The Healthcare Bubble and How to Survive It

Why can't new nurses get jobs? Why are my insurance premiums rocketing up? Why is U.S. healthcare so much more expensive than healthcare anywhere else? Why is my hospital adding two new wings during a recession? Nurses Announcements Archive Article

The answer: the healthcare bubble. What it is and how to survive the "pop."

Is there a healthcare bubble?

The experts waffle, but facts are facts; between 1999 and 2011, government spending on healthcare increased 240 percent while GDP increased 62 percent. Health insurance premiums, according to the Kaiser Family Foundation, have increased 168 percent between 1999 and 2011 while earnings increased only 50 percent (Foy, 2012). Such vast and rapid increases are not sustainable.

"The unfortunate fact is that Americans spend twice as much on healthcare as people in other developed countries, but receive lower quality care and less efficiency" (Colombo, 2012).

When value becomes detached from valuation, bubble problems start. Why we have a bubble is the subject of another article but we can see the effects in the proliferation of MRI machines, hospital wings, and new nurses (like myself). The indisputable truth is that all bubbles must pop.

Don't panic yet, however.

Bubbles are part of the modern economic cycle - observe the dot com bubble, the housing bubble, Japan's economic bubble. As this blog by Stan clearly articulates, bubbles have some benefits - increasing incomes and standard of living and improving access to certain technologies. Yes, they are painful when they pop - ask anyone who has sold a house in the last five years. But, big picture, there's not a lot we can do to stop them.

As Stan says, "Unfortunately, however, bubbles are difficult to detect as they occur because they typically begin with modest and innocent optimism. That makes bubbles inherently difficult to stop a bubble from forming. Besides, who wants to be the guy taking away the punch bowl as the party just gets started?"

I don't know when, how, or even if the healthcare bubble will pop. Perhaps America will grow into its ballooning healthcare. I have a feeling that sequestration will have something to do with it - the abrupt reduction in Medicare and Medicaid payments that will be happening in January (Anderson, 2012). There will always be a need for healthcare but perhaps not in its current bloated state. Looking ahead, here are 6 tips to surviving...

  1. Enjoy the bubble while you can and be prepared for the pop. Enjoy the good times now and save what you can for a rainy day.
  2. Make yourself indispensable. If your company had lay-offs, how high on the totem pole would you be? I would like to think they will always need floor nurses but I'm not sure how cuts will happen.
  3. Have a Plan B. Do you have another talent you've been dying to try? Another iron in the fire?
  4. Don't get caught up in other bubbles. There is also an education bubble going on right now (Colombo, 2012). Oh, go ahead, get educated... but be conservative and do what you love. Don't max out your loans on a degree that may leave you high and dry.
  5. Don't panic and don't blame. We will all be going through this together - doctors, nurses, hospitals, MAs, CNAs, CNSs, NPs, PAs, and all the rest of our wonderful alphabet soup.
  6. Get informed and involved! Be a change agent and find ways to help reduce wasteful expenditures in your healthcare organizations.

I am not sure if there is a health bubble or not but I do believe that there is no shortage in any medical profession at this time. I graduated with a big group of nurses and majority of them do not seem like people who are in the field because they are passionate about nursing or because they love nursing but they are in it for job security which does not exist anymore. I do believe that the new graduates need to understand that they will be working more in home health or LTC vs. acute care. They need to be prepared to work with the elderly population more than ever and unfortunately, a lot of them in my class do not want to do. Acute care is very costly and due to that a lot of nurses are assigned to 6-8 patients per shift which I think is the downfall and will become problematic. If Obama does take office in January, the ObamaCare will bring in 32 million people into the pool of people who need medical care. It will be mandatory for them to get health insurance. For medicare/medicaid, the hospitals will have to follow guidelines to be paid for their surveys which means providing good care to the patients. And that means that the ratio of 6-8 patients per nurse will drop and more nurses will be coming back into acute care. The other thing is that a lot of nurses who have BSNs will move onto getting their NPs and filling the gap of internal medicine care. The community colleges will not stop providing education for ASN degrees because that is where the government makes a lot of money and they will pair up with other colleges so people can get their BSN. It will become mandatory that nurses must have a BSN...and as far as the LPNs go, unfortunately those programs will go away.

I do believe that there are jobs out there for new graduates but you have to be open to moving into different states/cities that people dont want to go to. And of course there is need in LTC as well has community healthcare settings...Just keep at it and stay stay strong. My other advice is that if you cant get a job, start your masters in nursing part time and at the same time keep looking for work so at least you will not lose your skills. In school, you will still be doing your clinical which will help you gain skills..best of luck!!

Specializes in OR, Nursing Professional Development.
The bubble won't truly pop until nursing salaries take a nose dive. So, so many of us are overpaid, sorry but it's true. These organizations could just arbitrarily decide to cut nursing wages in half if they wanted to, and what would we do?

If my salary were to be cut in half, I'd go work at McDonalds or Walmart. Half the salary is definitely not worth the liability and the amount of work. Sometimes I wonder if the salary is worth it now.

Specializes in ICU + Infection Prevention.
The bubble won't truly pop until nursing salaries take a nose dive. So, so many of us are overpaid, sorry but it's true. These organizations could just arbitrarily decide to cut nursing wages in half if they wanted to, and what would we do?

I think nurses are paid what the market will bear. I don't think most are overpaid. If my salary took a nose dive, I'd go back to IT. If it was cut in half, I'd make more as a ski patroller or ambulance EMT, jobs that are regarded as massively underpaid and only require 3 months of trade school.

New grads start around $22/hr around here. That is already so low that some people go back to their previous careers or don't go in at all. You think that people would go through nursing school and work as a nurse for an $11/hr job?

The market simply wouldn't bear it. Nobody will undertake 2 or 4 years of schooling to earn the same pay as 3 months or less.

Specializes in geriatrics, hospice, private duty.

Just some random comments on the article and comments so far:

1. I agree that a lot of the problem stems from presenting the medical profession as "inflation proof". "They will always need nurses", you hear people chant at you over and over again. I live in a factory town where most of the factories have closed. We just lost one last year that employed 70% of the county residents. Our nursing classes are FILLED with displaced factory workers who buy in to the hype and are understandably just looking for some job security. The increase in students has lead to increase in number of nursing classes and we have 5 schools in a very small geographic location EACH turning out 2 classes/year. My town has one small hospital, 3 LTCs and about 5 home health/private duty offices and that is about the average for all the towns in my area.

2. Just because people will always need healthcare does not mean they will be able to afford it. I can only imagine the people not getting propper care because they are having to choose between health care and feeding their family. People not being able to afford health care = lower census = nursing hours being drastically cut and/or nurses being laid off. It's bad for EVERYONE! I have been underemployed or unemployed since getting my LPN five years ago (I currently get 12-24 hrs/week if I'm lucky) and I had several years of previous experience as a mlitary medic before getting my LPN.

3. I agree that there is a possibility that nursing salaries will be slashed and more nursing jobs (especially LPN jobs) will go to UAPs. I'm already seeing that trend where I live as far as UAPs go, which is one of the main reasons I'm in RN school (I'm also seeing LPNs getting traditional RN jobs such as MDS coordinators, skilled nurses, and admission coordinators here so that they don't have to pay RN salaries for those positions).

If my wages got cut in half I would go back to security or bench tech. I love nursing but will not be responsible for some ones life for 14.00 an hour. Health care is expensive because of demand people are dyeing to get it. The problem in the industry is that a large amount of people do default 1/4-1/3 in some areas. It is very difficult to run a business with that kind of payment schedule.

Have you been to London? The subway system there costs at least 4 times what the NYC subway system costs, I mentioned this to a Brit in London one night in a pub.

He sniffed and said, "Well. Perhaps the tube is overpriced. But perhaps your subway is underpriced. ...would you like a drink?"