Few things make people grouchier than change, which may well explain why so many people working in healthcare delivery today are so crabby. Just ask any patient. Change has come so fast and so furiously; it literally came in one era and out another.
“These are changing times,” we are told. Not true. Time doesn’t change, people do. Events do. Circumstances do. And not always for the better. Some ideas, some values, some ways of doing things really ought not to be put to death before their time just to make room for change, especially since change is not always motivated by some great cause, or brought about as a natural evolution. Sometimes “change” actually may be regressive rather than progressive.
At any rate, I think these changes are decidedly regressive, especially in the face of full implementation of the Accountable Care Act. According to recent Bureau of Labor Statistics (BLS) data, there were 13 hospital mass layoffs (defined as involving 50 or more employees) in August, resulting in 1,085 initial unemployment benefit claims. If this layoff pace continues, BLS analysts say hospitals will post 127 mass layoffs this year involving 8,257 people, giving 2011 the third-highest number of mass layoff incidents in the last decade.i Meanwhile, earlier this month the American Hospital Association (AHA) said hospitals would lose $41 billion from 2013 to 2021 if Medicare payments were cut by 2%. According to AHA, the 2% cut would cost 92,866 jobs in 2013 and 194,522 jobs by 2021.ii How stunningly stupid!
How might one distinguish between regressive and progressive change? Regressive change offers simple, quick “solutions” and nothing more: a method with an end, so to speak. It gains most of its momentum by proclaiming what’s wrong with what is (in this case, reduced Medicare payments). It doesn’t look at what’s about to happen, such as full implementation of healthcare reform, dramatic changes, and dramatic increases in demand for services.
Progressive change arises out of what is and moves one into the future. Progress has deep roots—in technology and science, in demographics and social mores, in economics, in law—and in the successful performance of predecessors and peers. Progress builds on strengths. And nursing has a lot of those.
iBureau of Statistics. Economic News Release. Mass Layoffs Summary. September 22, 2011. www.bls.gov/news.release/mmls.nr0.htm. Accessed October 6, 2011.
iiStagg Elliott V. Economic pressures prompt increase in hospital mass layoffs. American Medical News. September 29, 2011. http://www.amednews.com/article/20110929/business/309299997/8/