Regulate–deregulate. Can we really solve the crises in the economy and health care by doing one or the other? Is it really so simple?

I’m not an economist, but I am a nurse and journalist who can tell you that regulations in health care serve to protect the public. They can also get in the way of better care.

Consider the story of Dr. Meridean Maas, RN, and Dr. Janet Specht, RN, two advanced practice geriatric nurse specialists who had extensive expertise in long-term care of people with dementia. Based in Iowa, they realized that the facilities where they had worked were not places in which they would put their own parents. They believed they could provide a better model of care and decided to prove it. They took out a loan for $350,000 and a received a grant from the Iowa Development Corporation to purchase a ranch-style home with acreage that they called Liberty Country Living. They created a home-like atmosphere for people with dementia who dressed in their own clothes and could walk the fenced-in property without fear of becoming lost. Staff ate with the residents and got to know their interests and backgrounds, often encouraging the residents to engage in activities that held meaning for them. Family were told to come any time and supported in being with their loved ones as much as possible. (more…)

The current state of health care systems in the United States is not accidental. It has a history and that history counts. Though there are many dimensions to that history, some that fly under the public discourse radar are worth exploring. I want to share my thoughts about a few of these “elephants in the room” that haunt me. This is not an exhaustive report; it simply highlights one of many processes that set the stage for the current conditions in health care today. I will be writing about other ones…

Some social commentators called the 1980s the decade of greed in the United States. I thought it was more accurately a cultural drift where greed was confused with success, embraced as a worthy motive. It was not the Baby Boomers finest hour, or decade for that matter. Just ask their offspring who are inheriting the inevitable results of this greed.

This drift was in part shaped by a conviction held by many that the free market could and would correct itself, even in the context of a complex emerging global economy. (It seems self-evident to note that the last few weeks beg to differ). This worldview created the conditions for the 90s where health care systems, seeing health care reform deep-sixed early in the Clinton administration, drifted toward a cost-containment marketplace mentality. (more…)