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View Point
NOW that the threat of a nurses' strike has passed and the community can collectively exhale with relief that patients will not be abandoned, it's appropriate to share some thoughts without getting caught between the two sides that I have to work with closely every day -- the nurses and the hospitals. Quality health care is
worth the high priceMany people might view the recent events as a typical confrontation between labor and management, purely a collective bargaining issue. But the conflict goes deeper than that.
The nurses were saying over and over that the issue was not one of money but of patient safety. Make no mistake: A good nurse is worth everything that you can pay him or her and more.
They are there with their expertise, at bedside where they belong, oftentimes up to their elbows in who-knows-what, whether it's midnight, a weekend or a holiday. And that's because you and I don't always get sick, have babies or need surgery during convenient business hours.
But, I agree, the issue was not one of higher salaries for nurses.
The nurses were involved in a conflict that involves the entire community and is, in large part, based on a peculiar mind set that has developed in the American public.
The mind set is this: wanting the best in medical care that money can buy, but not wanting to pay more for it. It's like wanting an Alan Wong meal at McDonald's prices.
Yet everyone understands that goods and services cost more today than they did 10 or 20 years ago. Consequently, there should be neither regret nor guilt in having to pay more for high-quality medical care.
Health care in America has been upgraded in ways that are phenomenal. Witness cancer chemotherapy, premature newborn intensive care units and organ transplants. However, these services come with a price. Who among us will be the first one to say they aren't worth it?
Somehow we have been able to carve out a significant proportion of our budgets for cell phones, video games and computer upgrades. Yet those who cringe at the thought of health care deserving a larger slice of the GNP are the same ones who expect an MRI for every headache, demand antibiotics for every sniffle, and visit the ER for an itch that has been there for the last week.
During the recent contract negotiations with nurses, the hospitals weren't the villains either. When the longshoremen settled their own talks, was it a surprise that Matson would increase its rates and we would all end up paying for the raises? Whenever the Hawaii Government Employees Association wins an increase in salaries, can a tax hike be far behind?
But when a hospital or any health-care provider these days ends up with increased expenditures because medication costs more, equipment and technology costs more, liability expenses cost more, and, yes, quality personnel costs more, it does them very little good to raise their rates.
Insurance companies, HMOs and government agencies that reimburse for these services unilaterally control the rates. And they have, at the public's demand, said not only that will they not pay health-care pro-viders more for individual services, they will in many cases pay them less. And that's that.
Does this make sense? We should shudder at the thought that, one day, when we or our family members become seriously ill and are in need of expert medical care, we will get exactly what we have been willing to pay for.
Dr. William L.T. Fong is an obstetrician and gynecologist
at the Kapiolani Medical Center for Women and Children.