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Health Care Reform:

Health Insurance & Affordable Care Act

No One on Duty: Will Healthcare Be in Jeopardy in 2020?

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Such shortages affect an entire hospital, especially the emergency room, Sharp tells WebMD.

"Because of the managed care environment, we are seeing more people coming into the ER as their first source of access," she says. "Of course, that puts more pressure on staff trying to take care of those who are critically ill and really need the ER."

Just last week, a handful of the nation's health care leaders met with members of Congress to address these issues. Their mission: to draw attention to the immediate and long-term repercussions of these labor force shortages. The American Hospital Association -- which represents the nation's nearly 5,000 hospitals and health systems -- has also launched a blue-ribbon commission.

It's a complex problem with no easy answers, industry leaders say.

The aging "baby boom" generation is creating more demand for healthcare services, says James Bentley, senior vice president for strategic policy planning at the American Hospital Association. However, the size of the workforce has decreased steadily -- with no end in sight.

Predictions made at the Congressional hearing were startling: While the nation will need 1.7 million nurses by 2020, just over 600,000 will be available.

People aren't drawn to health care as a profession, not like they were 20 or 30 years ago, says Bentley.

"In the 1960s, when baby boomers started entering the workforce, health care was attractive as a career. In a manufacturing economy, we were high-tech. Now we're in an information economy, and many people perceive us as low-tech. Right or wrong, that's how they perceive us. If you think of this as hands-on care, touching sick people, you have a different view than if you see this as the wired ICU."

Hospital employment, once viewed as stable, now faces looming mergers, closures, and downsizing, says Bentley. And while nursing was once one of the few careers open to women, that's all changed.

Other things that have changed: There's not so much "emotional compensation" for health care workers as patients' hospital stays have shortened. There's much more emphasis on documentation and paperwork. The "24/7/365 world" of health care also makes it less attractive.

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