Attack on nurses shows how deep the health care crisis really is

regularRN · Dec 20, 2007

The cost of living in Santa Cruz is very high. Already professional people are leaving the town because it's too expensive to buy a house (the average price of a modest two bedroom home is over $700,000) or even rent. The local hospital (Dominican) risks loosing nurses if wages are not sufficient, not only from nurses relocating to less expensive areas, but to the many hospitals in the Bay Area, who also offer very competitive compensation.

marie-francoise · Dec 21, 2007

I'm all for government subsidizing health care - if government is there for anything, it's to protect the health of its citizens.

But single-payer has to be done right. The UK does have social health care; BUT it appears the nursing situation there is even worse than it is here - the following thread provides some examples:

https://allnurses.com/forums/f8/overhaul-health-care-system-needed-address-nursing-understaffing-268702.html

MBANurse · Dec 24, 2007

Hi, Spacenurse...

I fail to see where the "attack" is. I see that there was a reference to an editorial (which is the linked piece *cough political ad* is). If there were an attack; I am sure that it is against the CNA and not the individual nurses. I am sorry but Unions are not synonomous with the workers that they supposedly represent; especially the CNA. But since there is no link to the alleged attack; one is left to assume the worst. I chose not to.

I can see nurse's desire to ensure that all are cared for and that no one goes needlessly without; but what on earth are unions thinking when the push for universal, single payer or what ever other euphenistic name you want to give to government funded healthcare?

If such a system is ever implemented the focus will shift to providing care at a predetermined budget. Which leaves two options. The first is spend up to that budget and then cut off all spending and the second is to try to minimize all costs that are associated with the program so that the prestated budget is met.

How does one cut costs in a healthcare program? Well the biggest chunk of healthcare workers that exists is nurses... then allied healthcare types and doctors. Then; you simply do not cover a whole range of diagnostics; medications, treatments; surgeries or referrals. Elective surgery... forget about it.

Another option is to cut off to whom the services are provided for I suppose... say a single person at 50K a year/ married at 100K and with kids at 115K a year... well thats not really universal at all is it?

MBANurse · Dec 24, 2007

I found the "attack!"

Nurses in Santa Cruz County make a lot of money -- in some cases up to $120,000 a year.

Their pay is a big part of why medical facilities in Santa Cruz County have among the highest labor costs in the nation, according to a study before the county Board of Supervisors last month.

But how much nurses make is not the issue. Their salaries are based on demand, and no one can argue that he or she doesn't want well-trained, qualified nurses when a family member goes to the doctor. The area's high cost of living and state-mandated staffing levels make meeting the demand that much harder.

http://www.santacruzsentinel.com/story.php?sid=51561&storySection=Opinion&fromSearch=true&searchTerms=Nurses

Wow... after you read the article- it doesnt appear to be an attack on nurses at all... rather a shot at the medicare system that fails to pay...

The model that the nurses in the "we were attacked" column want to emulate.

Something seems to be off about this situation...

gwenith, BSN, RN · Dec 24, 2007

I'm all for government subsidizing health care - if government is there for anything, it's to protect the health of its citizens.
But single-payer has to be done right. The UK does have social health care; BUT it appears the nursing situation there is even worse than it is here - the following thread provides some examples:
https://allnurses.com/forums/f8/overhaul-health-care-system-needed-address-nursing-understaffing-268702.html

You will never find ANY single payer system anywhere that people are 100% happy with. Often the countries that have single payer systems look on public complaints, especially in the media, as a method of feedback into the system to make it better. Waiting lists too long - complain to the papers - incompetant surgeon - complain to the papers. Unfortunately this can come across as the fact that single payer systems are unworkable or fraught with problems

MBANurse · Dec 26, 2007

crickets....

pickledpepperRN · Dec 26, 2007

Hi, Spacenurse...
I fail to see where the "attack" is. I see that there was a reference to an editorial (which is the linked piece *cough political ad* is). If there were an attack; I am sure that it is against the CNA and not the individual nurses. I am sorry but Unions are not synonomous with the workers that they supposedly represent; especially the CNA. But since there is no link to the alleged attack; one is left to assume the worst. I chose not to.
I can see nurse's desire to ensure that all are cared for and that no one goes needlessly without; but what on earth are unions thinking when the push for universal, single payer or what ever other euphenistic name you want to give to government funded healthcare?
If such a system is ever implemented the focus will shift to providing care at a predetermined budget. Which leaves two options. The first is spend up to that budget and then cut off all spending and the second is to try to minimize all costs that are associated with the program so that the prestated budget is met.
How does one cut costs in a healthcare program? Well the biggest chunk of healthcare workers that exists is nurses... then allied healthcare types and doctors. Then; you simply do not cover a whole range of diagnostics; medications, treatments; surgeries or referrals. Elective surgery... forget about it.
Another option is to cut off to whom the services are provided for I suppose... say a single person at 50K a year/ married at 100K and with kids at 115K a year... well thats not really universal at all is it?

Dominican and Sutter are the hospitals in Santa Cruz. The system is "non profit" but is generating revenue:

Dominican is owned by Catholic Healthcare West. Their net income was $59,468,205.00 or nearly sixty million in 2006.

http://www.chcf.org/documents/hospitals/CHCMarketReport2006.pdf

Sutter Health, which has faced criticism for alleged high prices and abuses of its market power, reported Friday total net income for the year ending Dec. 31 of $587 million, up from $445 million in 2005.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/04/14/BUGM1P8FH31.DTL

Nursing care is the reason for a hospital.

Hospitals make these profits because of the work of nurses.

The article blamed nurses.

Read the link and you will find that the for profit health insurance companies are reducing payment to hospitals but those hospitals still take in more than it costs them to run their operations.

Your link perhaps correctly stated that Medicare needs to reimburse the hospitals at a higher rate because Santa Cruz County has a much higher cost of living than most rural locations.

After years as an LVN I chose at earn my RN & BSN.

I am not as familiar with the business side because my job is to care for critically ill people at night.

MBANurse · Dec 26, 2007

I suggest that you re-read the article. IT DOES NOT BLAME NURSES. In fact it says NURSES' SALARIES ARE NOT THE ISSUE.

What it does do; however, is castigate the model of medicare that the nurses whom claim to be victimized wish to emulate for everyone.

pickledpepperRN · Dec 27, 2007

You are right. I apologize.

I assumed they were reacting reacting to decades of hospital management saying that nurses are a cost drain. In the 90's they laid off licensed nurses and hired people who weren't even certified nursing assistants as replacements.

(I think CNA certification should me the minimum required before providing nursing care)

I am not sure but they may be referring to this article:

County hospital labor costs are nation's highest
...Local hospitals afford the high cost of labor by passing the expense on to patients, explained Larry deGhetaldi, CEO of Sutter Maternity and Surgery Center in Santa Cruz....
...Insured residents here can expect to pay higher medical premiums than those in other parts of the country as insurance companies pay higher prices for treatment and charge subscribers accordingly, deGhetaldi said. Uninsured residents also can expect to see higher medical bills than elsewhere in the United States, deGhetaldi said.
The logic follows that in Bismark, N.D., for example, where the study cited labor costs as being 56 percent lower than in Santa Cruz County, patients would pay less for hospital visits.
While the relatively high salaries might attract nurses to Santa Cruz County, they can "rub salt in the wound" of medical doctors, whose pay is taking a hit because of the area's relatively low Medicare reimbursements, deGhetaldi said....
http://www.santacruzsentinel.com/story.php?sid=51037&storySection=Local&fromSearch=true&searchTerms=nurses+salaries%2C+opinion

MBANurse · Dec 27, 2007

You are right. I apologize.
I assumed they were reacting reacting to decades of hospital management saying that nurses are a cost drain. In the 90's they laid off licensed nurses and hired people who weren't even certified nursing assistants as replacements.
(I think CNA certification should me the minimum required before providing nursing care)
I am not sure but they may be referring to this article:

Possibly; but even that article is an attack on medicare and not on the nurses' salaries. The article states several times that the high nursing salaries are needed to attract and maintain nurses because of the high cost of living in the area. They state that the problem is medicare and the designation of a "rural" area as to the problem.

In ANY health care facility; hospital or otherwise, labor is almost always going to be the highest cost. It stands to reason then that if there is a high cost of living; the cost of labor is going to cost more than places where the cost of living is lower. The article even states that SF-Bay nurses may make more... but because of the "urban" designation medicare reimburses more per procedure or treatment.

The labor costs are going to hold true for any skilled position as well. I am willing to bet that other jobs in that area also pay more because of the high cost of living; not just nursing.

To me; this article is not an attack on nurses or even the nurses union... but again medicare.

The "rebuttal" that the CNA provided makes little or no sense imo.

This is how I read the article and CNA response....

Article: We have high labor costs because of the high cost of living... but because Medicare sucks in its ability to pay ... doctors are leaving and more expenses are paid by other insured patients!

CNA Response: Nurses are not the problem... we work very hard for our money. How dare you blame us! MEDICARE IS THE SOLUTION!

The article that I linked as well as the second one that you posted both state that poor payout by Medicare is problem... so in response the CNA states that we need to go to medicare for all?

As I stated earlier; I fail to understand why the CNA would propagate a system that will ultimately hurt the salaries of their "constituents" and end up costing taxpayers a fortune while at the same time; do very little, if anything, to improve the healthcare in the United States.

Remember- socialism just means that everyone is equal; that is, equally miserable.