Category Archives: Health Care

Business unusual.

How Many Nurses Can Fit…?

We had a disturbing survey call the other night, all about nurses and how many patients each nurse should be caring for at one time. The Massachusetts Nurses Association has obtained enough signatures to place a ballot question for the November, 2018 election.

The gist of the question is whether the Commonwealth of Massachusetts shall create or expand an agency that monitors nursing staffing levels in order to enforce certain ratios of nurses to patients. The mechanism of enforcement would be $25,000 fines for each instance of “failing” to maintain nursing levels that are satisfactory to nurses(!).

Arguments in favor run the gamut of every negative consequence of inadequate nursing levels. Further strictures in the proposed law demand that nurse staffing levels be brought into conformity with the nurse-association-prescribed nurse-patients ratios without reducing other staffing levels as for maintenance or food-service departments. This, naturally, would increase hospital costs per patient-hour and of health care generally. Still, the over-arching deep concern for everything patient-related causes the M. N. A. to forge ahead despite the cost implications.

Some of the nurses’ arguments are valid. Patient outcomes are better with adequate nursing attentiveness. Sometimes this means simple numbers of nurses, but not always. Poor outcomes often result from poor administration or administrative requirements – requirements that sheer numbers won’t correct.

This is essentially a pro-union effort at the ballot box, sponsored by about 25% of nurses, hoping to increase the numbers of nurses (and union dues-paying members), but it threatens exactly what they hope to “improve.” First, if it passes and hospitals are forced to add nurses, the average pay is going to decline. This is not hard to understand. The only alternative to that likely outcome is the threat of nurses’ strikes for higher pay, and this is, like all union initiatives, the fundamental bargain – read: threat.

Neither care quality nor care cost will come in to alignment with patient desires until patients, themselves, return to the position of customer. Customers do some research on what they are going to buy. They are able to check out Consumer Reports, for example, where experts have done the research for them. They can visit different sources for the same products and services before choosing one to buy from.

In truth, people know more about their next car or flat-screen television than they do about their next medical procedure, the likely providers involved or even about their own doctor(!), never mind the amount of nursing attention they might receive. Maybe if patients – or a trusted advisor – knew enough about health providers and institutions to make rational judgments about which provides the best balance of nursing care, cost and outcomes, cost would come down, nurses would not be overworked and patients would be best served.

Asking the government and its politicians to make and enforce more rules about how to make patients well (ostensibly) is not an answer or even a good question. Restore the concept of “customer” to potential patients, in place of “entitled victim.”

As for nurses, the last thing we need is for skilled professionals to be relegated to average “service-unit” status for bargaining purposes, leaving neither room for excellence nor sanctions for failure.

TO LIFE, TO LIFE, L’CHAI’IM

Now that life, itself, is measured only in financial terms, at least for many – mostly young First-Worlders, the shining wisdom of liberal thinkers is becoming clearer… and more frightening. Canada recently completed a study that showed “savings” of nearly $140 Million, Canadian, that might be realized with more accessible “end-of-life” care, as they call it.

Or suicide, for the crudely honest. And that $140 Million could finance, ummm, infrastructure improvements and transportation safety! For those who remain, of course. One hopes that all that protein won’t go to waste – maybe pet food. After all, we’ve been eating animals like forever and they’re only human, too.

This is a side-effect of socialized health care, like those ads for the latest wonder-drug where the disclaimers about side effects like moods of depression or suicide, elevated heart rates, rash, constipation, diarrhea, dry mouth, bad breath, loss of vision and tingling in hands and feet, are three-fourths of the ad. Certain cancers and even death have occurred. If you experience any of these symptoms, speak to… your… doctor. He or she is a caring, white-smocked employee of the Government Accounting Office.

Abortion as a “constitutional right” is the first step to the destruction of not just life, but of freedom. We have been sold on abortion providing “Freedom” of choice for women who are shocked, shocked to find themselves pregnant when a child is too much to cope with… for any number of reasons. Even Planned Parenthood, responding to the outcries of stranded, pregnant, shocked women, has found ways for all that protein to not be wasted, as a market exists for whole, pre-natal organs and tissues. Financial value and loads of freedom for those who remain. They’re a non-profit, you know, so not much help with the infrastructure thing.

Some Planned Parenthood executives have had their own infrastructures improved.

And yet, despite all the excess babies we produce, “scientists” are struggling to clone humans like frogs and sheep, as if there were not enough, already. Maybe we just don’t want to accept the risk of imperfection; let’s replicate a human that “we” like.

We’ve followed the liberals, the socialists, the communists, the progressives and the Democrats down the path to where dollars or other forms of power define the value of life, even as the role of churches, religion, spirituality itself, are cast aside like so much magical mumbo-jumbo, a drag on society and on tax-receipts. We should be taxing all that church-owned property because our collective costs to protect it are born unfairly by non-believers. Abortion, and infrastructure, and voting… that’s real.

Since we can’t keep up with fertility, and since more people born into the last, best hope for freedom is a big public problem, we have got to destroy hopefulness, as they have in Russia, for example, where too few people are being born. Perhaps some terrorism will help spur the youngest, most fertile citizens to fear bringing children into “such” a world… a world where Donald Trump can be elected. Let’s just hook up after lecture hall and if I get pregnant I can get an abortion before mid-terms.

The value of life is primarily spiritual, if there’s any purpose beyond finance and fun, at all. Isn’t that the big question? What is the purpose, the meaning of life? Didn’t you see the movie? Hilarious. No, but honestly, sometimes I get the feeling that there just must be more to it than eating and screwing, don’t you think?

Well, we could help people who are having problems – that always makes me feel good. You should take that job at the clinic and you could help girls with unwanted fetal masses. When I get my promotion at the condom factory we’ll have enough money to maybe donate to Greenpeace or PETA. How would that be?

I’d rather donate to my alma mater where the money could help poor kids get their Masters. Aren’t they a religious school? Oh, they used to be.

Roughly speaking, Americans can choose, now, between the Death Party and the Life Party. The Deathers are pretty firm in their beliefs, while the Lifers are kind-of soft in their defense of Life. The former can state their death wishes as matters of Freedom, and Choice, and purging the country of brown people… except they don’t mention the last part. Lifers are almost afraid to mention their beliefs or their spirituality, yet they somehow won an election the other day. Seemed like spiritual intervention, but with all this warm weather we’ve been having, who can worry about that?

The main thing is to get back on the death track or we’ll never balance the budget. Consumer confidence is high, though. Maybe Christmas sales will cap a really good year, financially.

I hate Christmas, don’t you? It’s so commercial.

“Single-Payer?” Single delusion.

Socialists never learn. Socialism, or Communism, failed in the past because the practitioners weren’t as smart as we are, today. Can you say ‘hubris?’ Can you recognize utter failure to learn from history OR from human nature?

Single-payer health care (they mean single-payer FINANCING) is some people’s answer to the problems governments have created in health-care. This is a pattern for statists: problems can never be solved by freedom or free enterprise (the system that has solved more ‘problems’ than any system ever devised) but only by the benign love of government bureaucrats.

If those bureaucrats have actually made things worse (typically), the solution is ALWAYS, always more money (from taxation) or more bureaucrats who are told to be nicer or to not be stupid, and to be “fair.” Laws are passed to these effects. Oh, what a glorious new morning!

Single-payer is sold to the gullible as THE means to “contain costs” of medical care. Only through coercion, my children, only through coercion. How benign can they get?

You need to read “Health Care, Fairness and Free Enterprise” and I’ll send you a copy if you send a stamped, self-addressed envelope to Prudence Leadbetter, PO Box (tba)

WHERE’S THE CARE?

The grand error that has been undermining health care for about 50 years is grandiosity. It is federal politicians’ belief in their greater-than-average wisdom and resulting ability to guide every individual’s life. Health care provides not 2 or 5 or 50 issues about which politicians can buy votes, but hundreds! Oh, the sweet possibilities.

Federalizing healthcare under Medicare was a stroke of genius: give needed stuff to a demographic that votes. At first, it was “free,” another key element for acceptance of big government. Medicare was originally paid for through Social Security… what a slick idea.

There will always be elderly citizens who managed to grow old without preparing for their old age. Today an observation that those people should have prepared is a radical, hateful statement; obviously it is the government’s job to take over responsibility for individuals once they reach a magic age. Everybody knows that.

Health care has not become “better” as a result of Medicare, but it has become more widespread. “Well,” say most, “that’s certainly ‘better,’ isn’t it?” Well, for some, certainly.

Medicare began the process of creating HMO’s and PPO’s and mediocritizing (if that’s a word) medicine. It’s a process that separates individuals from the doctor-patient relationship, one that will ultimately separate individuals AND DOCTORS from personal responsibility. Only government is left to fill that “responsibility vacuum.” The statists’ dream realized.

Maybe such matters of state and culture are too intellectual. All that matters is that people get health care when needed. Unfortunately, that has not been the greatest effect of federal intrusion in our personal lives. The greatest effect is cost, followed by government growth, followed by fraud, followed by new, tangential costs. All in all, it’s unaffordable and governmentally wondrous.
Amidst the federalization is incredible confusion and obfuscation. Very few patients know what to do or who to do it with for the best results. Almost none has much choice of who or where to go unless he or she pays high premiums to augment or supersede Medicare. For non-Medicare-age workers, everyone must now pay for Medicare in addition to the 13+% of payroll they pay for Social Security. And we are 20 Trillion in debt, placing everyone’s health care at risk, along with our ability to defend the nation.

Obamacare tried to involve the federal government in every health-care decision. Amazingly, costs went up faster, options declined to only 1 in many states, and the government got bigger faster than ever before. Do we discern a pattern, here? Yes! The greatest advantage and success is for government! Not patients, not costs, and not care.

So we really ought to divest ourselves of the “government solution.” There are many ways to provide care, to sell it and buy it, to negotiate the cost of it and to compete for a share of the business. Statists distrust nearly all of them, except those most infused with federal cost-saving finesse. Since we’ve allowed statists to make the rules we are left to hope ever more diligently that the doctor we saw truly cares what happens to us – if it was a doctor.

Statists seem to distrust insurance companies, also, yet love them beneath the sheets of propriety since they provide substantial bribery for re-election and other purposes. Let’s hope that the double-dealing done with the insurance companies and the reverse bribes Obama finagled with the people’s money, is brought to light so that we may never attempt such thievery again. In any case, the attention called “health care” is spent on the wrong target: “coverage.”

It ought to be spent on HEALTH.

We need better ways to inform patients on how and what to buy that will improve their health, repair their injuries and treat their diseases. That’s health care. It’s not sex-obfuscation operations or breast enhancement. Such are not the public’s concern. What is of widespread concern is the 40% of “health-care” costs that go to administration. Anything proposed as a “solution” that increases administrative overhead must be resisted with every fiber of our citizenship.