WCVB channel five Boston, is now airing, Healthcare Uncovered. A live panel show discussing healthcare and it's cost in Boston. The moderator, Timothy Johnson, MD. One of the panelist, Zane, the CEO of Tufts Medical Center whose 1100 RN's just voted 70%, to authorize a one day strike. This is what I just heard and this is verbatim.
"We may need fewer nurses in the hospital, but we will need more in the community, helping patients to stay healthy. so there maybe some modest job losses, I think there is a great opportunity to retrain caregivers in new professions."
"Doesn't the rank and file worry though, if I am dislocated as a healthcare worker. The job that may be available for me on the other end is nothing of the caliber of the job I trained for and gone to school for as a RN or whatever."
They avoid that question and go on about being unable to sustain the hospital budgets. Over half of budgets are employee salaries(nurses). We must address these salaries and benefits and look into job revocation. They go on to justify this thinking, due to small business unable to afford healthcare here in Mass and therefore leaving the state. There are great opportunities to shift our thinking from acute care to physician and patient remaining well. (paraphrase).
Helen Zane: what the trajectory we are on, the public will not tolerate. Better we get ahead of it. ( she is addressing nurses who want better nurse/ patient ratios). Fueling her position, against the nurses.
They go on and defend physicians who do needless test...talk about salaries and fraud in the same sentence. Implying, nurses must make sacrifices...my reading between the lines. Then go to prevention and teaching. Intervention is most important right now. (agree,but, where are nurses in this) Their focus, doctors, PA and NP.
You all need to watch this, there is so much more. Primary care doctors aren't paid enough, but no mention of professional nursing. Again, ANA where are you?? BSN's you are not being addressed at all. They are talking about eliminating your job. They are talking about retraining you and "retooling" your career. And you all are worried about the difficult patient? We need to get busy...are we even listening to what is happening right before our eyes? Are you all satisfied with your degrees when you have no say in policy? Do we even care?
The lie has been told so much, ever since I can remember 27 years ago. All we needed was BSN to get taken seriously...really?
But no definitive solutions :-(. I am completely onboard with meaninful use and the NHIN efforts however as a better means of containing health care costs and improving outcomes rather than just letting the ship run amok and then giving the middle finger effectively to tens of millions of people who have paid into it for years.
Would really like to see a lot more nurses involved in these efforts.
They need to cut MANAGEMENT. The Assistant Director, and the Assistant Director's Assistant, and the other Directors of the Directors, and the Manager under the Director, etc., etc., etc. How many chiefs does the tribe need?
You mean the EU country that is closest to bankrupt? Hmmm, sounds like a real solution, not!
Do you have a recent citation for that? Japan may be in danger of bankruptcy. I'm not aware of France in any imminent danger. Tho interestingly like the USA France has been running deficits since instally a rightwing Prime Minister, so I'm not sure you want to use it to support your agenda .
Nor would it prove the deficits are the cause and effect results of healthcare that you imply. If that were true at all we'd expect to see the EU currency less than ours instead of well above it and all of the EU nations facing bankruptcy as well as Canada and Australia and other nations with similar plans and demographics.
As Maslow once said, for every complex problem....
"I can assure you I have never had a "handout" in my entire life. Also, as someone who has worked with the poor who you no doubt would classify as being lazy and wanting handouts I do take offense to your statement above.
It's tough for people to "pull themselves up by the bootstraps" when they don't have any boots."
I apologize for offending you with my statement but believe you have completely misunderstood my comment. I am not referring to the people the programs were set up for. The one's in need when times are tough, but rather the ones who have chosen to use them as a lifestyle.
That said, I could argue this point further with you but we both realize this is not the appropriate post for this debate.
Inheritance makes up a far larger percentage than elbow grease, I'm sure, for a few reasons:
The agricultural revolution is over.
The industrial revolution is over.
I guess you've never heard the term "old money" before.
How does pointing a finger at the government excuse the actions of the citizenry??
Oh yeah, it doesn't.
The "all people who accept public assistance are lazy and good for nothing" argument. Haven't heard that one before. [/sarcasm]
You want to know what real punishment is?
A single mom, whose husband was permanently injured on the job after twenty years of employment as a machine operator for General Motors, who has to work three jobs to support their 3 children and still make use of the local food bank in order to feed them all. You want to talk about fairness. She works hard too. If it were all based on hard work and not pure luck and connections, why isn't she wealthy? Oh I know...Because the American business model is pyramid shaped and paying her (and others like her) $7.40 an hour to break her back is how the rich gets rich. Look around, son. You've got a lot of learning to do.
It's so funny to me the sheer denial of the middle class. So many are only a few paychecks away from the food stamp line because they don't actually OWN anything. Their homes, their vehicles, their computers, their televisions, their college educations, their children's college educations, are all leased, paid for on credit, owned by the bank - and not nearly enough savings to cover their credit balance... A disaster or debilitating illness away from the poverty line and pointing fingers from their 12 mpg SUV at the "wasteful" lower class.
What's worse is they actually believe that Republicans care about them. They don't care about you. They do not care about you. They rally your support against taxing the rich without ever telling you that you will never make enough money per year to ever be affected. And you eat it up. And spit it out vehemently in political conversations, screaming "Socialism!!!"
There's so much wrong in the world that is easily visible if you only look around. What's it going to take to wake you up?
You have made a lot of assumptions about me in your statement. I don't think you were able to comprehend what I wrote because you are too angry at what you have been hearing. I said nothing of "lazy" "Republican" "wasteful lower class" (or my gender)...
I simply believe EVERYONE should pay their FAIR share of taxes. No more ~ no less. You have a lower income you pay less, you have a higher income, you pay more BUT... Everyone pays the same percent (that is %) of whatever that income is and no matter how they came by that income i.e. paycheck, wellfare check, OR inheritance (I added that one in the spirit of compromise )
I realize this is a touchy subject right now and it is very personal to people on both ends of the spectrum. I never intended to raise anyones blood pressure.
Now... I would like to say...
I think nurses are necessary and under appreciated by the hospitals that depend on them. They are only concerned with covering the bottom line, increasing the workloads as a result without compensation. (think this might be a bit more on topic)
Someone who makes over $380,000 is taxed at the same 35% rate whether he makes $500,000 or 2.5 million dollars - while someone who sees an annual income increase from $32,000 to $80,000 pays 10% more.
You do the math and tell me how "unfair" it is to tax the wealthy.
A single mom, whose husband was permanently injured on the job after twenty years of employment as a machine operator for General Motors, who has to work three jobs to support their 3 children and still make use of the local food bank in order to feed them all. You want to talk about fairness. She works hard too. If it were all based on hard work and not pure luck and connections, why isn't she wealthy? Oh I know...Because the American business model is pyramid shaped and paying her (and others like her) $7.40 an hour to break her back is how the rich gets rich. Look around, son. You've got a lot of learning to do.
We are like that person too ..backbreaking work. Not getting rich despite all our hard work and education (which doesn't make most of us rich - just another $20,000 a year if we are lucky)
It's so funny to me the sheer denial of the middle class.
The educated middle class still believe in the baby boomer dream ...but it aint going to happen anymore. The middle class is going down in living stds most western countries
What's worse is they actually believe that Republicans care about them. They don't care about you. They do not care about you. They rally your support against taxing the rich without ever telling you that you will never make enough money per year to ever be affected. And you eat it up. And spit it out vehemently in political conversations, screaming "Socialism!!!"
We are money making cogs for the big corporations
There's so much wrong in the world that is easily visible if you only look around. What's it going to take to wake you up?
"I can assure you I have never had a "handout" in my entire life. Also, as someone who has worked with the poor who you no doubt would classify as being lazy and wanting handouts I do take offense to your statement above.
It's tough for people to "pull themselves up by the bootstraps" when they don't have any boots."
I apologize for offending you with my statement but believe you have completely misunderstood my comment. I am not referring to the people the programs were set up for. The one's in need when times are tough, but rather the ones who have chosen to use them as a lifestyle.
That said, I could argue this point further with you but we both realize this is not the appropriate post for this debate.
i have seen many co-workers (those at the low end of the pay scale such as CNA's, dietary, etc) who receive "handouts" and they are by no means lazy. i know one particular person who was college educated and working as a CNA while she went to nursing school and she averaged 50-60 hours per week on the night shift as a single mother with two children. SHE received "handouts" not because she was lazy, but because she didn't make enough money to support her children (including insurance) even working overtime she qualified for medicaid. i don't think any nurse on the planet would say another nurse who worked 10-20 hours overtime on the night shift to beat it all was "lazy" but the difference is - they make more money. so, go to school and get an education you say? well, she did. she couldn't find a job. that's why she got a job as a CNA while she went BACK to school. lazy? no way. she ran circles around the others and i had no doubt she would be and is now, i'm sure, a great nurse.
I have seen so much waste in healthcare in the US, it makes me sick. Here is what I see:
1) Entire, unopened bottles of narcotics being thrown away because of DEA regulations. I have pulled bottles out of the pharmacy box and put it right into the waste box because the patient was gone. We don't get credit, these get thrown away.
2) Patient has a peg tube/trach/amputation or some other expensive procedure the day before being put into hospice.
3) Repeat tests being done in a different organization. For example, stress test positive at one hospital, patient decides he wants to go to another hospital and that institution repeats the same test rather than trusting results of original test.
4) Multiple tests being done on 90 year old patients, often at the family's insistance. Time for the doctors to take back control and say, NO, that is not appropriate.
Specializes in Spinal Cord injuries, Emergency+EMS.
That can't happen when 35% means more to one in terms of basic survival than it does to another.
That is not equal.
which is why the vast majority of income tax and income tax like systems have progressive tax rates i.e. once you earn above a threshold - the income above that threshold is taxed at a higher rate and concepts such as personal allowances to off set against tax on earnings .
it's amazing how few people have any real understanding of how income tax works...
Specializes in Spinal Cord injuries, Emergency+EMS.
I have seen so much waste in healthcare in the US, it makes me sick. Here is what I see:
1) Entire, unopened bottles of narcotics being thrown away because of DEA regulations. I have pulled bottles out of the pharmacy box and put it right into the waste box because the patient was gone. We don't get credit, these get thrown away.
even though the drugs have never left the facility ? there are valid concerns over storage for drugs which have been out in the community and consequently even if the law allows these drugs to be returned to pharmacy all they will do is destroy them ...
2) Patient has a peg tube/trach/amputation or some other expensive procedure the day before being put into hospice.
neither pegs, trachs or an amputation are 'expensive' in the grand scheme of things and all these interventions can have a positive impact on quality of life ... hospice care is not a death sentence, just a recognition that appropriate curative treatment options have been exhausted and that good effective palliative care is the option, and these options are certainly less expensive than Senior clinicians and management being unable or unwilling to put a stop to futile escalation of care - how many days of futile ITU admission is equal in cash value to inserting a PEG or a trache ?
3) Repeat tests being done in a different organization. For example, stress test positive at one hospital, patient decides he wants to go to another hospital and that institution repeats the same test rather than trusting results of original test.
portability of results ? opportunities to charge ?
4) Multiple tests being done on 90 year old patients, often at the family's insistance. Time for the doctors to take back control and say, NO, that is not appropriate.
yes but then you are into the scenario of the 'Death Panels' controlling the ' Evil Socialist NHS ' that would have killed Prof Stephen Hawking ...
)
WIN007
281 Posts
But no definitive solutions :-(. I am completely onboard with meaninful use and the NHIN efforts however as a better means of containing health care costs and improving outcomes rather than just letting the ship run amok and then giving the middle finger effectively to tens of millions of people who have paid into it for years.
Would really like to see a lot more nurses involved in these efforts.