Basic Health Access

It is a time of great change and challenge in health care. The challenges are best seen in those who deliver the health care. Marginalization of nursing has been present for decades. Financial designs have long resulted in pressures for fewer nurses doing more as patient care gets more complex. Now this is seen in physicians and across those in health care.  The chronic provocations of the broken-down  healthcare "delivery system"  relegates physicians into a chronic  and unsustainable fight-or-flight mode. (Hood) It is indeed a cruel irony that we are all alone – together. (RCB) Innovation and disruption discussions have been converted into policies, regulation, and the push for digitalization. This rapid change focus is fixed on fixing health care. Instead the relentless bandwagon of disruptive innovation has rolled over those who deliver health care.  Rapid regressive changes are taking the humanity out of health care. They are takin...

When you spend a decade or more preparing and training for a career as a physician or as a nurse practitioner, you expect that you life will improve with your new employment. This is no longer a reliable expectation. Decades of overproduction of NP, PA, DO, and MD graduates will have consequences for graduates as well as for our nation. High debt from tuition, higher cost of living, the challenges of becoming a young health professional, and the difficulties dealing with employers that hold all the cards - will collaborate for worsening outcomes. The burnout, turnover, productivity, and suicide issues will intensify. Slowing Population Growth Magnifies Overproduction The new census figures indicate a slowing of population growth. This translates to a glut of health care workforce even worse than previously projected. Previous calculations of expansions used 0.72% as the annual growth rate from older census data. The newer figures are 0.62%. The decline will continue to 0.6% or ...

The corporate takeover of health care is more obvious with each passing day. The power goes with the trillions of health care dollars. Insurance corporations, drug corporations, and largest systems dominate. They can dictate the disposition of dollars. They can effectively prevent reforms, They can design legislation and programs that favor their interests. Generally this marginalizes dollars for patient care, dollars for the support of those who deliver the care, dollars for basic services, and dollars for most Americans most in need of care. In other words, health care has been redirected to care of the corporation. Sadly much of the rhetoric that guides this transition claims to be focused on the patient and on better outcomes. This is clearly not the case. Journalists are often engaged in some new innovative intervention that has great promise - but that mostly requires more dollars for same or less outcomes. This is can even be termed value-based even when the outcomes stay the...