There is no denying COVID-19 has had a devastating effect on our world. In our healthcare system, resources have been stretched beyond breaking point. Medical professionals are being overworked and subjected to traumatic experiences. As a result, a narrative that the pandemic is the primary cause of the current healthcare crisis has emerged. However, the healthcare crisis in this country was well underway long before the pandemic hit. Indeed, the increased need for medical treatment has served to highlight just how broken our current system is.
Let’s take a closer look at just a few of the primary elements contributing to our broken system.
Income Inequality
The most obvious factor contributing to the healthcare crisis in the United States is income inequality. It should be unthinkable that there are many people living in the 5th wealthiest country in the world who simply cannot afford to get the medical treatment they need.
However, it remains the case that our insistence on a profit-driven, insurance-based healthcare model is directly influencing the growing crisis. The design of our system means those with lower incomes are hit the hardest. Comprehensive insurance remains unaffordable for many Americans, and the fact that coverage is most often linked to employment status means that some of those who are unexpectedly made unemployed lose their coverage. Even when some form of insurance is in place, this is often not sufficient to cover most costs.
This is certainly not helped by the skyrocketing price of treatment. This often leaves those with a low-income with two choices when they are sick. The first is to avoid using expensive treatment, which may lead to the illness worsening, resulting in more expensive treatment later on. The other is to get expensive treatment they can’t afford, taking on significant amounts of debt, which reduces their resources further. This often leads to other problems — for instance, medical costs are the primary reason people file for bankruptcy — that can, in turn, lead to stress-related health issues requiring further expensive treatment. Until we break these cyclical wealth-linked issues, the healthcare crisis will not improve.
Toxic Labor Policies
A significant factor in the U.S. healthcare crisis at present is the toxic labor policies putting frontline healthcare workers into risky situations. This often revolves around the unrealistic expectations placed on healthcare workers by administrations and governments. As a result, healthcare professionals often end up taking on ever-greater responsibilities.
Rather than address staff shortages, facilities tend to push their professionals to work long days, often having them go for significant stretches without a day off. It is common for workers to experience symptoms of burnout — including fatigue, headaches, and sleeplessness. However, a burnout diagnosis isn’t always useful as there is little the employee can do to affect the underlying causes; these are most often systemic. The result can be a workforce constantly experiencing such illnesses, which not only impacts their own health and wellbeing but may also lead to mistakes being made in the course of their duties.
These toxic work conditions have been especially prevalent during COVID-19. There has been a dramatic spike in hospital admissions, which puts pressure on an already stretched staff. This, of course, hasn’t been helped by a lack of support from government agencies to ensure healthcare workers’ protection in a risky situation. But the fact is vocational pressure and management expectations have plagued the healthcare service for far longer, which can be attributed to a system that is not sufficiently focused on the well-being of people.
A Growing Skills Gap
Finally, one of the primary elements contributing to the U.S. healthcare crisis is a lack of skilled professionals to meet the demand from a growing population. Until this is addressed, patients are unlikely to get the timely medical attention they need for it to make a tangible difference. As previously touched on, patients who don’t get medical attention early enough may develop more serious illnesses, which also pushes up the costs of treatment. So many of these issues are interconnected.
The skills shortage is particularly evident in nursing professionals. Aside from the increase in demand, this is exacerbated by nurses aging out of the industry, with 500,000 nurses expected to retire by 2022. Educating more specialized nurses to create more family nurse practitioners (FNPs) and adult-gerontology acute care nurse practitioners (AGACNPs) can be instrumental in tackling some of the challenges caused by the skills gap. This is because nurses with these qualifications have a greater ability to help patients with a wider variety of assessments and treatments, rather than taking patients through a system of seeing different specialists.
However, the problem remains that there often aren’t incentives to encourage people into these roles. Education in the U.S. is notoriously expensive and there aren’t enough scholarship programs to make a difference. Not to mention that the promise of high salaries alone isn’t enough to tempt younger generations toward these roles. Until there are educational resources and the mentioned toxic labor conditions of the industry are addressed, it will be difficult to gain the numbers of professionals needed to fill the skills gap.
Conclusion
The healthcare crisis in the U.S. has not been caused by COVID-19. For many years now, our for-profit, insurance-based system has created inequality in treatment availability. From the professional side, toxic labor conditions and skills gaps have disrupted the ability to provide services to meet the demand. Until these root causes are addressed, it may be the case that we will struggle not just to overcome this pandemic, but any future public health emergencies.