There are other compelling arguments for a national, single-payer plan for healthcare, but to my mind none of them is nearly as persuasive as the developing power of Genomics. But change will not come easily. As Jack Stapleton comments in Marker: "What's reasonable and what isn't has little to do with decisions about healthcare in this country… Everything is decided according to vested interests." Difficulties aside, it is my fervent belief that the sooner we move to such a plan, the better off the country will be. Luckily, we have the experiences of a number of other industrialized countries that have already enacted single-payer systems to learn from.
I would like to add just a few words about how a nurse as antisocial as Jasmine Rakoczi could get-and keep-a nursing job. Quite simply, there is a severe nursing shortage in the United States, and our hospitals, even our premier academic centers, are forced to continuously recruit nurses. As mentioned in Marker, this recruitment extends to other countries, including undeveloped nations. The combination of low compensation and the pressure to increase productivity (translated into forcing individual nurses to take on more patients than they can reasonably handle) has created enough of an adverse working environment that experienced nurses seek alternate employment, and young men and women are reluctant to begin the long, arduous, and expensive training. What makes this particularly unfortunate is that we all know (at least those who have experienced hospitalization) that the onus of care is not on the doctors who write the orders and leave to go back to their busy offices or cozy homes but on the nurses who stay and carry them out. And for those people who have suffered a major problem in the hospital, it's more likely than not that it was a nurse who recognized it, called the physicians, and instituted lifesaving care. In my opinion and experience we need less high-priced administration, and better pay and optimum working conditions for our beleaguered nurses, who are, as Jasmine Rakoczi herself said, in the trenches, actually taking care of people.
– Robin Cook,
March 2005
