Thursday, January 27, 2005

THE CALIFORNIA MESS

Democrat damage plain to see

"Will California ever escape the pall created by the misdeeds and miscalculations of our former governor? As if it wasn't enough that Gray Davis left us with the highest electricity bills in the nation, spiraling workers' compensation and health insurance costs, and budget deficits as far as the eye can see, a protest lodged by California's nurses at the state Capitol building last week is a reminder that our former governor did his best to destroy this state's hospitals as well.

To refresh everyone's memory, on Oct. 10, 1999, with the signing of AB 394, California became the first state in the union with minimum requirements for nurse-to-patient ratios in its hospitals. Though initially meant to go into effect Jan. 1, 2001, the bill's author, Assemblywoman Sheila Kuehl, D-Santa Monica, agreed to have the phase-in start Jan. 1, 2002, with full compliance mandated by Jan. 1 of this year. Surveying the wreckage that has already been wrought by this bill, and foreseeing further damage to California's hospitals if full implementation was allowed to proceed, Gov. Arnold Schwarzenegger in November issued an executive decree delaying these new standards until 2008, much to the chagrin of the California Nurses Association.

Why did our governor intercede? Well, because California leads the nation in hospital closures, and survey after survey suggests that the No. 1 reason is their inability to be profitable. Hospital administrators say any further requirement to increase payrolls at this time would add to their burgeoning red ink. And they note that given the circumstances in the nursing profession, even if hospitals had the money to add to their staffs, there just aren't enough employable nurses out there to meet the edicts of Kuehl's statute. "In the past two years, our cost of providing quality services increased 23 percent, but payments for those services increased only 4 percent," reported Jan Emerson of the California Healthcare Association. "Hospitals in California have reached a tipping point." As for the nursing shortage, she said, "Conceptually, you'd think more nurses means better patient care, but if you do not have enough nurses in the work force, you run into the exact opposite of what you intended. There are not enough nurses in California we have the worst nursing shortage in the country."

Given this backdrop, it's baffling that any state leader would push for a staffing-ratio law that would cost hospitals an estimated $1 billion per year in salaries and benefits. This is money that our cash- strapped hospitals just don't have. They weren't much better off in 1999 when Davis signed the bill. In fact, an article that appeared in Nurse Week in May of that year - "Closing Time: California leads nation in hospital closures" - chronicled the problems. And even if it is somehow possible that Davis wasn't aware of the financial problems facing the hospital industry when he signed this legislation, it's all but impossible to assume that he was still in the dark by the time the law went into effect.

That's because in May 2001 - 19 months after the bill was signed and seven months before it kicked in - CaliforniaAttorney General Bill Lockyer issued a policy briefing titled, "Financial Problems Most Common Reason Cited for Recent Hospital Closings." How could Gray Davis embrace this bill? How could he do this to us? It's hard to fathom the scope of his mismanagement.

More here

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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