Health Reform is Not the End of America as We Know It
Hanna Rosin posted yesterday on this NPR interview with James Morone, one of the authors of The Heart of Power: Health and Politics in the Oval Office.
In that interview, NPR cites Ronald Reagan, opposing the creation of Medicare, thus:
One of the traditional methods of imposing statism, or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it.
Morone responds that Reagan went a step further in his opposition:
If this program passes, Reagan said in another speech, one of these years we will tell our children and our children’s children what it was like in America when men were free.
To the chagrin of my farther-left-than-I colleagues and readers, I continue to have tremendous respect for Ronald Reagan and great appreciation for how he helped refurbish the American spirit at a critical time in our history. But even as a Reaganophile, I am forced (with the benefit of 20-20 hindsight) to respond with a snort to Reagan’s doomsday predictions about Medicare.
I am of roughly the same generation as Reagan’s children; my son of roughly the same generation as Reagan’s grandchildren. My parents did not need to tell me, and I have not yet had to tell my son “what it was like in America when men were free” — because (guess what?) we actually live in an America that can still be described as “land of the free.”
Imagine that.
Granted, the pending tidal wave of aging Boomers threatens the solvency of Medicare and other social programs — and by extension the solvency of the nation — and some hard choices will need to be made soon. But I see those choices, those adjustments, as part of the logical evolution of government programs. Any failure to make those choices — and any resulting compromise to America’s viability — will be the responsibility of today’s crop of politicians, not those who voted for Medicare two generations ago.
Sadly, it is Reagan’s political heirs who are now making those hard choices even harder, by invoking the false image of death panels and otherwise stirring up Medicare beneficiaries to shout down fiscally necessary reforms — even as they invoke Reagan’s anti-Medicare language to resist the larger, related slate of reforms.
Don’t get me wrong: I’m not entirely sold on the current reform proposals. I have many questions and doubts about them. I think caution and precision should still rule the day. I’m also still curious about alternatives to the “public option,” such as “co-ops,” even after reading more about the latter and realizing that, yes, they might have as many con’s as pro’s — as many potential flaws as the public option has, if not more.
By the same token — while there may be multiple risks to virtually any reform; while whatever type of reform passes today will likely, eventually require some amendment to fix unanticipated (or unanticipatable) issues — I flatly reject the premise that the public option will be the end of America as we know it. I reject the premise that the public option, if enacted, will force us some day to “tell our children and our children’s children what it was like in America when men were free.”
I reject those premises based on the history of Medicare to date and the experience of countries like contemporary Germany (also here), which purportedly has a “public option” and still affords its citizens considerable freedom.
Imagine that.
Bottomline: Members of Congress — Democrat and Republican alike — need to grow up. Drop ideologically discredited claims (on both sides of the aisle) and honestly, cooperatively explore how a public option might be fine-tuned to replicate here the successes realized elsewhere, even as they honestly, cooperatively explore alternatives to the public option. Yes, eventually, said exploration needs to end and votes need to be called. But I don’t think we’re there yet, not until a little more of those “honest” and “cooperative” modifiers are attached to the process.
26 Responses to “Health Reform is Not the End of America as We Know It”
Are you suggesting, as indicated by the title of this post, that “health reform” = “public option”? I would suggest that the two are not synonymous and that reform can occur (and, indeed, must occur) whether there is a public option or not.
“Any failure to make those choices — and any resulting compromise to America’s viability — will be the responsibility of today’s crop of politicians”
Day, after day, after day: actual, true reform is fought. Look at the Dems' doing nothing about Social Security when they easily had power over the Bush White House to boost their ratings by rescuing a program they “own.” They resisted reform and did absolutely nothing (duly noted by some) to save it.
The “public option” in no way constitute anything essential whatsoever about health care reform. The “public option” is central to the Dems but is correctly seen as what it is, the core of their current effort, and the incremental means of choice (a general variant of what they've done with S-CHIP) to 100% federal takeover, provision, and control (“finance”) of health care in this country — obviously.
The public option has nothing to do with “reform.” Reform in no way needs any involvement with it.
I've already listed numerous reform items — true, honest reform, of the current system — free from it.
That doesn't mean any and all moves toward increasing federal health care involvement are doomed, or must wait another twenty years, or other silly means of trying to scare the easily scared who want the public option. (In fact, any reform of the current system obviously would augment the role of the federal government, not merely from enacting legislation.) What it does mean is that we can be sane.
And of course, in addition to reforming the private insurer-based system now, what about keeping the promise Obama made (as if anybody would have been fooled earlier by him) and reform Medicare and Social Security before adding to the size and scope of federal entitlements? Is that too sane for y'all?
“[R]eform can occur (and, indeed, must occur) whether there is a public option or not.”
I could even add confidently that it will occur, too, that it almost certainly inevitable in way or another.
Pete,
I don't agree with everything you wrote, but I definitely think the gist is well-taken.
“I am forced [...] to respond with a snort to Reagan’s doomsday predictions about Medicare.”
Actually, the kind of things Reagan said in the past, or the elder William Simon, or Barry Goldwater, were correct. And, as I've written elsewhere, Kennedy represents dinosaur New Deal, Great Society, and Sixties-radicalized liberalism that peaked and against which the public pushed back in 1980 (and with health care, notably, in 1994, after a strongly leftward lunge in Washington), and which has been held in check, is nothing like it was in the 1960s (as is true with Detroit automakers and the lifestyle associated particularly with them, which is viewed wistfully when not fervently by those who want to return to it). Teddy Kennedy and others are going away from us, as has their kind of liberalism.
1964 was a referendum on the New Deal; the New Deal won. But the public said “too much” in 1980.
* * *
“cooperatively explore how a public option might be fine-tuned to replicate here the successes realized elsewhere”
Fine-tuned? Aieee (Just as the economy can be “fine-tuned,” when not defribrillated by “stimuli”).
The current effort is incoherent and in fact, incompetent.
And, the Medicare model is problematic, and itself needs reform, as Obama has said, if not meant.
The best approach (with or without Medicare reform) is to reform the existing system first, then establish if or how Washington should involve itself (subsidies, vouchers, tax credits for the poor in addition to “insurance” reform and additional regulation).
You want to reform healthcare, get the related industries to stop gouging the public. Costs in healthcare are skyrocketing even while pharma companies are showing record profits. When costs go up and manufacturers pockets are bulging, guess what? People are getting screwed. I hate to sound like some sort of anti corporate lefty, but sometimes that's the case.
I love big business, its what makes the economy go. But I don't TRUST big business any farther than I can throw it. Time and again they have shown that profit comes even before human lives. Hell, the most spectacular stories in the last decade come in the form of companies putting short term profit above the health of their own organizations. Companies like Enron, Arthur Anderson, and recently the entire financial sector, can't even be trusted to look after their own best interests if it conflicts with making the next quarterly report look good. You want these guys to run our healthcare?
Except that costs are skyrocketing in all the government run programs as well as in the private non-profit medical sector. How do you explain that?
The point being that there are systemic problems and the “lefty” focus on corporate profits and their perceived evils is misplaced. There's no evidence that eliminating corporate profits completely will make the entire system financially sustainable. I might suggest, therefore, that instead of (or in addition to) a public option, that more fundamental “reform” is needed. The left's narrative that opposition to a public option = opposition to reform is, therefore, self-defeating and wrong.
“I might suggest, therefore, that instead of (or in addition to) a public option, that more fundamental 'reform' is needed”
Actually, two-pronged.
a) Reform of “insurance” (pre-paid health care of all kinds), be it mainly regulatory or also conceptual;
b) Medicare (and Medicaid, VA, Indian Health, etc.) reform, to try to approach sustainability at least.
It leaves the private and public health care sectors in better shape, and in better position for integration.
While I was growing up in Canada, we had a running joke about the stereotypical American who thinks that any country besides the U.S.A. isn't a “free country” (see lyrics to “I'm Proud to be an American”). No real offense was meant, we just liked to poke fun at the way Americans flaunted their freedom and rejected anything done differently in other countries (with France seemingly one small step above Nazi Germany and the U.S.S.R.). After living in the U.S.A. for eight years, I now see that our stereotype of Americans was mostly based on members of the far right. I was raised in a fairly conservative community, but even we could see how foolish it is to let this excessive talk of freedom get in the way of pragmatism.
By the way, last year when people were worried about the reinstitution of the fairness doctrine, I actually heard a local conservative morning talk show host say to one of his callers, “now, I don't know that much about Canada, but listen. Canada is not truly a free country!” Idiot. That was the last time I listened to him.
“Except that costs are skyrocketing in all the government run programs as well as in the private non-profit medical sector. How do you explain that?”
Because they are all buying from the same trough. And those programs are getting gouged from the private sector as well. Basic fact is prices are rising way faster than inflation and everyone just accepts it. No one want to take a look at the industry to fix things. For instance, the AMA decides how many types of how many of each specialty they will allow into a field every year. This is their mechanism to keep salaries up. They are the ones in effect who are rationing healthcare. As well as say Pfizer, who sells pills here for $25 that they sell to countries like France, with its socialized medicine and consquent purchasing power, for $6. Why? Because the system is currently structured in a way that this price fixing can go on and most people will never notice. They will simply look at the rising costs and shrug their shoulders as if nothing can be done.
Andy,
Good question. I did not mean to suggest that “health reform” = “public option.” But I can understand why that might be less than clear.
My thinking behind the title of the post was based on the following: Certain prominent Republicans have rejected both a “public option” and “co-ops,” describing the latter as a path to the former, and the former as a path to “single payer” … and thus to the end of America as we know it.
Accordingly, I tried to short-hand the baseline sentiment of these Republicans, i.e., the sentiment that any substantive reform (at least any suggested by Democrats or RINO's) will lead to some tragic lessening of “America as we know it.”
You and/or others can debate whether I was precise enough in doing so, or whether it was a fair leap in logic to make, but I hope that at least explains my path from blank screen to the post's title.
[...] Excerpt from: Health Reform is Not the End of America as We Know It [...]
I think the idea of ending “America as we know it” might be worth discussing, with regards to healthcare. I've had periods where I was working up to sixty hours per week and had no healthcare – and stayed awake nights because my wife's pneumonia wasn't considered emergent enough for the hospital to do anything about and I couldn't afford a doctor's visit PLUS the antibiotics she needed. Meanwhile, one of the four jobs I held was with Columbia HCA – the largest healthcare organization in the world.
I spent six years in the Navy and I can tell you that the healthcare has some problems, but it's better than nothing.
Case in point, my mother, who lives in Texas. She is now retired – but without a pension because nurses in Texas aren't unionized and the employers see no reason to give out pensions. So she lives on Social Security and what little she is allowed to earn on the side. Ten years ago, the doctor told her that she needed her knee replaced. But it isn't considered medically necessary because she isn't crippled. So she could “elect” to have the surgery, but in order to save the money necessary to pay her co-pay, she would be kicked out of the public housing where she lives. Not to mention lose a substantial part of her Social Security.
So my mom limps around the nursing home, providing care for those who are barely five years older than her (or, in some cases, younger than she is). If she were to discover a patient who had fallen, she could not get on the floor to provide first aid, but would have to call an aide and provide direction. Yet her patients depend on her just the same.
Meanwhile, the younger nurses where she works pick up forty hours in three days so they can have four days per week off. You think there's no drop-off in care by the time that thirty-eighth hour hits? Oh well, they bury their mistakes anyway.
If this is the “best system in the world” and the result of “freedom” – well, it's just damn sad.
Slam, I don't think we agree often, but I do agree with you on the cost side of healthcare.
And the lack of Demcare actually addressing it head-on, as opposed to offering a) believe us, it will lower costs, b) hey, we'll find “savings and efficiencies” in Medicare, c), hey, we'll eliminate private sector profits and advertising costs (which comprise somewhere in the neighborhood of 1.5% of annual US healthcare costs…..meaning your cost will go up only 7.5% per year as opposed to 7.8%).
I don't think Rush Limbaugh's radio show cost Obama and Demcare 20 support points. I think the more people hear details, the more they realize this is more about expansion of the cost pool and doing very little for the costs they are now already paying.
But the Dems are content to simply proselytize about their greater moral virtue while public support sinks lower and lower.
Slamfu, this is so true. I work in the public healthcare section, at a public hospital largely supported by state taxpayers, providing services to mostly indigent patients. We recently hired then fired a CEO who had spent their entire career in the private healthcare sector. The CEO appalled our facility by abusing resources (state vehicles, housing, etc.), and at some point I realized his sense of entitlement was related to the fact that in the private sector, the company could write off all those expenses. Ironically, there is more accountability in our system, expenses must be justified as whether they benefit patients and the state as a whole…
“You think there's no drop-off in care by the time that thirty-eighth hour hits?”
Aside from the dangers from sleep deprivation of doctors, too, their residencies have been viewed for years cynically as having become an obvious kind of slave labor.
Reform of shift durations and related issues in medicine as well as elsewhere (sentry duty or watch aboard ship, transportation, etc.) is something I've thought about for a long time. Note it's something (fatigue and workload, staffing, etc.) that should be part of an intelligent health care reform mission.
http://www.cirseiu.org/policy/Institute_of_Medi…
http://www.pubmedcentral.nih.gov/articlerender….
http://newsblaze.com/story/2009050808390200004….
http://www.bizjournals.com/triangle/stories/200…
http://www.atwonline.com/channels/airlineFocus/…
http://www.aviationweek.com/aw/generic/story_ge…
http://narap.org/educational/sleep.php
Except I dont hear a whole lot details being put out there. There are a lot of caricaturizations of details, but mainly just blanket statements from both sides. Dems say insurance companies are evil and the government is the only entity that can solve the problem and the Fox News crowd just says government=evil. I've been to plenty of healthcare fora where most of the people have no idea what's been proposed, they're only responding to statements they hear on television.
“The AMA decides how many types of how many of each specialty they will allow into a field every year. This is their mechanism to keep salaries up. They are the ones in effect who are rationing healthcare.”
An excellent point. The accreditation path for nurses is likewise narrow and steep, thanks to the tireless lobbying efforts of nurses' unions eager to reduce competition and preserve their six-figure salaries. “Nurse shortage? We've heard ugly rumors, but there never seems to be any at our union meetings.”
The solution is not less private enterprise but more. The AMA and the unions and Enron have all gotten away with their protectionist maneuvering thanks to the gullability or collusion of regulators. The private groups correctly identify the government with it's power to regulate as the vulnerability in the system, the single point of failure, and they take advantage of it.
A competitive market, though, has no single point of failure, no single body lobbyists can bamboozle. No company (or union) can exact too sweet a deal, because the next one will undercut them. We desperately need more competition in all areas of health care.
I don't know if Reagan was right, but I think your argument is not logical.
Reagan said that passing Medicare would eventually lead to our losing our freedom. Pete notes that it hasn't happened yet (some might argue that, but we'll give him the benefit of the doubt), so Reagan was wrong. Therefore, we should implement more government involvement in health care, since if Medicare didn't end our freedom, increasing the involvement of government won't either.
It's a little like your mother telling you that if you play with matches, you'll burn the house down. After playing with matches for a few days, the rug catches on fire a few times, but you manage to put the fires out before they spread. Based on this experience, you're confident you have things under control and continue to play with matches, and you get out some lighters also. Your foolish mother is just clinging to an old wives tale.
Let me repeat, before anyone jumps to conclusions: I don't know if Reagan was right, but your rebuttal to his argument doesn't make any sense to me.
(There's no question that Medicare does limit our freedom to some extent. Whether the benefits of the program are worth the freedom that we give up–the freedom to prepare for our retirement health care needs as we see fit–is a separate question)
I am considered to be of the same generation as Reagan's grandchildren, yet I definitely do not find myself asking “what it was like in America when men were free.” Rather, I find myself questioning what will happen when the “pending tidal wave of Boomers,” of which my parents are a part, finally reach retirement. What is the future of the medicare system? It is definitely in no condition to support the quickly approaching masses. There is no question about whether or not health care reform is necessary–our expensive and inefficient system simply will not survive for much longer. Although I in no way pretend to be an expert on health care reform, I have to wonder if one of the most effective (and quickest) ways to cut costs would be to tackle the issues stemming from the legal system. Our current litigious climate causes physicians to order numerous costly and unnecessary tests in order to escape the possibility of a lawsuit. Perhaps reforming this would make a big step towards the change we need.
If the findings of CBO over inaction had been released earlier, Ted Kennedy could've seen his lifetime wish come true.
Inaction cost, $9trillion over the next decade, can not be compared to the balance between estimate and outcome in a worst case of scenario, and this balance could be adjusted each year. ((Some of CBO analysis : While the costs of the financial bailouts and economic stimulus bills are staggering, they are only a fraction of the coming costs from Social Security, Medicare, and Medicaid. Over the next decade, the Congressional Budget Office (CBO) projects that each year Medicaid will expand by 7 percent, Medicare by 6 percent, and Social Security by 5 percent. These programs face a 75-year shortfall of $43 trillion–60 times greater than the gross cost of the $700 billion TARP financial bailout)). Time does not fix endless greed and energy depletion.
When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ills patients get, the more profits they make, and it will debilitate the overall economy involving education for the future, not to mention continued bankruptcy of middle class.
Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007, and that implies the total of this promising reform will be cheaper than expected, I guess.
In case of an unexpected injury or ill, they might give up their learning or aspiration, in this regard, this reform means liberty, job opportunity, competitiveness for them and future.
1. The contents of savings (below) in this reform 'have nothing to do with' limit to medical access, rationing, tax raise, and deficit etc.
Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing, more tax raise, and more deficit etc than today.
$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).
$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility) + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).
As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.
“Health reform can help pay for itself, but both private and public insurance choices are critically important,” said Commonwealth Fund President Karen Davis, who coauthored the new report. “A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost.”
Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class, the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.
In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. And the bill expands coverage for mental health services, and defines what will be covered. It also prohibits co-payment charges for wellness and preventive medical care. There is no mention of rationing. The use of this term is, again, a gratuitous distraction aimed at feeding fear
“what will happen when the 'pending tidal wave of Boomers,' of which my parents are a part, finally reach retirement”
The entitlement programs' unsustainability will be finally exposed, if not before (and I say it will happen before, even if the Faithful and Crusading Defenders of the Status Quo on the Left are dead-set against reform, when not doing other things like robbing Medicare to pay for new federal care).
People (including me) have tried to make this point year after year, despite being ignored or abused.
Reconciliation is inevitable, it's not an “easy, simple” [sic] matter to raise taxes, and have the federal government consume European or higher levels eventually of the GDP to keep these programs operating. (Europe faces even worse problems than we have, something the Left refuses to admit.)
To the latest the latest Trustees' summary. (No use of “unprecedented” here; this will be explained.)
“When cost exceeds income excluding interest, use of trust fund assets occurs in stages. For HI, the process began in 2008 [...] For OASDI, interest income will first be needed to pay a portion of benefits in 2016 [...] the growing burden that the programs will place on the Federal budget well before the trust funds are exhausted.”
“During 2009-17 for HI, general revenues must be used to cover the interest earnings and asset redemptions required to offset the shortfall of HI tax revenues. Similarly, general revenues cover these offsets for the OASDI deficits during 2016-37. In addition, general revenues pay for roughly 75 percent of all SMI costs under current law. [...]
[... B]y 2016, net revenue flows from the general fund would total $369 billion (1.8 percent of GDP). The positive amounts that begin in 2016 for OASDI, and started in 2008 for HI, initially represent payments the Treasury must make to the trust funds when assets are depleted to help pay benefits in years prior to exhaustion of the funds. Neither the redemption of trust fund bonds, nor interest paid on those bonds, provides any new net income to the Treasury, which must finance redemptions and interest payments through some combination of increased taxation, reductions in other government spending, or additional borrowing from the public. [...]
[... T]he difference between outgo and dedicated payroll tax and premium income will grow rapidly in the 2010-30 period as the baby-boom generation reaches retirement age. Beyond 2030, the difference continues to increase nearly as rapidly due primarily to health care costs that grow faster than GDP. After the trust fund exhaustion dates (2037 for OASDI, 2017 for HI), the increasing positive amounts for OASDI and HI depict the excess of scheduled benefits over projected program income. When the statutory SMI general fund revenue requirements are added in, the projected combined Social Security and Medicare deficits and statutory general fund revenues in 2083 equal 9.7 percent of GDP. A similar burden in 2008 would have required all Federal income tax revenues, which also equaled 9.7 percent of GDP.”
http://www.ssa.gov/OACT/TRSUM/index.html
Related to retirement years of the Boomers are reconciliation with government employee retirement costs (“promises” will face long-overdue alteration or breaking) and the specter of a big bear market as the Boomers sell assets to finance their retirement privately (still the major means in the USA, if not in most other countries, of financing retirement — mainly privately, by one's own actions).
But here and now we “should” ignore this and “should” insist on greatly increasing such programs.
Perhaps it explains the lack of the advising the public that the future of these entitlements would involve an unprecedented situation. Perhaps the Obama administration wants this suppressed in order that we not be as worried as we otherwise might be by such thing. Or, they approve of it.
Let's step back a year or so to an earlier Trustees' summary, now, because it includes references to historical experience with the size of the federal government, which for some reason later was not mentioned now that the summary is issued by the Obama administration, which apparently believes it's not important to continue to tell the public the following — or doesn't think it's a bad thing at all.
No use of “uprecedented” in the latest, Obama, Trustees' summary. But in earlier summaries?
“To put these magnitudes into historical perspective, in 2006 the combined annual cost of HI, SMI, and OASDI amounted to 40 percent of total Federal revenues, or about 7 percent of GDP. That cost (as a percentage of GDP) is projected to double by 2042, and then to increase further to nearly 18 percent of GDP in 2081. It is noteworthy that over the past four decades, the average amount of total Federal revenues as a percentage of GDP has also been 18 percent, and has never exceeded 21 percent in a given year. Assuming the continued need to fund a wide range of other government functions, the projected growth in Social Security and Medicare costs would require that the total Federal revenue share of GDP increase to wholly unprecedented levels.”
http://www.ssa.gov/history/pdf/tr07summary.pdf
“An excellent point. The accreditation path for nurses is likewise narrow and steep, thanks to the tireless lobbying efforts of nurses' unions eager to reduce competition and preserve their six-figure salaries. “Nurse shortage? We've heard ugly rumors, but there never seems to be any at our union meetings.”
You're falling back on pipe dreams of the right. By far, more nurses are not in a union than are unionized.
The shortage of nurses is due to 1) hospitals constantly under-staffing to make a buck 2) abusive doctors who scream at them to cover their own mistakes, 3) frustration with a system that neither encourages nor wants input in the healing process from people who 'merely' work with patients.
I'm going to do you a favor and not let my wife, a nurse of 35+ years, see your comment. She'd kick your butt.
Hemm, I didn't claim most nurses are unionized or that their job is easy. I claimed the accreditation process is steep, that nurses' unions want it that way, and it's not only their patients' interests they're looking out for.
J
RNs in hospitals are held responsible for the well-being of patients, and must carry insurance to avoid law suits. The only people who want less accredited people are the bean counters.
RN to patient ratios used to be 4 or 5 to one for floor nurses. Before my wife got off the floor, the hospital had her and two Assistants – not even LPNs – watching 12 patients. Find some other place to lay the blame. Nurses are like non-comms, they are the ones who keep things going.
I got your Social Security fix, its easy and fun! START HAVING BABIES PEOPLE!! Oh, and make sure they get an education and jobs.