Shortage of frontline health-care workers poses challenge to reform

Maria Flynn, director of Jobs to Careers, writes that the millions of health care workers on the front lines are key to the success of health reform - but they have been mostly absent from lawmakers' discussions.

As representatives on both sides of the aisle battle over the fine points of health care reform, the debate focuses primarily on the scope and cost of proposed changes.  Few on the Hill seem aware that one of the greatest challenges to achieving affordable, accessible health care is the persistent and severe shortage of frontline health-care workers.

There’s no doubt that increasing the number of primary-care physicians and nurses is needed to improve care. But the five million health aides, medical assistants, laboratory technicians and other workers who make it possible for the nation’s hospitals and clinics to operate nearly round the clock are also in increasingly short supply and in need of opportunities to increase their skills and education.

Frontline workers comprise nearly half of the health care workforce, and demand is rising as we face an ever-growing pool of aging patients. Adding the newly insured and increasing access to care for millions of people will also dramatically increase this demand. Right now, the health care industry has no comprehensive way to address this issue.  Most care providers use a “catch-and-release” approach--allowing high turnover among their low-wage, entry-level workers.  Workers who pass through this revolving door are offered few, if any, opportunities to enhance their skills or master their jobs.

A number of employers and their partners, including those participating in Jobs to Careers, have found a much more productive approach. We call it “grow your own.” By working with the nation’s community colleges and creating on-the-job learning opportunities, we give frontline workers the education and support they need to become better at their jobs, advance to higher-level jobs and build family-sustaining careers.  

It’s important that our representatives in Washington understand that the resources that support programs like Jobs to Careers have been diminished by the recession.  Our community-college system has always been poorly funded, but Tuesday’s New York Times reported that enrollment at the nation’s community colleges is now up 35%, with thousands waitlisted as more people seek affordable training to further careers or get back into the job market. 

Some help may be on the way. The president’s Student Aid and Fiscal Responsibility Act of 2009 (H.R. 3221)—a $12 billion plan to shore up community colleges—is exactly the kind of assistance that’s needed to build the workforce and support effective health care reform.  How does it pay-off? We’ve trained staff in a Philadelphia psychiatric hospital, for example. The behavioral health therapists there have received workplace-based skills training, and doctors report improvements in their ability to chart patient progress, monitor patients and safely use medications.

At this critical juncture, the future of the U.S. health care system depends upon identifying, creating and implementing models like these that can increase the efficiency and effectiveness of our care-giving institutions.  These programs need to be the standard, rather than the exception.

For now, this key segment of the health care workforce is invisible in almost every discussion about health care reform.  As H.R 3221 and other legislation take shape, the powers on the Hill must be aware that helping frontline workers advance helps their employers create and retain a talented and driven workforce--a crucial step on the path to successful and lasting health care reform.

(Jobs to Careers is an initiative funded by the Robert Wood Johnson Foundation, The Hitachi Foundation and the U.S. Department of Labor)