The Health Care Crisis in the United States: A Call to Action

Redmond, Helen, Health and Social Work

At the millennium, the health care system in the United States continues to be in crisis. The United States, to its shame, is the only industrialized country in the world that has not established universal health coverage. It is estimated that 42.6 million people have no health insurance--10 million are children (U.S. Census Bureau, 1999). The loss of health coverage and delays in care have resulted in thousands of deaths. (Himmelstein & Woolhandler, 1994). Despite the numbers, we can never calculate all of the human suffering that results from not having access to medical care. As social workers in the health care industry, we are eyewitnesses to this suffering on a daily basis. Medical social workers are expected to alleviate much of this suffering. We are on the front lines of the health care crisis in the United States. We explain the eligibility requirements for insurance programs and how to enroll in programs to purchase low-cost medication and counsel patients who cannot pay medical bills. Medical soc ial workers have a vast knowledge base and access to resources in the community to help patients and their families cope with illness and disability.

PROFESSION UNDER ATTACK

The profession of medical social work itself has come under attack. Social workers are laid off when hospitals and clinics close or merge. Entire social work departments have been eliminated in hospitals, and nurse discharge planners or case managers have assumed the role of social worker. Social work as a discipline in the medical setting is struggling to survive (Globerman, 1999). Health care administrators often do not value the role social work plays because they do not see how it contributes to profitability. Social worker's "productivity" is increasingly measured by the number of patients seen (patient contacts) and how quickly the patient was discharged. Shortened length of stay and other efforts to lower acute-care costs have greatly affected social work practice in hospitals (Hammer & Kerson, 1998). It is becoming more difficult, and at times impossible, for social workers to do comprehensive and patient-centered discharge planning. Downsizing and hiring freezes leave social workers with higher casel oads and less time to spend with more patients and families.

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Publication information: Article title: The Health Care Crisis in the United States: A Call to Action. Contributors: Redmond, Helen - Author. Journal title: Health and Social Work. Volume: 26. Issue: 1 Publication date: February 2001. Page number: 54. © 1999 National Association of Social Workers. COPYRIGHT 2001 Gale Group.

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