Who took the “Care” out of Healthcare?

There is a health rationale for segregating land uses. There is even a health rationale for desegregating them. For the sake of health, there are sanitation services to remove garbage, a sewer system to remove human waste, and yet there is no overarching health care system to provide of all things, health.

Today’s healthcare system does not provide health. Not even close. Just as medicine treats symptoms rather than curing the ailment, healthcare treats ailments rather than promoting health. Often, the culprit is the medical industry itself, where special interests continue to lobby for what roles their respective professions get to play (and as a consequence the pay they receive) rather than advocating for better patient care.

With the Republicans taking over control of congress at the start of next year, comes their completely misguided hopes of overturning the new healthcare legislation. Case in point, the Las Vegas Sun has pointed out the flaws of the very system they claim as “the best in the world.”

via NJ.com

Nevada is exactly what Republicans want healthcare in the United States to be like. They do not want government run, tax payer funded healthcare (let alone anything else other than an army for that matter). According to the Sun article, Nevada and Clark County have the highest concentration of for-profit hospitals of any state or urban county in the nation.

The Sun likens Nevada’s hospital system to an industry rather than a system. Hospital care is said to be “shaped by market forces – entrepreneurship, cutthroat competition and whats best for the bottom line.”  State for-profit corporations control 70 percent of acute-care beds in Las Vegas hospitals.

Profits at these hospitals were as high as 25% in the 1980s before legislation required them to reduce billed charges if their profits exceeded 17%. That legislation has since expired.

Now there is nothing wrong with profits in a business. The problem arises when that profit comes at a cost to patient care.

Academic studies cite poor nurse-to-patient ratios as a contributing factor in patient deaths and nursing burnout. A 2007 study published in the journal Medical Care linked insufficient staffing levels to patient bedsores, infections and deaths.

In 2009, eight of the 13 Las Vegas hospitals had high rates of postoperative blood clots, ranging from 40 percent higher than expected at Spring Valley to 95 percent higher than expected at UMC, the Sun found.

Nurses told the Sun that helping patients get out of bed to move around — which helps prevent blood clots and bedsores — is usually the first task lost when they are overworked.

Now this isn’t an endorsement of government run healthcare. Government has failed to properly regulate and enforce its own rules on the private healthcare industry. The Sun points out that in Las Vegas, the federal government depends upon a body comprised of hospital administrators and lobbyist as a consultant to improve care. This body seems dubious at best at looking out for the best interest of patients.

When a woman wearing an oxygen mask was being prepared for surgery at Desert Springs Hospital in March 2009, technicians made two mistakes, according to a state investigation. They cleaned her chest with an alcohol-based solution but draped her before it dried, trapping the combustible vapors. The techs also failed to remove a pad under her body that had absorbed the flammable solution.

When the surgeon sparked the electric knife, the patient erupted in a fireball. She suffered second- and third-degree burns on her neck and chest.

The state fined the hospital the maximum allowed, $800.

The hospital staff further violated its own procedures when they did not call the fire department. Worse yet, an investigation was launched by the family’s complaint, not the hospital’s disclosure.

As healthcare costs continue to skyrocket, conservatives often advocate for “tort reform” as a means of controlling those costs. Doctors often over-test in order to shield themselves from the possibility of being sued for malpractice. In other instances, hospitals will fail to report what is referred to as “sentinel events,” also for fear of malpractice lawsuits. Hospitals will even fail to inform patients when something goes wrong.

A novel idea would be to provide adequate care so as not to incite malpractice lawsuits in the first place. Why is it that the healthcare industry believes that it should not be held accountable for its failures?

Healthcare is just like any other service. When you check into a hotel, and the room is filthy, housekeeping is held accountable for the mistake. When nursing assistant ratios are 26:1, nursing ratios are 8:1, and 65% of nurses say hospital conditions are not conducive to patient care, the industry needs to be held accountable. When technicians mis-prep patients leading them to catch on fire, they should be held accountable.

Why communities do not have healthcare plans in addition to open-space, land-use, noise, safety, circulation, conservation, economic development, community design, and housing elements is a mystery to me. The article sums it up best.

…patient services are provided by a fragmented collection of special interests — doctors, nurses, competing hospitals, insurance companies and government payers. There is no overarching assessment of community needs and no integrated planning.


Urban planners to the rescue?


Read the full article here


1 Comment

Filed under Healthcare, Las Vegas, Planning

One response to “Who took the “Care” out of Healthcare?

  1. Anna

    Great insights! =] hope there is a solution to this pblm soooon.

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