The Healthcare Crisis Hits Home

The country is in the middle of a healthcare crisis, and hospitals are overburdened and overcrowded.  Unemployment is up, government benefits are being spread thin, and money is not going where it should.  We are in bad times, and there is no end in sight.

This week, the effects of the healthcare crisis hit close to home.  In a cost saving measure, the largest hospital system west of Worcester, Massachusetts laid off 170 employees, and eliminated almost 180 unfilled positions.  All of this was done while construction continued on a large addition to the hospital which includes a brand new state of the art emergency room and a plan to increase the hospital’s bed count.  To my colleagues that work for the Baystate Health System, I hope you made it through this week unscathed.  To those of you who will find yourself unemployed, I’m sorry that you have to bear the burden of this current crisis.

As I read Jim Kinney’s article from the Springfield paper The Republican there was one statement that stood out to me: “The three hospitals were underpaid $26.5 million by the state for the cost of care for Medicaid patients in 2010.”  The Baystate Health System is just the latest victim of a health care system that is underfunded, and not properly reimbursed.  The story is not a new one.  We have seen almost every other hospital in the area lay off staff as well, but the sheer volume of eliminated positions, the 350 hospital staff system wide that will not be there is staggering.

Cuts and reimbursement rates are already taking their toll on some ambulance services, and it is only a matter of time until that lack of money trickles down hill even more and begins effecting more services both in the emergency and non-emergency business, which is scary considering how much EMS volume increases every year.  What are we going to do when the government and insurance companies make it even more difficult to collect pay for care?  What are we going to do when people can’t afford the bills that are landing in their mailboxes?

Providing care is expensive.  The equipment that we use is not cheap, and the upkeep that it required for the wear and tear that it takes in the field is costly.  Right now, the only way an ambulance provider can get paid for services rendered is if they transport the patient which makes almost a quarter of calls nationwide unbillable.  Considering the state of the economy, changing that is going to be difficult.  Where is that money for those diabetic workups and responses to refusals going to come from?

And what about ER overcrowding?  The issues displayed in the movie Firestorm that was released last year are not just present in urban settings.  Community Medical Center in the suburban town of Toms River, NJ is an enormous ER that sees itself close to being at capacity on a daily basis.  It is one of four hospitals with emergency rooms in Ocean County, and is the primary destination for a number of the emergency ambulances in the area.

No alternative solutions, no annexes that can handle sub-acute patient complaints, and no training for EMS providers to help them determine what those sub-acute emergencies are.  The focus continues to be “put them on the stretcher, follow your protocols, and take them to someone who can make a decision about where they belong.”  Why does it take a major national crisis to people to even consider looking at the most used gateway to the health care system: the ambulance?  Access to the system is key, and steering those patients to the right care could not only stimulate the job market in the health care field, but it could land only the most critically sick and injured where they belong: in the emergency room.  ERs end up being less crowded, hospitals end up being less crowded, nurses, LPNs, and other health care professionals find jobs in urgent care and primary care doctor’s offices, and the field flourishes.

Until then, we are going to keep pushing patients through the bottleneck that is access to care in the United States, and we are going to allow the staff in these facilities to struggle as their numbers are reduced and their responsibilities and patient counts grow.