The State of Oregon’s Healthcare

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(St Charles Prineville | Photo courtesy of Neenan Company)

The healthcare sector, locally here in Oregon and across the nation, is a massively important and influential sector of our economy. Not only does this sector affect an individual’s health and well-being, but it also matters due to its sheer economic size. Just about 60 years ago, healthcare accounted for about five percent of the US economy. In 2018, that figure had more than tripled to reach 17.7 percent. Health insurance is now the largest component of nonwage compensation, and healthcare in general has become a massive source of consumer spending. Nationally, about one in eight workers are employed in a healthcare-related field, and the Oregon numbers are very similar.

Therefore, a well-functioning healthcare sector is crucial for a well-functioning economy. This begs the question: how is Oregon’s healthcare doing?

In terms of labor, Oregon has seen both a rise and a decline in certain healthcare-related occupations. Counselors and therapists, physician assistants and clinical social work associates all saw the most growth: 10.4 percent, 8.6 percent and 7.4 percent, respectively. On the flip side, non-clinical social workers saw a decrease of 5.1 percent, while clinical nurse specialists saw the most significant drop of all: 7.1 percent.

Hospitals around the state and nation have reported issues during and after the COVID-19 pandemic and related shutdowns. For nurses especially, the Oregon Center for Nursing has reported difficulties with nursing students completing clinical rotations during the pandemic. While this trend is getting better and clinical rotations have become more accessible in the absence of shutdowns, it is a fact that we are still reeling from the effects.

In short, Oregon hospitals are still struggling. While COVID-19 hospitalizations in Oregon are less than half what they were at their peak last fall, hospitals are still wildly understaffed, and even those with excess beds are having trouble accepting patients due to staffing constraints.

State epidemiologist Dr. Dean Sidelinger told reporters at a press conference in July that Central and Southern Oregon have been hit the worst, especially St. Charles here in Bend. On a random Tuesday this last July, 96 percent of inpatient adult beds at St. Charles Medical Center were occupied, with several patients waiting in the emergency room for the next available bed. If the severity of the situation has not been made clear, Chief Medical Officer Doug Merrill said in a July 15 email, “Now more than ever, we must have no patient in a hospital bed who doesn’t absolutely need it.”

Megan Bovi, a registered nurse at St. Charles for the last 15 years, said in an interview with OPB that the working environment and staffing issues have recently gotten “horribly worse.” Nurses at St. Charles and beyond have been working up to 16 hours in a single day, while many time-off requests have been denied due to staffing constraints. Combine these working conditions with the previously stated effects of the pandemic shutdowns on nurses, and it becomes clear as to why so many hospitals across Oregon and the nation are struggling to hire nurses at all.

A core hurdle in solving these staffing issues is that the issues themselves create a positive-feedback loop: low staffing results in more difficult and strenuous working conditions for the remaining workers, which makes potential new hirers less likely to apply. If new hires are less likely to apply, the issues caused by understaffing will become more challenging to fix.

A key point to be raised for non-healthcare workers is the fact that hospital struggles have persisted well after the decline of COVID-19. Many people across the state falsely assumed that these issues would fade away with the pandemic, but Becky Hultberg, president and CEO of the Oregon Association of Hospitals and Health Systems, said hospitals face a situation as bad as the delta and omicron waves of the COVID-19 pandemic in late 2021 and earlier this year when sick patients flooded hospital rooms across the state.

In short, staffing issues at hospitals were exacerbated by the pandemic, but the leading causes of the issue still persist. For example, much of the issue is actually financial. The first quarter of 2022 was the worst for Oregon hospitals since the onset of the pandemic, and St. Charles has already reported a loss of $40 million this year.

While the state of Oregon healthcare depends on many industries, from physical therapy and podiatrists to dentists and psychologists, there is no denying that the hospital system is the cornerstone holding the entire sector together. Therefore, while Oregon’s healthcare is intact and functioning, action will need to be taken and issues need to be addressed to keep healthcare available and affordable in the future.

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