The quote is an all-inclusive summation of American health care.
“Our current system is failing all of us,” a Washington union leader said recently. While she was speaking about nurses and other workers in the health care industry, the words also apply to doctors, administrators and – most important – patients. The COVID-19 pandemic both exposed and exacerbated shortcomings in U.S. health care, and solutions are required from the private sector as well as state governments and federal leaders.
The hospital system in Washington saw financial losses of approximately $2 billion in 2022 – a situation echoed throughout the country. Health care providers have had difficulty retaining workers, particularly nurses. Hospital closures have left rural areas without accessible nearby health care. And planned changes to Medicare payouts threaten to add additional financial stress for providers.
All of this calls for action from Congress. Addressing health care issues would serve the American public better than engaging in specious investigations. But the Legislature also can play a role in bolstering care throughout Washington.
Employee unions plan to pursue legislation focused on working conditions for nurses. It would establish strict requirements for patient-nurse ratios, bolster enforcement of meal and rest breaks, and end mandatory overtime policies. Similar legislation passed the Washington House last year but failed in the Senate.
“We’re going back to Olympia for safe staffing standards, because it’s the one policy that health care workers have said would help reduce burnout,” said David Keepnews, executive director of the Washington State Nurses Association.
Nationally, burnout contributed to the nursing field losing about 30 percent of its workforce in 2019 and 2020.
Hospital administrators argue the government intervention could have a deleterious impact. Chelene Whiteaker of the Washington State Hospital Association said: “Any time you put something rigid like a ratio into law and require hospitals to follow it, you’re going to have unintended consequences. We think ratios are not the solution. I would love to know, what happens in a workforce shortage when you can’t meet the ratio?”
In other words, having a shortage of staff could lead hospitals to turn away patients.
Indeed, government should be cautious about regulating health care providers. But it is essential that private-public partnerships be forged to help train and retain health care workers.
Several bills have been passed in recent years to bolster health care in Washington, ranging from lowering insulin prices to expanding coverage for low-income residents to aggressively addressing the COVID-19 pandemic. In 2021, according to the U.S. Census Bureau, 6.2 percent of Washington residents did not have health insurance – a rate far lower than the national average but still higher than 18 other states.
Insurance, however, does not guarantee health care. With a growing shortage of providers, care is in short supply.
The Washington Hospital Association is pushing for the Legislature to increase Medicaid reimbursement rates in a manner that triggers federal payments. Another proposal would have Washington join a reciprocal agreement allowing nurses licensed elsewhere to work in this state.
Regardless of the eventual solutions, lawmakers must recognize that the current system is not working well for employees, administrators or patients.
