Did the nursing problem start when President Reagan implemeted Managed Care????

  1. I was reading that in the 80's President Reagan started Managed Care and thats when HMO"s and PPO's and all the mess that nursing has become started. Managed Care was implemented to provide quality care at the lowest cost possible. Im assuming that is why nurses have to work in such horrible conditions and the hospitals have to keep a close eye on their budgets, which may include having to short staff. IS all this true? Is Managed Care a good or bad thing? Are there any seasoned nurses that worked before these times that could share how things were when nursing was about care and not profit? Were the working condition better?
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    About Misslady113

    Joined: Sep '08; Posts: 165; Likes: 255

    10 Comments

  3. by   heron
    It's my purely anecdotal experience that it was the advent of large for-profit service providers that caused the problem, or at least aggravated it.

    With the large for-profits came the ascendancy of the bean counters who attempted to apply the same cost-cutting, profit-enhancing strategies to health care delivery that worked so well in the manufacturing sector.

    And don't forget the insanely high mark-ups on drugs and medical equipment.

    I, personally, don't think there's anything wrong with managed care. I guess I see it as an attempt to respond to ever-higher costs for ever-deteriorating quality of care, rather than the cause of the mess.
  4. by   TheCommuter
    Our increasingly sedentary lifestyles are partly to blame for the Managed Care fiasco, too. My lifestyle is sedentary, so count me in as well.

    People are less active than in previous generations. Many of us smoke, overeat, avoid exercise, and fail to comply with healthcare regimens. Since the population of unhealthy, chronically ill people started exploding in the 1980s, the insurance companies responded in a way that would minimize their monetary losses. Hence, managed care arose.

    Although I work in elder care, many of my nursing home residents are middle-aged people from the Baby Boomer generation. I've got people in their 40s, 50s, and early 60s who have had strokes, heart attacks, and complications of uncontrolled diabetes such as blindness, limb amputations, nerve pain, and renal failure requiring dialysis.

    The "hard living" of certain members of the population has resulted in a "hard line" approach by the insurance companies.
  5. by   PeachPie
    I will say that nursing gained some power in this era of cost cutting, what with APN's being cheaper than doctors. I do think that managed care and this insurance fiasco have caused a lot of deteriorating health care, but there is always something that will gain in any situation.
  6. by   tulip928
    FYI You might want to look up Ted Kennedy's HMO Act of 1973 for the formation of managed care.
  7. by   Mobeeb
    [FONT="Comic Sans MS"]I agree with all posters, but President Nixon signed on the dotted line of the HMO Act in 1973.
  8. by   Misslady113
    Yes. I was confused about which Presidents had the idea and the one who actually made it come to pass. Thanks.
  9. by   tulip928
    Ted Kennedy had his name on the bill which originated in the Senate by him, not the President.
  10. by   CRNA2007
    wow, I didn't realize nurses were forced to work anywhere? Is there something wrong with providing QUALITY care at the lowest cost possible??? Come on first people on here whine about the costs of health care now someone wants to know if all the problems are brought on by lowering costs?


    Quote from Misslady113
    I was reading that in the 80's President Reagan started Managed Care and thats when HMO"s and PPO's and all the mess that nursing has become started. Managed Care was implemented to provide quality care at the lowest cost possible. Im assuming that is why nurses have to work in such horrible conditions and the hospitals have to keep a close eye on their budgets, which may include having to short staff. IS all this true? Is Managed Care a good or bad thing? Are there any seasoned nurses that worked before these times that could share how things were when nursing was about care and not profit? Were the working condition better?
  11. by   BBFRN
    How are the costs lower now than before? i.e. How have the manage care companies managed to lower costs for the insured? I don't see where that has been done, so apparently they have failed to meet their supposed objective.
    Last edit by BBFRN on Jun 6, '09
  12. by   exnursie
    Quote from BBFRN
    How are the costs lower now than before? i.e. How have the manage care companies managed to lower costs for the insured? I don't see where that has been done, so apparently they have failed to meet their supposed objective.
    I do not believe that the insurance companies were looking at reducing consumer costs when they introduced managed care. The purpose was to manage the treatment and tests that were ordered to reduce the money they paid to the facilties and providers.

    Overall cost was lowered by the requiring referrals, needing to approve expensive tests and procedures based on criteria, hospital stays were lowered, and they added preexisting clauses, paying doctors with HMO pts a set amount per pt, regardless of the number of visits, or degree of health, and they created a fee schedule that was negotiated based on performance.

    The result... the insurance companies are all making a nice profit, while doctors and hospitals have taken a financial hit.

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