When I Go On Medicare . . . Who Will Change My Bedpan?
by Jan Jennings
http://www.pittsburghhospitalnews.com/Archives/08Aug02/080201medicare.htm
In ten short years I will reach age 65 and will be enrolled in one form or another of the Medicare Program. But, when I inevitably become sick, who will change my bedpan? Today I am in the workforce of baby boomers, the single largest demographic of American society. Actually, born in 1946, I am in the lead year of my peers who were born between 1946 and 1965. Our generation represents 2.3 workers for each current retiree. When we retire, our current workforce shortages will look like the golden era of human resources management.
Twenty years from today, in 2022, when I am 75 years of age, only one half of the baby boomers will have entered retirement. However, even in 2022, there will be only 1.3 workers to support and/or care for each retiree. How will the generation that follows the baby boom meet the usual and customary obligations to seniors?
The press has widely covered the economic dilemma that generation faces in terms of financing Social Security and Medicare. The challenge of paying for these programs pale by comparison to the stark reality that there simply will not be sufficient workers to provide hands on service to the baby boom population.
How could the current circumstance possibly get worse? It is difficult to imagine? Receiving "quality service" has become the standard by which all other oxymorons are judged. In the interest of fairness, I will pick on my favorite restaurant... McDonalds. As a shareholder and an almost daily customer for nearly forty years, I feel empowered to make several observations. Forty years ago, I was never quite good enough to secure a position at McDonalds. It was extremely competitive and a mark of distinction to join the rarified circle of those selected to work at McDonalds.
Today, the McDonalds Corporation faces unique opportunities and challenges. On the one hand, it is a mature industrial giant. The McDonalds Corporation displaced the Chrysler Corporation to join the prestigious circle of 30 corporations that comprise the DOW 30. On the other hand, have you visited a McDonalds recently?
The drive thru line is frequently so long one becomes worried about the engine overheating. At the root of this problem is the quality and quantity of the workforce from which the local McDonalds draws from to make up its employment. It is no longer a mark of distinction to work for McDonalds.
For the American Hospital the challenges of maintaining a viable workforce are far more complex. The typical U.S. Hospital has 75 to 90 functional departments. It is difficult to recruit service employees in housekeeping, security and nursing assistants. The shortage of professional nurses is well known to the general public. There are other profound shortages in technical and professional positions.
For examples, there is an inadequate supply of pharmacists, physical therapists, radiographic technologists, laboratory technicians and others. A Certified Registered Nurse Anesthetist (CRNA) starts in Pittsburgh with an annual base compensation, before overtime, at between $100,000 and $125,000.
The predicted glut of physicians has become a public policy joke. Try to name one physician specialty or sub-specialty in over-supply. The shortages are critical. Money is not the answer, although it is in play. Driving up compensation has a way of distributing the short supply of physicians, but no amount of money can eliminate the shortage in absolute terms. There are too few anesthesiologists, radiologists, rheumatologists, endocrinologists, emergency room physicians, family physicians and on and on.
Most of us are so busy trying to keep the operating rooms open tomorrow we dare not waste a moment thinking about the problems of 10, 20 and 30 years from now. On the other hand, can we afford not to plan for the future? And are there any real solutions? Well, as it turns out, there is hope for a brighter future! We need to go to the industrialized nations of Europe to find our future today. Because of the disproportionate loss of life among young men in Europe during WWII, they did not experience the same level of baby boom that the United States experienced.
Appropriately, the Europeans refer to their birthrate following WWII as a "boomlet." However, Western Europe developed the same taste for service and the same technological explosion that occurred in American Society. With these changes came the same kind of growth and demand for new and different jobs. The gap has been filled with the modification and reform of immigration policies that encourage service workers, technical and professional staff to come largely from the third world or underdeveloped nations.
And so, the character of Europe is changing. If you have dinner next month in a Paris restaurant, your maitre d' may be French, but it is unlikely that any of the wait or service staff will be French. If you are admitted to an Italian hospital, you may have an entirely new concept of the term "foreign medical graduate." And if you visit a friend in a German hospital, you might find that the nurse who greets you has a first language from the Philippines or Indonesia. This is a part of our future as well. The remaining questions relate to how well will this be planned as opposed to whether or not it happens.
American immigration policies will change and a whole new wave of people from many lands will sweep into America on a level even greater than the immigration period of our grandparents 100 years ago. These immigrants are likely to arrive more comfortably. For the protection of our heritage, we should never forget the inscription of the base of the Statute of Liberty which refers to "...your tired, your poor, your huddled masses...." The next wave of immigrants should also see a new inscription on the base of the Statute of Liberty which says something like, "...Give us your bright, your enterprising, your innovative and your energetic.... "
Jan Jennings is CEO and President of Jefferson Regional Medical Center. You can reach Jan Jennings at [email protected].
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???? Another letter writing campaign in the making here.
eddy
263 Posts
Youda,
I agree with you on just about everything you said. However, I don't see the fix coming by way of turning all medical facilities over to the public not for profit domain.
Profits aren't the enemy. It is the sacrifices that companies are willing to make for them that are. Better regulations, tighter control of minimum standards and a nationwide publicly available rating system would be a good start though.
Profits encourage innovation and invention. Profits encourage competition. However, people and corporations alike tend to only perform to a level that makes them competitive with the rest. "Why do more and spend more if no one else is?" If the public was better educated and informed, the changes we so desperately need would begin. They would begin because the facilities that didn't become competetive in the consumer's eyes would lose business AND profits.
Public healthcare is quite expensive and poorly managed too. Government controlled healthcare in the US is already a mess. Just check out your nearest VA for a vivid example. The government isn't doing any better than the private sector, and in many areas are far worse.
That's why I say educating the public should be the most important mission of the ANA, local unions and every nurse who is concerned about these problems (which should be all of us).