My wife (an RN and a manager) says with this and the way college is changing for health degrees we are going to have some problems.
Anyone can go to HVCC for 2 years and walk out with an LPN license for cheap. And everyone needs nurses right? So the job market is flooded right now with freshout of school, no expierence licensed nurses. Mix in the law of averages saying half of them will have a shitty work ethic, and the younger generations “sterotypical” demeanor… finding a GOOD nurse isnt easy. Infact my wifes small company lost 3 of the nurse managers, and the few applying for the position are not what they are looking for to put it nicely. And the hundred or so RN’s & LPN’s working under her are a revolving door of crap. Some are good and work very well, but a majority should be flipping burgers, not pushing meds. A few days ago at 1:30 AM she got a call from a nurse saying she didnt want to be at the case any more and was going home, and hung up! Ignored the calls back, didnt come to work the next day, and finany showed up and gave my wife and the director a line of bull shit why she “had” to leave the patient, and that her phone died. I could go on and on about the crap she sees.
Back to school. Tuition for anything past an entry level nursing position is steadily rising. Infact my wife watched her tuition rise twice in the year and a half she has been attending, while the government still has no problem handing loans out to anyone under the sun to give it a shot. What this is doing is once again filling job applications with under expierenced people who now have a fancy degree and a giant debit to pay back. Those people wont settle for an entry level position becasue the money isnt there to pay the debit back, and the pride is too high becasue they have a specialist degree now.
So from the provider standpoint, you are loosing the grey area in the middle, where quality care is given to patients through good ethics and proper pay. You are getting a mass of entry level people chomping at the bit to take anything they can get (which allows the providers to lower the pay rate), and now they see that they can push the primary care providers out of the system and hire the new specialists (again at a lower pay) to fill in up top, since this obamacare stuff is fluffing the pillows for “better quality care” and wanting to send patients right to a specialist more so than a PC provider.
Thats the jist of it from what she tells me. It doesnt look good. The ballance isnt there to keep people working, learning and living honestly in the healthcare market, when plans like this are pushing everyone to one extreme or the other.