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Thursday, January 02, 2003The cumulative effect of the public-policy and marketplace changes of the 1990s has been the near-elimination of the system's reserve capacity and the exhaustion of available compensatory mechanisms. Each part of the health care system used strategies to maintain its own stability. Hospitals closed beds and tried to increase the productivity of their workers, particularly nurses. Physicians added staff and worked harder to maintain their income in the face of managed care. Employers passed on some health insurance cost increases to employees, with the average worker's single-coverage contribution rising from 11 percent of the premium in 1988 to 15 percent in 2001, and with even greater cost sharing envisioned in the future. ...Even the Federal Employees Health Benefits Program and the California Public Employees' Retirement System, two of the best-managed and most aggressive purchasers, faced premium increases of 13 percent and 25 percent, respectively, in 2002. Use of emergency departments increased 14 percent between 1997 and 2000, and many emergency departments are reaching capacity, prompting diversions of critically ill patients to other facilities. Over the 1990s, the number of students entering nursing school declined by 25 percent, and the age of the average nurse increased from 37.7 to 45.2 years. ...medical-school applications have decreased 15 percent over the past four years. He paints a picture of a healthcare system straining under the burden. Overworked, dispirited doctors and nurses; hospitals with limited capacity, both in the sense of physical space and staffing levels, unable to handle any unexpected surge in patient loads, and patients being forced to use their retirement savings to pay for healthcare insurance. It isn’t pretty. posted by Sydney on 1/02/2003 07:28:00 AM 0 comments 0 Comments: |
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