Wide health insurance coverage does not always translate into better healthcare facilities– this debate has long been at the helm of various health reforms. Various administrations have taken the incorrect approach to equating health insurance with improved healthcare service, and the Affordable Care Act seems to be on a path to the same debilitating mistake. After the closure of first enrollment period, Obamacare has caused an increase in the workload of nurses in hospitals across the country. This increase in burden is making nurses compromise on the quality of healthcare for patients, especially those that have recently got health insurance under Obamacare.
With 8 million enrollments under Obamacare’s belt and an increase in hospital usage, according to preliminary studies, the burden on healthcare providers is steadily increasing. The burden is expected to increase in the months to come, with another influx happening when the next enrollment period opens. Amid this increasing burden, nursing staff is falling short on manpower. With many hospitals reducing nursing staff and allocating resources toward primary care facilities, the situation might worsen in the future.
Although healthcare spending is up by 10 percent, a mammoth number since 1980 spending, the newly insured patients coming in to the system require more care. These newly insured patients are a part of that demographic which hasn’t had care in a long time, especially people with preexisting medical conditions who couldn’t afford treatment. For nurses, these patients require more care than an average patient due to years of neglect of their existing medical conditions. Since the condition of the patient is a prominent factor in determining the ‘care load’ it will put on doctors and nurses, hospitals need to figure it in their budget allocations.
Currently, hospitals do not put the severity of the patient into account; they typically determine workload and required staffing levels by putting available money, instead of the workload, and relevant benchmarks of the industry into perspective. Trouble is that benchmarks across the industry are skewed, and most hospital money is being allocated to primary care without much heed on the demands of the nursing team. As a result, the nursing net is narrowing across hospitals, causing a decrease in available nurses, an increase in collective patient workload, and thus, a reduction in the quality of healthcare being provided to newly insured.
At the ground level, nurse shortage is already playing in. Nurses share that the new patients coming in are in a poor state of health, and are requiring more attention than an average patient. As a result, residing nurses are occupied with their healthcare, making them sacrifice time and attention reserved for other patients. Unfortunately, no extra nurses are available for taking care of the other patients. To make matters worse, hospitals are noting a decrease in the number of patients admitted for overnight stay in the last couple of years, prompting them to consider reducing inpatient nurse staff. Hospitals feel that budget allocations to improving primary, medical, and surgical care has improved patient health and reduced the need for hospital admission. The ACA does not bar hospitals from moving toward an outpatient setup, and hospitals feel that their money can be better utilized by cutting nursing staff and investing in primary care improvement. Naturally, this combination, if it happens, is going to cripple the system and increase the load on nurses tremendously, ultimately resulting in poor healthcare quality.
Although ACA and Obama administration do not have a direct role to play here, hospitals definitely need to see the folly of their actions if they decide to cut short the nursing staff. The same care cannot be provided in an outpatient setting, with few family members caring for the patient and a visit-at-home nurse doing her duties once or twice a week. To provide better healthcare and meet the increasing demand brought by ACA implementation, hospitals need to make smarter utilization of their budgets and reduce the burden on inpatient nurses to improve healthcare quality.