will most likely see a tax increase to help pay for all the new legislation. Although I'm not a fan of paying more in taxes, I'm also not 'anti-tax' across the board. Paying taxes for certain things that benefit society, such as healthcare, is a good thing. I'm one of those crazies that believes in the greater good so I'm willing to pay a little more for it.
Many people disagree with this view completely and feel that healthcare reform is nothing short of socialism and the end of the American Empire. During a recent webinar hosted by the Staffing Industry Analysts, many CEO's of large staffing companies were discussing how detrimental this legislation will be to their business and all the other horrible things healthcare reform will bring. I've even had people on my blog leave comments and send me emails suggesting the same. For example, Randy Mensinger from Custom Healthcare left a comment on one of my healthcare reform blog posts stating he feels this will put the company he works for (and many others) out of business. He was so upset with my opinion that he even followed up on my comment with an email full of obscenities and calling me all kinds of things I won't repeat here.
So obviously not everyone shares my opinion. I'm willing to admit I could be wrong. If I am and businesses have to start carrying such a heavy tax burden that it puts them out of business I'll be right back here advocating against healthcare reform. I completely respect an opposing view and honest debate on healthcare reform. However, there are several things I don't understand, such as:
Being disrespectful and unprofessional to each other. It doesn't matter who you are, but, if you work for or represent a staffing company in our small industry I don't think it benefits you in any way to be unprofessional and disrespectful.
Where was the vociferous anti-tax movement during the bush years when we were spending trillions of dollars on an unjust war that was started for made up reasons? Perhaps if we hadn't spent so much money then (and now) we'd have money for things like healthcare for our citizens.
Many people are up in arms about the mandate that every American will be required to have health insurance. However, the health insurance mandates are actually a Republican idea. These mandates are only going to benefit the health insurance industry and those politicians beholden to this industry. So clearly their outcry is merely political posturing.
No matter how you feel, what we all really need is information, facts and a real debate. Much of the information coming from the media is full of sensational, unfounded claims. It's not only irresponsible, it's dangerous. Unfortunately, without reinstating the Fairness Doctrine it's only going to get worse. For example, this video:
I'm all for free speech but when this much hateful, misinformed rhetoric is pumped through the media for several hours a day, every day, it's no wonder people are resorting to violence against members of congress over something like healthcare reform. There are many reasons justifying the call for revolution. However, I assure you, healthcare reform is not one of them.
In summary, I truly believe that healthcare reform will benefit us as individuals and as a country. It will be a huge win for the healthcare staffing industry. That said, I'm not a fan of the government and will watch the outcomes of this legislation closely and with a critical eye. I am also willing to admit when I'm wrong. Therefore, if the sky starts falling or we witness the collapse and devastation of the medical staffing industry, you'll see me at the next tea party rally.
I hope the opposite is also true. If you're an opponent of this legislation and none of these horrible things come to pass it would be great to hear you admit you were wrong someday.
Think about the services you make use of every day from business to personal. Booking a hotel, finding a photo online, sharing information with your friends, or managing your internal work projects. Imagine if any of these services were as difficult to work with as our current healthcare system. Would you continue to use them?
Not being a big fan of the government, what shocks me is that, in this case, we're not talking about the government running something inefficiently. We're talking about private business. It's the private insurance companies that have failed to deliver a viable model or useful service when it comes to healthcare. How people can continue to support this broken system when they would have no tolerance for a similar level of service from the services they use everyday is beyond me.
This video is a parody of what it would be like to book a plane ticket with a travel agency that had a business model similar to our current healthcare system. Makes you think.
Over the next few weeks both of my sons have birthdays and I plan on spending some down time with my family for the holidays. Therefore, this will be my last post until the new year.
I thought I'd use this post to highlight some of the big events that affected the healthcare staffing industry in 2009 as well as make a few predictions about the industry for 2010. (is it 'twenty-ten' or 'two thousand ten'?)
What the healthcare staffing industry looked like in 2009:
Major downturn in spending on healthcare temporary staff.
As you can see, 2009 was a very eventful year for the healthcare staffing industry. So what will the next year bring?
My predictions for healthcare staffing in 2010:
More consolidation of staffing agencies and VMS companies.
After struggling through the economic downturn of the last 1.5 years many companies are now really feeling the effects. I see several staffing agencies closing their doors and many more acquisitions in 2010. I wouldn't be surprised if we even see some consolidation with some of the major players. In addition, I expect we'll see some more acquisitions of healthcare VMS companies.
The industry has gotten a bit stale in terms of innovation and new technology options. In addition, we've seen a decent amount of consolidation of industry technology companies. Both of these facts suggest to me that new players will enter the market and hopefully they will bring with them some exciting and innovate technologies. As these players enter the healthcare staffing industry I expect we'll see more and more hospitals and healthcare staffing companies embracing technology to improve their staffing process. Stay tuned!
Even though there are some positive signs for the economy overall and there has been some slight improvements in the healthcare staffing industry I don't see anything that suggests we should get too excited. Earlier this week the Staffing Industry Analysts (SIA) hosted a webinar about the economic outlook for 2010. Their predictions suggested that every industry will improve in 2010 - except healthcare staffing. In fact, they are predicting an overall decline of -1%. Therefore, unfortunately, I believe 2010 will still be a year of struggle. There will be some positive bumps here and there but we won't start fully pulling out of this down turn until early/mid 2011.
What are your predictions for healthcare staffing in 2010? Please share them here if you have any.
I wish you all well - happy holidays - happy new year. See you in 2010!
This week saw the formation of the largest nursing union in the history of the U.S. The National Nurses United organizes
over 150,000 nurses by uniting the California Nurses
Association/National Nurses Organizing Committee with the Massachusetts
Nursing Association and some members of the United American Nurses. The
goal of the new union is to influence healthcare
reform and improve the quality of care through efforts
such as extending California’s patient ratio law to other states.
Dec. 7, 2009 - To standing cheers, delegates to the founding convention of the National Nurses United (NNU) today unanimously endorsed the creation of the largest union and professional organization of registered nurses in U.S. history - and projected a major escalation in campaigns to expand union representation of nurses and an expanded voice in healthcare reform.
When I started my blog I promised myself I wouldn't talk about politics. However, since then, the heatlhcare debate went into full swing. This is an incredibly important issue to me and therefore, hard to ignore. I've blasted out several tweets and written some previous posts on why I think we need reform and what changes healthcare reform will bring to medical staffing. This has put me in the middle of a few debates with some people.
This week I spent some time in Canada and wrote a post about how healthcare staffing works with our northern neighbors based on the conversations I had with some people on my trip. Gregg Dourgarian of TempWorks and the staffing blog - Staffing Talk wrote a rebuttal to this post. I was going to comment back on his blog but my response grew past an appropriate length for a comment. Therefore, below is my response to Gregg's post.
Of course it's easy to find examples of inefficiently run government healthcare systems as Gregg's post talks about. And yes, there are several stories of unsatisfied Canadian’s coming to the states for care, just as there are several stories of unsatisfied American’s who turn to Canada for care and cheaper medications. But lets be honest, you can also find the same inefficiencies in the private sector. It’s
fair to say that both solutions are imperfect. However, according to the stats, the vast majority of Canadian's are satisfied with their system of care.
What about the current government run healthcare programs in this country such as Medicare, Medicaid and the V.A.? If you asked people receiving healthcare from one of these sources if they want their “government healthcare” taken away to be given private insurance instead I'd be surprised if you found any takers. When I left the military I received care from the V.A. for several years. It was some of the best, most efficient, cost effective care I’ve received to date. Everything I’ve done since with my private insurance has been a costly hassle.
In regard to my comment on "unnecessary for-profit medical centers." Often times, private hospitals, clinics and imaging centers will establish their entities next to competing medical centers creating a shortage of staff and a glut of beds or imaging equipment such as MRI’s. This equipment and these facilities are expensive. Their cost, as well as the increased demand now created for staff increases our country's overall healthcare costs. In addition, many of these private facilities get money from the government to start their new operations which comes from tax dollars.
These facilities are unnecessary in terms of needing more beds or care options in a particular area that already had a lack of demand. This situation has happened several times here in the Portland market causing situations of vacancy in the newly established medical center, as well as exacerbating those in the centers with which they’re competing. These new centers exist for one reason - to create profits for the individuals that establish them. While often times the newly established medical center offers lower prices and different medical options in order to compete, (thereby providing “the consumer with choice” as it was put in the Staffing Talk post), the greater cost of healthcare to society as a whole increases from these situations. You may personally save a $1 today but you’ll pay $5 tomorrow.
There's no question that having a privately run healthcare system in the U.S. has led to major advancements in healthcare and medicine for the world as a whole. However, what good are these innovations if the vast majority of Americans (or people in the world) can’t afford them and therefore, are denied access to them? I am a big believer in keeping things private and also believe that government creates bureaucracies and inefficiencies in most things it touches. However, the private sector has been running things for years and that is why we are now in this mess. If the private sector could deliver on its promise in healthcare we wouldn’t even be having a debate.
The costs of healthcare are simply too high, the system is broken and we need a new solution. Here's what private companies and a private healthcare system have produced for us over the last 8 years:
I appreciate the debate Gregg. And, while although I agree that most things in this country should be run by private enterprise, healthcare is not one of them.
I spent the last couple of days in Canada and learned some interesting things.
Lots of people really do say "eh" and "a boat" (about)
It's really a lot colder that far North
Vancouver is a beautiful city and has tons of great restaurants
Green traffic lights blink for some reason
The walk sign (little white light man) is different than the one in the states
I also met with a Canadian based company that makes staffing software for hospitals and they gave me some interesting information on healthcare staffing in Canada such as:
All hospital census is always at 100%. There are 0 vacancies. The theories as to why were everything from - there is a waiting list for care in Canada and no beds are ever empty to - there are too many, unnecessary for-profit healthcare delivery organizations in the states causing a consistent census gap, mismanagement and poor staffing.
All hospitals employees are unionized and the same organizations that run the educational centers for healthcare professionals negotiate on behalf of the unions.
All of the hospitals are not for profit and effectively owned by the government.
Due to all of this, there is little to no market for healthcare staffing agencies in Canada even though there is still a shortage of healthcare professionals.
When polled, consistently, the people of Canada approve of their healthcare system by 80+%
The company I met with also makes payroll systems for countries all over the world and claimed that 1) the U.S. has the most complicated tax laws over any other country and that 2) no other country they work with has local or regional taxes.
This information is anecdotal, as it came from a handful of people. However, I'm interested in learning more about it so I'll be doing more research on it. If anyone else has information on any of this please let me know.
"While the short-term economic environment may have temporarily eased the ability to recruit and retain clinical staff, the long-term dynamics of an aging population will drive the need for thousands of additional healthcare professionals," Susan Nowakowski, president of AMN Healthcare, said. "Any plan to expand access to care would intensify an already anticipated critical shortage of clinicians."
There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. ...if you leave everything else
the same -- the volume of procedures, the days we spend in the
hospital, the number of surgeries we need -- but plug in the prices
Canadians pay, our health-care spending falls by about 50 percent.
My favorite quote in the article talks about a key missing component to the healthcare reform debate - price:
The health-care reform debate has done a good job avoiding the subject
of prices. The argument over the Medicare-attached public plan was, in
a way that most people didn't understand, an argument about prices, but
it quickly became an argument about a public option without a
pricing dimension, and never really looked back. A health-care debate in this country that isn't aware of the price
differential is not an informed debate.
There are some great graphs in the article. Look at this one on the cost of hospitals stays in the U.S.
Keynote with Senator Tom Daschle: National
Healthcare Trends and Issues and Their Impact on the Healthcare
Workforce
Being in D.C. last week, you couldn't help finding yourself in discussions about healthcare reform and its impact on the healthcare staffing industry. The highlight of
the Healthcare Staffing Summit was listening to former Senator, Tom Daschle speak on the topic. Whether you agree with him
politically or not, you can’t argue with his knowledge and command over the topic of healthcare, as well as his speaking ability. It was an amazing opportunity to hear him.
Here are some highlights of his speech from my notes:
Reforming
healthcare is a transformative event, equivalent to similar events that happened
after WW2, the civil rights movement and 9/11.
50 million people are uninsured
at part or all of the year and 48% of those insured are not adequately insured.
The U.S. is the only
industrialized country that has a problem with healthcare coverage for its
citizens.
Healthcare costs everyone in the
U.S. about $8K per person. This is 40% higher than the next highest country –
Switzerland.22% of these costs go
to administration.
Starbucks spends more on
healthcare than they do coffee.
Ford spends more on healthcare
than they do steel.
Medical costs are the #1 reason
for personal bankruptcy (over 50%) in this country.
The U.S. starts its spending on healthcare at the most expensive
part of the cost pyramid (the top) and works its way down, running out of money before everyone can be covered. Other societies work in reverse, in order to cover more
people adequately at a more cost effective rate.
Senator Daschle calls the debate about
healthcare reform “the noise of democracy” which he states is “far better than
the noise of violence.”
Healthcare reform will create a
tremendous demand for healthcare professionals, thereby having a positive effect on the healthcare staffing industry.
Today we have 21st
century operating rooms with 19th century administration.
Primary areas of the healthcare reform bill without consensus
- public option; financing mechanism of $1 Trillion; to what extent cuts should
be part of funding, mandates; role of the employers; medical malpractice;
insurance companies selling across state lines; federal health board.
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