5 ms·

Yup, news reports about "hospitals are 90% capacity" or whatever is a business decision by design. They might have a couple more floors available but no staff f

Yup, news reports about "hospitals are 90% capacity" or whatever is a business decision by design. They might have a couple more floors available but no staff for them because they aren't scheduled, because patients aren't there. They proactively cut staff wherever possible and then try to react.

deleted 5y ago
[deleted]
schaefer 5y ago
There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.
- nradov 5y ago
  At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.
- RhodesianHunter 5y ago
  There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.
  - mumblemumble 5y ago
    And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
    - dantheman 5y ago
      Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
      - mumblemumble 5y ago
        At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
        dantheman 5y ago
        Where do you think these cartels get their power? Does the clinic post their prices online? Do they provide estimates on what care will cost before it happens? If insurance is costly and troublesome can you compete on a cost basis?
- jaywalk 5y ago
  We should just put new doctors into an emergency six month fast track program.
  - objectivetruth 5y ago
    Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
  - preordained 5y ago
    A bootcamp for doctors, that's the ticket!
- rtkwe 5y ago
  Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.
readams 5y ago
Actually regulations limit the number of beds hospitals can have. The theory is that this will cut health care costs to insurers and the government because they assume hospitals will find a way to admit patients until they are full.
- greedo 5y ago
  Regulations also limit the number of hospitals you can have in a city/county. You have to demonstrate a need for the healthcare facility. Currently 35 states require a CON (Certificate of Need) to open a new healthcare facility.

deleted 5y ago

[deleted]

schaefer 5y ago

There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.

nradov 5y ago
At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.
RhodesianHunter 5y ago
There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.
- mumblemumble 5y ago
  And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
  - dantheman 5y ago
    Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
    - mumblemumble 5y ago
      At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
      - dantheman 5y ago
        Where do you think these cartels get their power? Does the clinic post their prices online? Do they provide estimates on what care will cost before it happens? If insurance is costly and troublesome can you compete on a cost basis?
jaywalk 5y ago
We should just put new doctors into an emergency six month fast track program.
- objectivetruth 5y ago
  Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
- preordained 5y ago
  A bootcamp for doctors, that's the ticket!
rtkwe 5y ago
Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.

readams 5y ago

Actually regulations limit the number of beds hospitals can have. The theory is that this will cut health care costs to insurers and the government because they assume hospitals will find a way to admit patients until they are full.

greedo 5y ago
Regulations also limit the number of hospitals you can have in a city/county. You have to demonstrate a need for the healthcare facility. Currently 35 states require a CON (Certificate of Need) to open a new healthcare facility.