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Being prepared for such an increase necessary means having that much capacity unused for the rest of the time. The private sector sure as hell isn't going to do

by franga2000 5y ago

Being prepared for such an increase necessary means having that much capacity unused for the rest of the time. The private sector sure as hell isn't going to do it and the public sector is beholden to the general population, which won't stand for "inefficient spending". What politician would dare run on a platform of "we'll build 50% more hospital capacity and hire 50% more doctors, then have them sit idle just in case a global pandemic hits". Two years ago, they would've gotten laughed out of the room.

eru 5y ago
The private sector could totally build the extra capacity. Look at 'peaker plants' for electricity generation. It's worth quoting Wikipedia here https://en.wikipedia.org/wiki/Peaking_power_plant https://en.wikipedia.org/wiki/Peaking_power_plant > Peaking power plants, also known as peaker plants, and occasionally just "peakers", are power plants that generally run only when there is a high demand, known as peak demand, for electricity.[1][2][3][4] Because they supply power only occasionally, the power supplied commands a much higher price per kilowatt hour than base load power. Peak load power plants are dispatched in combination with base load power plants, which supply a dependable and consistent amount of electricity, to meet the minimum demand. > Although historically peaking power plants were frequently used in conjunction with coal baseload plants, peaking plants are now used less commonly. Combined cycle gas turbine plants have two or more cycles, the first of which is very similar to a peaking plant, with the second running on the waste heat of the first. That type of plant is often capable of rapidly starting up, albeit at reduced efficiency, and then over some hours transitioning to a more efficient baseload generation mode. Combined cycle plants have similar capital cost per watt to peaking plants, but run for much longer periods, and use less fuel overall, and hence give cheaper electricity. > As of 2020, open cycle gas turbines give an electricity cost of around $151-198/MWh. The issues is that the natural mechanism that incentivises the private sector to provide peak capacity is what some people call 'price gauging'. And that's a big taboo for 'sacred values' like anything to do with medicine or health.
- bildung 5y ago
  The problem isn't the qualified beds but the personnel. In contrast to gas turbines, which are small standalone plants where an operator already there essentially just presses the power button.
  - sterlind 5y ago
    We've had to massively scale up the number of doctors and nurses before - in WWII. Learning was substantially accelerated and abridged, and the population was being drafted so being a doctor might sound better than being a combat soldier. I don't think this would work here though, since enlisting to work in a covid ward is a hard sell when you're not being drafted, and standard of care would suffer with all the inexperience. Substantially raising nursing pay and increasing the powers of nurse practitioners would be a good idea though.
  - eru 5y ago
    Why? The economics are exactly the same. Many people would happily do some courses (and plenty of refreshers) to be a stand-by nurse or doctor who only gets activated for a few weeks every few years, if they get a few tens of thousands of dollars for that trouble.
- franga2000 5y ago
  The main cost of operating a power plant is fuel, which costs you nothing if not used. Keeping a bunch of doctors (like, thousands) trained and ready to handle an emergency at any moment is a huge ongoing cost with a by definition low probability for a payout each year. Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic. I remember hearing some official on the TV saying we'd need another 300 doctors to keep everything running smoothly. Let's half that. Congratulations: your company is 15 million € in debt. Let's call it 20M € because obviously you need to make yourself at least a little rich too. So that's the bill you need to give the government in order to break even: 20M € for 150 under-trained medical personnel with basically zero work experience. Not a good business model, imo
qwerty456127 5y ago
> then have them sit idle Can't they do research when idle?

eru 5y ago

The private sector could totally build the extra capacity. Look at 'peaker plants' for electricity generation. It's worth quoting Wikipedia here https://en.wikipedia.org/wiki/Peaking_power_plant https://en.wikipedia.org/wiki/Peaking_power_plant > Peaking power plants, also known as peaker plants, and occasionally just "peakers", are power plants that generally run only when there is a high demand, known as peak demand, for electricity.[1][2][3][4] Because they supply power only occasionally, the power supplied commands a much higher price per kilowatt hour than base load power. Peak load power plants are dispatched in combination with base load power plants, which supply a dependable and consistent amount of electricity, to meet the minimum demand. > Although historically peaking power plants were frequently used in conjunction with coal baseload plants, peaking plants are now used less commonly. Combined cycle gas turbine plants have two or more cycles, the first of which is very similar to a peaking plant, with the second running on the waste heat of the first. That type of plant is often capable of rapidly starting up, albeit at reduced efficiency, and then over some hours transitioning to a more efficient baseload generation mode. Combined cycle plants have similar capital cost per watt to peaking plants, but run for much longer periods, and use less fuel overall, and hence give cheaper electricity. > As of 2020, open cycle gas turbines give an electricity cost of around $151-198/MWh. The issues is that the natural mechanism that incentivises the private sector to provide peak capacity is what some people call 'price gauging'. And that's a big taboo for 'sacred values' like anything to do with medicine or health.

bildung 5y ago
The problem isn't the qualified beds but the personnel. In contrast to gas turbines, which are small standalone plants where an operator already there essentially just presses the power button.
- sterlind 5y ago
  We've had to massively scale up the number of doctors and nurses before - in WWII. Learning was substantially accelerated and abridged, and the population was being drafted so being a doctor might sound better than being a combat soldier. I don't think this would work here though, since enlisting to work in a covid ward is a hard sell when you're not being drafted, and standard of care would suffer with all the inexperience. Substantially raising nursing pay and increasing the powers of nurse practitioners would be a good idea though.
- eru 5y ago
  Why? The economics are exactly the same. Many people would happily do some courses (and plenty of refreshers) to be a stand-by nurse or doctor who only gets activated for a few weeks every few years, if they get a few tens of thousands of dollars for that trouble.
franga2000 5y ago
The main cost of operating a power plant is fuel, which costs you nothing if not used. Keeping a bunch of doctors (like, thousands) trained and ready to handle an emergency at any moment is a huge ongoing cost with a by definition low probability for a payout each year. Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic. I remember hearing some official on the TV saying we'd need another 300 doctors to keep everything running smoothly. Let's half that. Congratulations: your company is 15 million € in debt. Let's call it 20M € because obviously you need to make yourself at least a little rich too. So that's the bill you need to give the government in order to break even: 20M € for 150 under-trained medical personnel with basically zero work experience. Not a good business model, imo

qwerty456127 5y ago

> then have them sit idle Can't they do research when idle?