Low Wages and Their Impact on Health Care Workers

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Health care workers face a variety of issues on a daily basis that can impede their ability to practice medicine in a safe and successful way. Though much progress is being made on a national level as well as through regional, state-level, and local involvements, low income continues to be a topic of serious debate and challenge for employers and employees within the medical field.

Entry-level workers are disproportionately affected. Home health aides and nursing assistants are in high demand but are offered exceedingly low wages, uncertain work hours, limited access to benefits, or career progression. Due to current employment options, many health care workers are independent contractors and do not have a stable income or employment agreement (McDermott, 2020). This surrounds them with a multitude of issues such as being ineligible for paid sick leave or being protected against harassment and discrimination. Additionally, the schedule can become unpredictable and cause these workers to be penalized for not accepting last-minute changes.

Currently, a fee-for-service, also known as FFS, is being implemented to pay most healthcare employees. But the current Resource-Based Relative Value Scale created by the Centers for Medicare and Medicaid Services places much more precedence on specialist services and a significant disregard for primary care (Park et al., 2018). The solution is not simply to increase wages but to create a strategy that will allow for performance growth and stability within the worker’s life and career (Vujicic, 2009). Though the accessibility it allows to patients is an advantage, it does not consider the well-being of primary care workers.

As such, a solution was hypothesized in prospective payments within the primary care model. The comprehensive primary care payment and direct primary care (DPC) allow the work settings to manage the fees in a way that will benefit their community and implement a reliable primary care infrastructure. Since the models are risk-adjusted, they take into consideration the opportunities of the patients while not discrediting the difficulties the healthcare workers face and would allow these employees to take leave or speak up in the workplace without fear of being completely financially despondent.