When the New York Times wrote recently about the "Future Face of Health Care," the system the paper singled out for consideration was California's Kaiser Permanente.
"When people talk about the future of health care, Kaiser Permanente is often the model they have in mind," read the lede of Reed Abelson's story March 20, 2013.
With its network of hospitals and ostensibly non-profit insurance plan, Kaiser's "the kind of holistic health system that President Obama's health care law encourages."
Unfortunately the people "talking" in Abelson's story included no California nurses. They have Kaiser on their on their minds, too, it turns out, but in a very different way.
"Kaiser's a great model of cutting costs," Bonnie Castillo, legislative director of the California Nurses Association told GRITtv. If current trends at Kaiser are any indication, she says, the future includes fewer, more overworked nurses with less time with patients and more robotic doctors, taking vital signs via remote.
Kaiser CEO George C. Halvorson told the Times, that "the way to get costs lower to move care farther and farther from the hospital setting." Sounds innocent enough. (For the record, Kaiser Foundation Health Plan and Kaiser Foundation Hospitals reported a combined $1.6 billion in net income last year.) In practice, Kaiser's cost-cutting initiatives include attractive aspects like a state of the art website packed with information that can take the place of doctor's visits, but also more emphasis on out-patient care (which has already raised concerns of CA state regulators), more electronic record keeping (a computerized system prescribed a potentially fatal dose for a county jail inmate in Contra Costa last year) and more doctoring via the internet.
The California Nurses Association (which, with the National Union of Healthcare Workers has mounted several short strikes at Kaiser facilities in the last few years) has already raised concerns about the "doc bots" that are showing up in some California hospitals.
"Problems with the machines might be a surprise to the consultants and industry executives, not to mention to the politicians who enacted financial incentives to promote rapid expansion of medical technology as key components of the Affordable Care Act," wrote National Nurses United director RoseAnn DeMoro recently, "But nurses have long been aware of the downsides for quality care and human healthcare employment."
Intensive care nurse, Michael Hill told GRITtv that he's seen nursing change dramatically over his two-decade career as nurses spend more time attending to technology and less to patients.
At the end of the day, who do you want at your bedside, asked Castillo, "A nurse or a computer screen?"
To give you a glimpse of what she's talking about, here's a picture of the first FDA approved robot doctor, a machine created by iRobot, the same company that made your Roomba vacuum cleaner. Think that nurses deserve a place in health care reporting? We do.