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The U.S. health care system is undergoing unprecedented change. The goals that launched the health reform movement earlier in the decade were to provide better access and consistent quality at reasonable expense. Since the Clinton administration's reform initiative in the early 90's, we've seen all sorts of change. Remember patient-focused care? Remember multiskilling? And, the beat goes on.

In the last couple of years, reimbursement cuts seem to be the strategy used by both government and non-government payers, while quality and access seem all but forgotten. This has caused an extraordinary amount of pain for consumers and providers alike. Hospitals, home health care, HME, skilled nursing and physician providers continue to be squeezed. Many providers have discontinued offering certain services, or worse, have laid off thousands of qualified nurses, physical therapists, pharmacists, speech therapists, occupational therapists, and respiratory therapists with the goal of using lesser-skilled, lower-paid substitutes.

Many of you are witnessing substandard, unsafe care for the first time in your careers. Others are reminded of the horrible conditions that existed in the late 50s and early 60s when unsafe, and in many instances incompetent, inhalation therapy was being provided. It was for those reasons our profession was created. Unfortunately, as the old saying goes, "If we forget history, we're doomed to repeat it." That's what we're now seeing in skilled nursing facilities.

We know you are frustrated. When many of you began your careers, you just wanted to be the best care providers you could be. But, now you must deal with the business side of health care as well as the clinical side. The AARC understands your frustration and has created a new outlet through which you can pose questions about the health care system, the future of our profession, and what AARC has been doing in response to these issues. This new, members only service provides you an opportunity to pose your questions and receive responses that will be posted on our website for the edification of all AARC members.

We recognize the challenges you undergo every day, and we want to help eliminate some of the uncertainty manifest in the health care reform movement. Ask us your toughest questions and we will do our best to provide you with answers.

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