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Analyze: States scramble to address the shortage of health workers



This week high-ranking Hawaii officials were given a dire warning. If they don’t take action, the state could not provide thousands of health professionals who are essential to combating the COVID-19 epidemic.

The state has not granted the waiver of licensing requirements, which had been in place for two years, said Hilton Raethel, head of the Healthcare Association of Hawaii, which represents Hawaii’s hospitals and skilled nursing centers, assisted living facilities, and hospices.

“This will place a materially increased burden on our existing workforce which has been stretched and strained dramatically during the pandemic, and we risk losing even more of our current permanent workforce which will have a significant impact on the ability of our hospitals and other healthcare institutions,” Raethel addressed state officials.

If the state does not take the necessary step, she told me in an interview, the health crisis that is causing it in care will persist. There aren’t enough health professionals of all kinds–doctors, nurses, respiratory therapists, lab techs, behavioral health professionals, medical assistants — to fill the vacancies, not just in Hawaii but also across the nation.


“Workforce in health care is an issue of national significance and is reaching a crisis in many parts of the country,” said Akin Demehin, the director of policy for the American Hospital Association trade group. “Leading towards the pandemic there are already major issues with the workforce. The pandemic has increased these, due to fatigue that has accompanied wave after rounds of the patient.”

The situation of workers not being employed has become so severe that more than 20 governors in the past year addressed the issue directly during their states of state addresses, offering a range of policies to address the issue as per the National Academy for State Health Policy which is a non-partisan group of state health policymakers.

According to Hemi Tewarson, director of the academy, it’s a significant change. Tewarson was until recently a health policy specialist in the National Governors Association. There has been a long-running shortage of certain health workers. However, she added, governors have instead focused on issues related to the misuse of opioids, prescription drug prices, and mental health.

This year, things changed when governors talked about increasing the recruitment process, easing license requirements and expanding education programs, and increasing provider salaries either directly or by raising Medicaid reimbursements.

Rural and economically weak urban areas, which have a more challenging time attracting health professionals, top the list of sites that federal officials view as “health professional shortage areas.”


“We just have increased difficulty recruiting and attracting folks who want to live and work in a rural area,” said Craig Thompson, Golden Valley Memorial Healthcare CEO. This rural Missouri health facility is located about an hour away from Kansas City.

In 2021, the vacant rate in Missouri hospitals was greater than 20 percent, according to Dave Dillon, a spokesperson for the Missouri Hospital Association. In the coming year, it’s likely to climb to 25 percent for all hospital medical specialties, including respiratory therapists, doctors, medical assistants, and dieticians, Dillon explained.

Similar crises are developing across many states.

Burnout and exhaustion

Burnout and exhaustion are high costs on the health healthcare workforce during the COVID-19 epidemic. According to a survey conducted by Morning Consult, a marketing research company, around 20 percent of health workers quit their jobs during the outbreak. Nearly three-quarters of them admitted to thinking about leaving.


The shortage did not begin with the pandemic, so it’s unlikely to stop because of it.

In 2019, The United States had nearly 20,000 doctors, less than the number needed to meet the nation’s medical requirements, according to an estimate made by the Association of American Medical Colleges, which analyzes the doctor workforce. At the current pace, they said this gap could get up to 124,000 by 2034. That includes the shortage of as high as 48,000 primary-care doctors.

“Within the next ten years, two of every five physicians in the workforce will be 65 or older,” stated Michael Dill, the group’s director of studies on the workforce.

In addition, the population is aging and will require more healthcare. “Just when we need physicians more, we will have a large cohort of physicians reaching retirement age,” said Dr. A. There aren’t enough doctors in training to take their place.

In the same way, the age average of registered nurses who were employed grew from 43 to 48 between 2000 and the year 2018, and nearly half are in the 50s as per research from the University of St. Augustine for Health Sciences in Florida.

The U.S. Bureau of Labor Statistics estimates that every year from now until 2030, there will be more than 195,000 nursing jobs available for registered nurses. The St. Augustine report says that the nursing profession isn’t producing nurses with enough speed to meet the need.


National Nurses United, a professional union with 175,000 members across the country, claims that most states have sufficient nurses to meet the demands. However, the policies regarding staffing and safety at hospitals can reduce the number of nurses willing to fill vacant positions.

“Hospitals often declare a nursing shortage when they don’t have the will to hire more nurses or to change the conditions which are unattractive to nurses,” for example, the safety protocols or the delegating of the responsibility to people who are certified and licensed, according to Michelle Mahon, the organization’s assistant director of nursing practice.

A registered nurse working in an area of medical-surgical care in Kansas City’s Research Medical Center, Zo Schmidt, said the hospital’s ratio of nurses to patients by a percentage from 4-to-1 to 6:1 earlier during the pandemic. This can have dire consequences for certain patients. “I am aware of patients still alive since I saw four patients on that day which I’m not sure would be alive had I had had six.

“We aren’t afraid to work to the max. What really kills us, and why nurses have left is that we don’t feel that we’ve done our best to help the nurses, as we’re only given two hands and are able to accomplish so much in the course of a single day.”

Research Medical Center Research Medical Center did not respond before publication to a question about staffing.


There is also a deficiency of nursing professors to train new nurses. As Raethel explained, one reason is that nursing schools do not pay teachers the same amount as nurses earn while on the job. He noted that private schools in Hawaii provide nursing instructors with a salary of $80,000, whereas the typical wage for registered nurses working in a hospital is $105,000.

Dr. Tochi Iroku-Malize, incoming president of the American Academy of Family Physicians, said doctors are being financially squeezed–mainly primary care doctors, who are reimbursed at lower rates than specialists. “Health care payment needs to be restructured, so people want to enter primary care,” Iroku Maize, a doctor on Long Island.

This contradicts the findings that Dill from the Association of American Medical Colleges stated in his report. “We’ve looked at it repeatedly over the years and found no evidence that economic factors keep down the supply of physicians in the United States,” Dill stated. However, he acknowledged that Medicaid’s poor reimbursement rates might deter some doctors from seeing patients with lower incomes and thereby hindering access to medical care.

Proposals of Governors

Many governors, such as those from Alabama, Colorado, Maine, New York, Wisconsin, and New York, have advocated for higher healthcare workers’ compensation.

In the state address of her state speech, Democratic Gov. Janet Mills in Maine cited the state’s commitment of 600 million dollars in federal and state funds to boost Medicaid reimbursement rates. This will increase the amount paid to physicians who treat low-income patients. She suggested spending an additional $50 million.


New York Gov. Kathy Hochul, another Democrat, suggested the $10 billion expenditure on the health workforce to boost the Medicaid reimbursement rate, give incentives to retain frontline medical professionals, and expand the number of people who go to health healthcare. It is believed that the New York legislature is discussing the possibility of a more significant amount of financial commitment.

Governors from Alaska, Georgia, Hawaii, Maine, New Mexico, and Oklahoma suggested expanding their educational programs to help train nurses and other medical professionals. For example, Georgia Republican Gov. Brian Kemp has said that he is including the sum of millions in his budget plan to further train nurses and expand the medical residency slot. In the future, he added that the aim is to grow the number of health workers by 1,300.

Alaska Republican Gov. Mike Dunleavy cited a state grant of $2.1 million to educate and keep nursing faculty.

In Iowa, Republican Gov. Kim Reynolds announced a new apprenticeship program for high school students, which will allow students to become certified nurses assistants before graduating.

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How people power drives climate-friendly business.



Before, price and manufacturer could have been king when it came to consumer decisions. But spurred by the effects of weather modification, New Zealanders increasingly want to support climate-friendly corporations that are thinking sustainably and performing their bit to donate to a minimal carbon economy and Aotearoa New Zealand.

The study highlights this shift in thinking. Based on EECA’s (the Energy Efficiency and Conservation Authority) regular Consumer Monitor, 82 percent of New Zealanders want corporations to complete more to lessen their environmental impact. And while EECA’s Business Monitor says only 24 percent of corporations think their customers or companies are stimulating them to achieve more, the proven fact that acting on weather modification can provide an aggressive benefit does seem to be gaining ground. This isn’t precisely about the giant corporations, either. New Zealanders want SMEs to be sustainable corporations as well.

Help the planet by choosing businesses with sustainable packaging or bringing your own containers.

Auckland early childhood educator and mother-of-three Dorothy Lacey spends lots of time – and income – shopping on the internet for her family and adding items to her childcare center. As the effects of weather modification have increased, she has discovered himself wanting to see corporations prioritize their footprint.

“Oh, for certain, I look up a business and observe green it is before I get any such thing from them,” she says. “If they’re carbon-neutral or use compostable presentation or perhaps overall have a commitment to increasing things when it comes to the environment, they get my money. It starts to have quite simple to inform which are the great kinds and you then only begin encouraging them and don’t work with the others.”

The ability these customers hold is twofold. Firstly, they inspire buddies and family to follow their case by getting more carbon-conscious when it comes to purchases – EECA’s research indicates that force from buddies and family includes a better effect than a societal strain on the number of weather actions people take.


Citizen Collective beer and bread.

As it pertains to corporations themselves, some do note that lowering energy use and taking a more climate-friendly approach is an intelligent organization’s decision future-proofing them from shifting consumer preferences.

Person Combined is one organization in front of the curve. The Auckland-based opportunity takes unsold supermarket bread and converts it into beer, and then uses the mash from the beer-brewing process to change it into bread.

“After the brew, we were left with this beautiful solution, and we decided there must be a method to use it,” says Add Founder, Person co-founder.

“We’re using less water, land, and energy to cultivate, harvest and dry the barley — that is very intense from a power perception — resulting in fewer emissions.

Customers can encourage businesses to be more climate friendly.

“We’ve also got some great opinions for the very reassuring beer,” says Shepherd. “We reckon we’re performing something worthwhile, but the products have to be excellent to work.”

New Zealanders can also straight inspire corporations to produce improvements to help minimize their energy use and carbon emissions. You will find a range of easy measures we could all follow to encourage corporations to go to the talk.

Taking a more climate-friendly approach is a smart business decision.

Use your effect

Showing the others what you’re performing differently in your living to support climate-friendly corporations is among the main things you can do – so ensure you reveal your finds and ideas, and chat, article and share. Given the energy of recommendations for weather action, we’re all influencers! Keep in mind this is focused on development and not excellence, and its key corporations’ sense is reinforced in (authentically) speaking about the measures they’re taking.

Election along with your budget

Where we invest, our income is the best way to exhibit consumer power. Once a business sees income and manufacturer commitment to being climate-friendly, the others can follow suit. Furthermore, a company not succeeding on an environmentally-friendly top might be incentivized to complete better.


Customers can vote with their wallet and choose climate friendly businesses.

Knowledge is (green) power.

Be interested and stay educated about energy, emissions, and weather change.

Use the practical Manual to the Language of Environment Change on GenLess.govt.NZ to discover or ensure what the words and words about weather modification mean. It will help with speaking confidently about the difficulties with others.

Ask questions

Wondering to visit a business’s sustainability strategy or asking what they’re performing to lower their environmental influence can go a lengthy way. Only a few customers asking could be the impetus a business needs to begin with on the journey. Clients can see if a company has environmental accreditation, like the people offered by B Corp or Toitū Envirocare.

“I’ll inform my buddies and workmates about a business I came across that’s excellent green credentials,” says Lacey. “Frequently, they will be smaller operators and have been encouraged to me, so I then go and pass that info along to someone else.”

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What is Open Enrollment for Health Insurance?



Health insurance is essential no matter what stage of your life. There are some exceptions to this rule, but most insurance policies require that you stay with the plan for an entire year. You can change your coverage and enroll in a new program during the annual open enrollment period. This is everything you need about open enrollment for your health insurance.

What is Open Enrollment?

Open enrollment is when you have the opportunity to change or select your health insurance plan. The timing of registration will vary depending on which method you are enrolling in,” said Anand Shukla (senior vice president, individual markets, Aetna), a CVS Health company.

The Medicare annual enrollment period, for instance, runs from October 15 to December 7. The Affordable Care Act (ACA), Marketplace/Exchange open enrollment period starts on November 1.

“If your employer offers health insurance, you may be eligible for an annual enrollment period. During this time, you can sign up or modify your coverage. Shukla says that it is essential to verify these dates with your employer.


How to Maximize Open Entry Periods

Open enrollment can be accessed in many ways. First, find out when you are eligible. Koleen Cavanaugh (Vice President of Marketing at Independence Blue Cross in Philadelphia) says that your open enrollment period will depend on where and how you buy insurance.

Next, assess your lifestyle and Health. Kyu Rhee M.D. is Aetna’s senior vice president, chief medical officer, and chief medical officer. To help you do this, Kyu Rhee recommends asking the following questions:

  • Are you currently seeing a primary care doctor, or do you see any other medical specialists?
  • Which medications are you taking?
  • What diagnostic tests such as imaging or blood tests do you require?
  • Are you due to receive critical preventive screenings such as vaccinations or cancer screenings?
  • Do you have multiple chronic conditions?
  • Are you planning any procedures or surgeries?

After you have narrowed down what you want, you can start looking at coverage options. Dylan H. Roby, Associate Professor of Health, Society and Behavior, University of California, Irvine’s Program in Public Health, suggests that you look for a plan that suits your needs for the next year, both in terms of monthly premiums in terms of your health needs.

You can also talk to a trusted broker or licensed advisor in your locality to learn more about the available plans. Shukla says that many insurers offer seminars in their local communities, which provide information on programs and allow you to ask questions.

When choosing a plan, consider the four Ds: doctors, drugs, diagnostics, and deductibles. Dr. Rhee says that you should ensure your doctors are connected, that your medications are covered, and that critical diagnostic tests such as blood tests and imaging can be accessed. Also, make sure your deductible is affordable.

He also suggests that you consider hearing, vision, and dental coverage. It is ideal to have telehealth visits or virtual care included in your health plan. He says that your health plan is your ticket for staying and getting well.


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Open Enrollment Management for Different Types of Health Insurance

Roby recommends that you consider more than just the premiums when viewing the details of any health insurance plan. He says that deductibles and copayments are significant, including coinsurance, coinsurance, and out-of-pocket limits.

These are additional tips for maximizing your open enrollment period based on your insurance plan.


The Advance Premium Tax Credit (APTC) is available to anyone who decides on an ACA Marketplace plan. Open enrollment starts on November 1. Shukla says that APTC can be a significant reduction in the premium you pay for insurance coverage, depending on your household income.

Roby adds that reviewing your options at each open enrollment period is wise as the tax credits or subsidies you have may be affected by changes in your local health insurance plans and policies.


Nearly 90% of the consumers who used to get their health insurance received the APTC during the 2021 open enrollment period. The average APTC amount for eligible recipients was 85% of their premiums during the 2020 and 2021 available enrollment periods.


According to Carrie Jardine (a revenue cycle manager at Heading Health in Austin), Medicare health insurance’s initial open enrollment period covers seven months. Heading Health is a mental health clinic. It starts three months before your eligibility for Medicare, generally when you turn 65. It continues until your birthday month and ends three months later.

However, the Medicare annual enrollment period runs from October 15 to December 7. Jardine says that you can either stay on the standard Medicare plan or choose to enroll in a Medicare Advantage plan through one of many commercial payers.

Employer-sponsored insurance

Jardine explains that if you get health insurance through your employer, the initial open enrollment period is when you are eligible to enroll with the employer’s insurance carrier. This is usually determined at the discretion of the employer.

An annual open enrollment period may be offered by your employer, in which employees can choose another plan. However, this is not an obligation for all companies.


Roby says it might be good to join a low-cost, high-deductible plan, significantly if your employer contributes money to your health savings account.

What if I want to make changes outside of open enrollment?

You can’t make any changes to your coverage options after the open enrollment period. This is only possible if you are eligible for a particular enrollment period due to a qualifying life event such as a birth, marriage or adoption, loss of coverage or change of residence, income change, or becoming a U.S citizen. You may be able to enroll in a new plan within 60 days or 60 days, depending on your circumstances.

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For better mental health, add these food items to your diet.



It could be due to many factors. Scientists have identified the gut-brain connection as one explanation. Neurotransmitters are what link the brain to the gastrointestinal system.

Healthy eating is one of the best things you can do for your health. A healthy diet is good for our bodies and minds. Studies show that a healthy diet high in vitamins, minerals, and protein can improve our mental and physical health.

Sutter Health states that a healthy diet can improve our moods and help us feel happier. However, eating a lot of sugar and processed foods can cause mental problems and worsen depression and anxiety. It could be due to many factors. Scientists have identified the gut-brain connection as one explanation. Neurotransmitters are what link the brain to the gastrointestinal system. Additionally, gut microbes produce critical mood-regulating neurotransmitters such as serotonin, gamma-aminobutyric, and gamma-aminobutyric acids, which help manage anxiety, fear, depression, and other emotions.

Bad diets can cause inflammation and negatively affect our emotions. Gut-friendly foods high in fiber, healthy fats, and probiotics can make you feel happier mentally.


Mental health is directly affected by diet.

Our attention and energy levels are also affected by diet. The brain must receive a steady supply of nutrients to function correctly. If the brain does not have certain nutrients, it can cause mental problems. Depressed people tend to prefer quick and easy meals to make healthy meals. This can lead to a vicious circle.

Sutter Health says that processed foods, which are often high in sugar and refined carbohydrates, may provide a temporary boost of dopamine but can lead to long-term inflammation, leading to anxiety and depression. The rush can be followed by a crash, which can cause increased sugar cravings and create a vicious circle of addiction.

Caffeine is another factor that can affect your mood. Too much coffee can be dangerous for your health. Although this popular stimulant is well-known for its energy-boosting properties, it can also cause anxiety symptoms like restlessness, nervousness, and stomach problems. It’s not only what you eat but also how often you eat. A drop in blood sugar can lead to irritation, fatigue, and depression.

Feeling better? Protein, complex carbs, and fatty acids can all help.

Sutter Health states that the brain needs a healthy mix of lean proteins and complex carbs to be more efficient. Lean protein is found in chicken, eggs, legumes, and nuts. It also contains an essential amino acid that the brain requires to regulate emotions. Mainly Omega-3 fatty acids are necessary for nerve cell structure and brain health. A diet low in Omega-3 fatty acids can harm brain functions such as learning, cognition, memory, sleep, and aging. Fish, flaxseed, and walnuts are rich in healthy fatty acids.

Complex carbohydrates are suitable for the brain, but they can also be harmful to the stomach. Complex carbohydrates are rich in fiber and minerals. They include whole grains, brown rice, starchy vegetables, and whole grains. They are also more slowly digested, keeping blood sugar levels in control and providing uninterrupted energy throughout the day.


Try an apple or handful of walnuts instead of reaching for chocolates and chips when you feel down. You will see a difference in your brain and body. Remember that sadness is a normal part of mental health. Even renowned chefs have expressed their feelings.

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