Health care HEALTH CARE in the United States is building up to rolling blackouts, just as in California's electrical power crisis, says the American Health Care Association's president and chief executive officer.
chief warns of
impending crisis
Aging baby boomers and a
nurse shortage factor
in the crunchBy Helen Altonn
Star-BulletinUnless something is done to turn the situation around, a huge gap will exist in 10 years between available nursing home beds and those required, Dr. Charles H. Roadman II said in an interview here.
He cited these reasons for the growing crisis: inadequate Medicaid and Medicare payments to cover health care costs, excessive and unrealistic regulations, a reduced nursing work force and increased needs with retiring baby boomers.
With bed capacity going down and aging baby boomers going up, wait lists will increase for nursing facilities, Roadman said. (Hawaii now has 200 on the wait list for nursing home care, and it's climbing, said Joan P. White, Healthcare of Hawaii Association vice president.) Patients unable to get into nursing homes will end up in more expensive acute hospital care, Roadman said.
"In the flying business, we call this a death spiral."
Roadman was surgeon general of the Air Force from 1996 to 1999, when he joined the Health Care Association, a federation of 50 associations with about 12,000 nursing facilities, assisted-living residences and sub-acute care centers.
He was here Friday to meet with Healthcare Association of Hawaii members, legislators and officials at a luncheon and engage them in a nationwide political campaign for change. The country has no long-term care strategy, and his job is to develop one, Roadman said.
In four years, he said, only five people will be working and supporting government medical programs for every retiring baby boomer. By 2010 there will be only 2.7 working people per retired baby boomer, he said.
THE ONLY OPTIONS will be to decrease benefits or increase funding, he said, noting the average cost nationally per patient in a nursing home runs $55,000 a year. (In Hawaii it's about $70,000, White said.)
Rather than increase taxes, Roadman suggests moving into a public/private insurance scheme for long-term coverage, similar to auto or life insurance, with some kind of safety net so coverage would not lapse.
He said congressional support is growing for reform in the U.S. Health Care Financing Administration. Regulations should be related to safety and quality care and not "stuff that doesn't make a difference," he said, adding, "More was done to damage health care in the last eight years than under any other president."
Instead of caring for patients, nurses must spend an inordinate amount of time on paperwork, he said, noting an 80 percent to 100 percent turnover per year across the country in nurse's aides.
The nation is short 250,000 certified nurse's aides, 90,000 licensed public nurses and 60,000 registered nurses, he said. "Nurse enrollment is down; nursing schools are closing." Roadman said he studied long-term care as he watched his father go through the transition and concluded, "This system is broken and needs leadership and help."
His biggest effort now, he said, is trying to get the usually silent health care community to come together as a political force and get the public and policy-makers to recognize a crisis is looming. "Issues of the elderly too long have been swept under the carpet."
The American Health Care Association recently increased members' dues to build a $20 million war chest to work for changes, Roadman said.
"In essence, many of us are like Paul Revere, riding through the country saying, 'It's coming, it's coming.' We need everybody to meet us at Concord."