Healthcare

I'm at that age when the quality of healthcare is in question I take notice.

For instance, an article appeared in my newsfeed talking about burnout in the medical professions reporting that nearly 25% of medical students are considering dropping out or working in an area that doesn’t require patient contact.  Similar stats in nursing. It shouldn't come as a surprise, what did we expect? Lawyers, the government, and the insurance industry have conspired to make the profession unrewarding, requiring more documentation, more continuing education requirements, more licensing fees, higher malpractice premiums, an increased workload, and a steadily decreasing amount of reimbursement with the constant looming threat of government-run healthcare. The three tenets of any job desirability are being tested:  1: Security is still present to a degree, albeit with onerous requirements to maintain your practice lest you succumb to malpractice, OSHA, or just mind-numbing documentation after seeing hundreds of patients a week. 2: Recognition still exists,  but the amount of respect healthcare workers receive from patients is steadily in decline, largely due to their bristling at the requirement for cover-your-ass medicine resulting in the experience becoming less personal. Further, assembly line practice is necessary to compensate for lower reimbursement from the insurance industry and government plans, making the appointment more of a business transaction. Lastly, 3: Reward has probably been the most affected. Given the cost of education and the time involved in receiving training, the compensation has failed to keep up with the negative impact the profession has on lifestyle. Government intrusion into healthcare and increased insurance penetration into the market have adversely affected reimbursement. Lower gross receipts, coupled with the requirement for a larger staff to cope with unwieldy paperwork,  and skyrocketing overhead contributes to less take-home pay, a situation that has resulted in many physicians choosing to migrate to associate positions, large group practices, or hospital staff positions where they can work regular hours and get a check, forgoing involvement in the business aspect of medicine. The price they pay is a trade-off: lower salary but an improvement in time constraints. This has been a trend, particularly with women accounting for an ever larger percentage of medical and dental graduates. Even with the introduction of PAs and NPs to augment the practice of medicine, the availability of a healthcare practitioner to treat our aging population is increasingly becoming problematic, particularly in rural locales. The choices will be stark: lower standards to cast a wider net, subsidize medical education, or the most unlikely, an increase in reimbursement. With the insurance industry and the trial lawyers engaging in significant lobbying efforts in Congress and the mere fact that our lawmakers are often attorneys, it is unlikely that we will ever see tort reform or legislation that will improve reimbursement at the expense of corporate profits. And the public is yet to acquiesce to increasing funding for government-run healthcare or anything that resembles “Medicare for all” but the prospect of socialized medicine is surely not going to drive an increase in medical school applications. Sure, just hand the government control of another fifth of the economy while simultaneously giving them control over our health. What could go wrong? So there you have it, the proverbial impasse. However, the short-term consequences will be a steady decline in the availability of healthcare and a reduction in the quality of that care. We shall see how the public reacts when we reach a tipping point.