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Ultimately, it's payers -- taxpayers and insurance payers -- that aren't down the the "hire more people" solution. Another stakeholder group that's not down wit

Ultimately, it's payers -- taxpayers and insurance payers -- that aren't down the the "hire more people" solution. Another stakeholder group that's not down with it? Doctors. The AMA, who doctors control corporately, don't certify enough medical schools to train sufficient doctors to make the reality you want possible.

whatever1 5y ago
Does the AMA certify the colleges of nurses? No. And yet here we are: https://www.theguardian.com/society/2019/feb/12/nurses-hospitals-understaffed-risks-burnout https://www.theguardian.com/society/2019/feb/12/nurses-hospi...
- asdfasgasdgasdg 5y ago
  I didn't say doctors were responsible for all understaffed roles in the country. But they are partly responsible for understaffed physician roles. :) The payer aspect I mentioned is relevant for the nurses.
  - whatever1 5y ago
    In America we pay on average ~$3000 per day of stay in the hospital. How much extra do we have to pay to have enough nurses so that we don't work them to death? Why British hospitals have a fraction of that cost (1/10th)? Oh yes, it is because they decided that it is not a moneymaking business. Overworked employees should not blame themselves for not being able to keep up with unreasonable hours. They should blame the real responsible for their misery. Their employer.
    - asdfasgasdgasdg 5y ago
      It feels good to have a villain to blame, but in a complicated problem, there are often complicated reasons. https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp https://www.investopedia.com/articles/personal-finance/08061... Hospital profits are part of the costs, but doctors and nurses here are also paid more than elsewhere. Doctors in the US are paid multiple times as much as doctors in the UK, and supply restriction is a big part of why that is possible. There are also administrative costs, drug costs, and insurance overheads to deal with.
      - nicoffeine 5y ago
        It's not that complicated. When we setup competition for infrastructure, we needlessly duplicate management, marketing, accounting, and everything else that does not directly result in the service being provided. The US is doubly idiotic by creating huge financial barriers for anyone who wants to enter healthcare. We make the problem even worse with a system that encourages people to delay treatment for problems that get more expensive to treat over time. The less money you have the more you delay, so the entire system eventually ends up overpaying for a worse outcome. This doesn't factor in all the time spent dealing with inscrutable billing practices for fully insured people having routine medical procedures, or the tens of thousands who are bankrupted every year by the same practices. We recently took our daughter to the ER, which is supposed to be a $400 copay. We now have three separate bills from that visit totaling $1100, and I have no idea how many hours it will take to sort out. The same billing department sent us a $380 invoice six months after her birth because (in their description) they forgot she was there.
        bumby 5y ago
        >It's not that complicated Just out of curiosity, what’s your proposed solution? There's been decades of very smart people working on this problem and its still a problem largely because of its complexity. If there was a simple solution, I have a feeling it would have been implemented already. The irony of your post that starts with "its not that complicated" ends with an anecdote about just how complicated the system is.
        nicoffeine 5y ago
        It was an anecdote about how complicated the US system is. Other countries figured out decades ago that adding competition to healthcare does not bring down the price or lead to better life expectancy. It is not complicated. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.ht...
        5y ago
    - bumby 5y ago
      There’s a saying that your can choose between access, quality, and low cost but you can only choose two. The US system has chosen quality and access at the expense of cost. Other countries benefit largely from the US healthcare R&D machine. The US funds over 40% of the world medical R&D. While other countries put price controls on their medicine, this arrangement won’t work with the current system if the US does the same. To a certain extent, US high prices partly subsidized the rest of the world.

whatever1 5y ago

Does the AMA certify the colleges of nurses? No. And yet here we are: https://www.theguardian.com/society/2019/feb/12/nurses-hospitals-understaffed-risks-burnout https://www.theguardian.com/society/2019/feb/12/nurses-hospi...

asdfasgasdgasdg 5y ago
I didn't say doctors were responsible for all understaffed roles in the country. But they are partly responsible for understaffed physician roles. :) The payer aspect I mentioned is relevant for the nurses.
- whatever1 5y ago
  In America we pay on average ~$3000 per day of stay in the hospital. How much extra do we have to pay to have enough nurses so that we don't work them to death? Why British hospitals have a fraction of that cost (1/10th)? Oh yes, it is because they decided that it is not a moneymaking business. Overworked employees should not blame themselves for not being able to keep up with unreasonable hours. They should blame the real responsible for their misery. Their employer.
  - asdfasgasdgasdg 5y ago
    It feels good to have a villain to blame, but in a complicated problem, there are often complicated reasons. https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp https://www.investopedia.com/articles/personal-finance/08061... Hospital profits are part of the costs, but doctors and nurses here are also paid more than elsewhere. Doctors in the US are paid multiple times as much as doctors in the UK, and supply restriction is a big part of why that is possible. There are also administrative costs, drug costs, and insurance overheads to deal with.
    - nicoffeine 5y ago
      It's not that complicated. When we setup competition for infrastructure, we needlessly duplicate management, marketing, accounting, and everything else that does not directly result in the service being provided. The US is doubly idiotic by creating huge financial barriers for anyone who wants to enter healthcare. We make the problem even worse with a system that encourages people to delay treatment for problems that get more expensive to treat over time. The less money you have the more you delay, so the entire system eventually ends up overpaying for a worse outcome. This doesn't factor in all the time spent dealing with inscrutable billing practices for fully insured people having routine medical procedures, or the tens of thousands who are bankrupted every year by the same practices. We recently took our daughter to the ER, which is supposed to be a $400 copay. We now have three separate bills from that visit totaling $1100, and I have no idea how many hours it will take to sort out. The same billing department sent us a $380 invoice six months after her birth because (in their description) they forgot she was there.
      - bumby 5y ago
        >It's not that complicated Just out of curiosity, what’s your proposed solution? There's been decades of very smart people working on this problem and its still a problem largely because of its complexity. If there was a simple solution, I have a feeling it would have been implemented already. The irony of your post that starts with "its not that complicated" ends with an anecdote about just how complicated the system is.
        nicoffeine 5y ago
        It was an anecdote about how complicated the US system is. Other countries figured out decades ago that adding competition to healthcare does not bring down the price or lead to better life expectancy. It is not complicated. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.ht...
        5y ago
  - bumby 5y ago
    There’s a saying that your can choose between access, quality, and low cost but you can only choose two. The US system has chosen quality and access at the expense of cost. Other countries benefit largely from the US healthcare R&D machine. The US funds over 40% of the world medical R&D. While other countries put price controls on their medicine, this arrangement won’t work with the current system if the US does the same. To a certain extent, US high prices partly subsidized the rest of the world.