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The hit film about overworked nurses that's causing alarm across Europe
- huijzer 1y agoYes can confirm this is real. I know both German and Dutch nurses who say that the workload is incredibly high. One older nurse also said the pressure today is much higher than years ago.
- thmsths 1y agoI am not surprised. Healthcare costs have been rising faster than inflation for several years. It's a difficult sell to increase budgets, so we have to resort to these "invisible" cost cutting measures to try and stay afloat.
- retrac 1y ago> rising faster than inflation for several years Over here in Canada healthcare spending has been rising faster than general inflation more or less continuously since the 1960s. Seems to be generally true of many wealthy countries. More tech and therapies. And an ageing population. And probably other factors. https://commons.m.wikimedia.org/wiki/File:Health_care_cost_rise.svg https://commons.m.wikimedia.org/wiki/File:Health_care_cost_r...
- betaby 1y agoSalaries probably pay factor as well? Check the sunshine list, plenty of radiologists making 600k/year. That's literally 10x of the median salary.
- thmsths 1y agoThat does not explain everything. While you could make a reasonable case that doctors are overpaid in the US, the same budgetary crisis is happening all over Europe where salaries are much lower.
- betaby 1y agoThe crisis in France is clearly not on the same level that is in Quebec. It's not the only factor, but a serious one. As a continuation of it we have a heavily caped number of doctors what can be 'minted' every year. Same caps exist in the USA states.
- genericacct 1y agoThis also happens in Italy, there's a maximum number of people who can get into med school. However, even though some complain of being overworked, some others complain that increasing that maximum number will lead to unemployment. So apparently medical professionals can either be overworked or unemployed, there is no in between..
- nicoburns 1y agoPerhaps in the US, but nobody is getting paid that in most public European systems. A quick google suggests that the absolute highest pay band for a doctor in the UK is ~£142k (~$190k USD). And there won't be many making that. See: https://www.worktheworld.co.uk/blog/highest-paying-medical-jobs https://www.worktheworld.co.uk/blog/highest-paying-medical-j...
- couchridr 1y agoSure but at least radiologists do something. What do hospital administrators do? Like a university a hospital has bureaucracy that grows.
- zeagle 1y agoThis cherrypicks a high billing specialty, doesn't appreciate an overhead of 25-40% for most physicians, and also overestimates the proportion of physician salaries in healthcare budgets (~15%). You could literally pay physicians half and not save that much. Also is that too high? I know a guy in his early 40s still finishing his 2nd radiology fellowship (4 years undergrad, 4 years med school, 5 years radiology, 1-2 years each fellowship = cost of his 20s/30s) to get a job... I find HN comments on healthcare compensation when it comes up funny because on the other hand compensation expectations in the tech gold mine here are justified. E.g. I take home less in CDN dollars than an L3 SE at google without benefits. I'm happy with what I do/get but there is a mismatch in rationalizing high compensation, markedly more years of university and training, and from my point providing a societal benefit.
- nradov 1y agoAnother factor is Baumol's cost disease. While some aspects of healthcare have been automated, much of it still comes down to individual clinicians performing procedures on patients. https://a16z.com/solving-baumols-cost-disease-in-healthcare/ https://a16z.com/solving-baumols-cost-disease-in-healthcare/
- hungmung 1y agoYeah hospital accounting is weird. I had family in the ER and one of their crappy meals was like $60, for basically just rice and canned vegetables on a tray. A single bandaid cost like $25 or something outrageous like that. This was pre-covid too. I'm sure that same meal is getting close to $100 by now.
- oldpersonintx2 1y ago[dead]
- ajmurmann 1y agoThis will continue to happen as long as automation in health care is slower than in other sectors. It's due to Baumol's Cost Disease: https://en.m.wikipedia.org/wiki/Baumol_effect https://en.m.wikipedia.org/wiki/Baumol_effect The same is true for other sectors that struggle with automation like education.
- ToucanLoucan 1y agoSo after every industry is fully automated and everyone has lost all their jobs, do we all just hold hands and walk into the sea together or...?
- fragmede 1y agoThe way I see it, you have three choices, the government, corporations, or billionaires. It's an oversimplification of power in this world today, but those are your choices. Which one of those do you pick to clothe and feed and house you, after the singularity happens?
- crmd 1y agoAnother potential alternative is healthy capitalism, where a large number healthcare providers are in competition with each other to provide the best service at the lowest cost. In this model a hospital, for example, would be forbidden to buy another hospital down the road, in the same way a doctor’s office would be forbidden to buy a second doctor’s office, because both cases reduce competition.
- kelseyfrog 1y agoThat would be government. Markets don't regulate themselves and monopoly is the natural equilibrium state of capitalism.
- crmd 1y agoNo, it would be a mixed economy, where private individuals and businesses provide most of the goods and services, and the government plays a significant role in regulating the market. Monopolized markets are almost always evidence of regulatory failure.
- Scarblac 1y agoIt's the baby boom. If level of care stays the same then at some point one third of the labour force is projected to have to work in healthcare, it's not possible.
- DANmode 1y agoIt IS possible, just unlikely the industry will be able to command more interest than the sugar-mill → grave pathway that's been established.
- e40 1y agoIn CA, USA. We got a 20% hike in healthcare prices for the renewal we just got this month. 20% is insane.
- markx2 1y agoIt's not just costs. It is patient (and relatives) expectations. It is knowing that any perceived issue could result in litigation. It is that management may well have never 'worked the floor' so have no insight in to what happens. There may well just not be the time to do all the tasks that someone else had decided needed to be done.
- hulitu 1y ago> It's not just costs. It is profits. When someone is sick, or dying, we really need to make a huge profit, before it is too late. Porsches, Lamborghinis, Malibu houses cost money. You can't just sit there and let others do it, instead of you.
- WalterBright 1y agoHealthcare costs have risen faster than inflation since the 1960s, when the government got involved with providing "free" healthcare. Before then, costs tracked inflation. Health care costs that are not provided "free" by the government have fallen, such as lasik eye surgery.
- nradov 1y agoYou seem to have the causality backwards. Prior to the 1960s, the healthcare system couldn't really do much. Most of the drugs, devices, and procedures were relatively cheap. After that the capabilities increased tremendously as did costs, and then government had to get involved to control costs and ensure patient access. (Although many of those government interventions ultimately had the opposite effect.)
- WalterBright 1y agoWhy did Lasik machines decrease in cost, while increasing in efficacy? Drugs were far cheaper before the 1962 FDA Amendments, after that was a massive increase in costs. See "Regulation of Pharmaceutical Innovation" by Sam Peltzman. https://www.amazon.com/Regulation-Pharmaceutical-Innovation-Amendments-Evaluative/dp/0844731285/ https://www.amazon.com/Regulation-Pharmaceutical-Innovation-... See also: How American Health Care Killed My Father https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ https://www.theatlantic.com/magazine/archive/2009/09/how-ame...
- nradov 1y agoDrugs were cheaper back then because they were less safe and effective, and because the easy stuff had mostly already been found.
- WalterBright 1y agoBefore 1962, drugs were already regulated to be safe. 1962 brought about the requirement for effective, which enormously increased drug prices. It's all in the book I referenced.
- huijzer 1y agoTo anyone here open minded enough to give it a shot, I encourage you to read The Real Anthony Fauci, or at least the first chapter. To people who feel resistance: what is the worst that can happen? If you after reading disagree then your brain will soon forget about it anyway so nothing is lost.
- hulitu 1y ago> so we have to resort to these "invisible" cost cutting measures to try and stay afloat. Yeah, this is the narative. In reality we only need increased profits.
- immibis 1y agoMost prices increase faster than inflation, interestingly enough.
- constantcrying 1y agoMuch of the west is getting older and getting sicker. How unsurprising. What even is the solution? Expand the already massive healthcare sector further? Where does the money for that come from?
- kubelsmieci 1y agoSolution: preventive health care, promoting a healthy lifestyle from an early age, and healthy eating
- constantcrying 1y agoObesity is currently only getting worse and many of these sicknesses are already irreversible in people. This also does not do anything about ageing
- nemomarx 1y agoLuckily obesity is getting more and more solveable tbh
- m463 1y agoI imagine that means people will face whatever the next problem is (heart disease, or dementia or etc...) but hopefully at a later age?
- nemomarx 1y agoYeah, although some of them are comorbid with obesity so they shouldn't get too much worse? But cancer treatments probably get more common if you're living longer and your heart doesn't get you, etc
- nemomarx 1y agoCuts down on health costs but also increases life span, so you have the issue with the number of elderly citizens vs number of working citizens who can provide care. That needs to be tackled too somehow.
- wonderwonder 1y ago[flagged]
- bboygravity 1y ago[flagged]
- roughly 1y agoYes, but someone got a yacht for reducing waste and controlling labor costs, so who’s to say what’s right.
- fragmede 1y agoThe person with the yacht, obviously. They have the money to fund making many more movies and marketing pushes about how awesome they are for reducing waste and controlling labor costs.
- asdfj999 1y agoIf I could change one thing about healthcare, it would be how we handle end of life care. Sadly, hospitals are full of 80-90+ year old people who cannot walk or talk for years, advanced dementia plus many other serious comorbidities, with severe malnutrition and recurrent aspiration pneumonia, with large non-healing sacral ulcers, who shit and piss themselves, and the family continues to insist we "do everything" to help this person. It is by far the most demoralizing part of working in healthcare, in my opinion, and an astronomical amount of expenditure and effort goes into torturing these people - at the direct order of the family - only to prolong suffering a few more months.
- hombre_fatal 1y agoIn most places is it even possible to give these people mercy and opt them out of life if they and/or the family wanted to?
- asdfj999 1y agoAt least in the US, in general we talk to the family about code status "Do you want your loved one to receive CPR if their heart stops?". We can make them DNR/DNI. Then next discussion would be hospice. They would have a hospital bed sent to their home, be discharged with a weekly nurse visit and doctor available by phone/text, and get minimal medications focused on minimizing suffering.
- polotics 1y agoDNR: Do Not Resuscitate DNI: Do No Intubate
- graemep 1y agoI suspect this happens in the UK too, although doctors (in my very limited experience of this) do tell families the truth about what they can do. I think there is a cultural problem about facing up to death, because people do not talk about it. It is a taboo subject to many, and people use euphemisms a lot (which is always a sign of a topic people do not want to talk about). We need much better end of life care. Hospices seem to do a great job (no experience from the patient and family end, but I knew someone who used to work in one) but there are not enough of them.
- gonzo41 1y agoTry to avoid a grizzly end of life. Go to the gym, and if/when you get some form of cancer or some other degenerative disease, think about how ending things well is important.
- cratermoon 1y agoEvery time I've been in the hospital - unfortunately too many times -it's the nurses I see and who do the work, with the occasional lab tech visiting to do a test or draw blood. The doctors show up once a day, doing their rounds. Don't get me wrong, I've had some wonderful doctors, hospital patient visits are only part of the work doctors do. I remember the good nurses, the patient nurses who understood why I'd be grouchy, even angry at times, and would sit down and talk to me. I remember the young new nurses, sometimes struggling with an IV placement but persevering to get the skill they know they need. Most importantly I remember how every time I'd wake from general anesthesia, the first face I saw was a nurse letting me know where I was and what's happening.
- jemmyw 1y agoYes but there are more nurses than doctors (2.5:1 oecd average, and it's probably higher in hospitals). The doctors are also working long hours and are under pressure. I've been in hospital more times than I'd like too. I remember one time a doctor in a non-english speaking country helped me in ER and then took me downstairs and bought me a sandwich and talked to me for a little while after a panic attack.
- zackmorris 1y ago"Nurses should be at the very top of our social hierarchy but we live in a world where it’s just the opposite," she says. "This film is a love letter to the profession." I moved furniture for 3 years in the early 2000s to support my shareware business. Something like 500 moves, sometimes 9+ hours per day, occasionally 6 days per week. It made me who I am today, but also broke me in countless ways. I witnessed single mothers giving us $20 tips each (around $40 today) while wealthy people didn't even offer us water. I saw the best and worst of the human condition, sexist pay policies, how workers are exploited by not being provided a schedule for the next few days so they have to call in each morning, how truck fuel costs more than workers' pay, how Right to Work states allow businesses to throw employees away on a whim, how tax brackets at the bottom create the impression that any additional pay gets skimmed by the man, among a great many other injustices, and how all of those conspire to keep the working class down so that a handful of individuals can become fabulously wealthy. With every improvement in tech, I see the gulf widening. We can talk about how poor people now have cell phones and flatscreen TVs, while conveniently ignoring how people with a net worth over $10 million who couldn't spend that money in a lifetime are now buying politicians to shred the social safety net, among other dubious endeavors. I say with complete confidence that the arrival of AGI will bring about ultimate wealth inequality. I foresee a world where 10 billion people work performatively to survive long after robots can do the work better, while less than 1 million people live like gods, free even of senescence. Assuming that we stay on this timeline and don't shift to a more equitable one. I went into computers in the late 1980s to eventually build an android like Data. I didn't know that Turing test-passing AI would arrive 20 years early, or that I would spend the first quarter of the 21st century hustling to make rent due to unfortunate geopolitical realities driven by unmitigated greed and regulatory capture. Now I'm not so sure that I even want to stay in tech anymore. It has been anything but kind to me. Every time I level up, so does the world, and expectations upon me just grow for the same pay. My people-pleasing has cost me my health on a number of fronts. I know that someday, I'll have to choose computers or my life. After all of that, one might think that I'm all doom and gloom. But I'm not. I've come to treasure my time at the warehouse as a teaching tool after a great deal of shadow work. I admire my foreman for being the provider that I can only hope to be someday. I look in awe upon the borderline homeless vets, deadbeat dads and ex-cons who showed me what it is to give without expectation of reward. I see them in all of us, even the people I disagree with, and that gives me hope that maybe we can come together and avoid the iceberg that's about to sink this ship. I'm reminded of this scene from Jaws which always stuck with me: https://www.youtube.com/watch?v=-xQQIqAiTYA https://www.youtube.com/watch?v=-xQQIqAiTYA And I just watched Mountainhead, here's the trailer: https://www.youtube.com/watch?v=27cN2_k0JF0 https://www.youtube.com/watch?v=27cN2_k0JF0 I see a world divided into two camps: one that does much for little, and one that does little for much. It makes me wonder where we all sit in relation to this. What kind of impact we could have on the future, and how that might help everyone to self-actualize. I don't pretend to have the answers. Some of my best years happened when things were at their worst, and vice versa. But I do know that everything is upside-down right now, and always has been, since the dawn of civilization. I feel that tech won't really be tech until it addresses and undoes that injustice. That's why I write this malarky when I should be working. For all the other working people who don't have time to say what needs to be said.
- nsksl 1y agoNurses in Spain make 2500-3000 euro a month, in a country where the most common salary is 1250 euro. Are they overworked? Well then they can take a pay cut so we can hire more of them.
- an0malous 1y agoSame for doctors, we constrain the number of new doctors trained every year to keep their salaries high. Just like constraining the housing supply to keep housing prices high, greed has corrupted these systems from getting better and now we’re just asking people to die instead.
- nradov 1y agoWhich country are you talking about, and who is "we"? In the USA, Congress constrains the number of new doctors trained every year not to keep salaries high but rather to limit Medicare expenses. If Medicare beneficiaries can't get an appointment due to a doctor shortage then no claim will be submitted to CMS. Most of the funding for residency programs comes from Medicare, and every year there are medical students who graduate with the MD but are unable to practice medicine because they don't get matched to a residency program. At one point the AMA did lobby Congress to limit the number of doctors but they reversed their position on that issue long ago. https://savegme.org/ https://savegme.org/
- magicalhippo 1y agoAt least here in Norway, the doctor associations fights hard against any talk about reducing the ridiculously long shifts that nets the doctors large paychecks. They'd much rather have 1-2 doctors do the work of 3-4, so they can cash in. Though there is a change of guard happening. Younger people, including doctors, value work-life balance much more and are less inclined to work long hours for more cash.
- esbranson 1y agoThe US is a federal system, and the states run healthcare and academia. If Congress can tax a state X amount of dollars, that state is obviously able to do so also. New York accounts for nearly half of all state Medicaid GME funding nationally, with NY state Medicaid GME alone reaching ~$1.8 billion of the $4.4 billion total GME spending in NY in 2012 (federal + state + private).[1] And is New York better off? Do these claims about GME hold up there? Don't blame AMA or Congress, blame your dominant state political party. Congress should probably require matching for GME which would completely cut off funding for most states. We can already read the headlines. If you actually knew about this before I mentioned it please let me know, but I think you likely didn't, even though you've obviously spent time researching this important topic. I am actually more irritated how little "people in the know" actually know. It's why I despise outlets like NPR who spread propaganda (agitprop mostly) and refuse to report relevant info and the damage it has caused to America's intelligentsia. Defund NPR and friends, they are the root cause of this mess. [1] https://www.ncbi.nlm.nih.gov/books/NBK248024/ https://www.ncbi.nlm.nih.gov/books/NBK248024/
- Simulacra 1y agoWasn't this Nurse Jackie?
- mensetmanusman 1y agoWe are now 5 workers supporting 1 retiree, this drops to 2 when we retire. The effect on nurse overload will be nonlinear.
- mikewarot 1y agoI just watched the trailer... and yeah... that fits with what I've seen tangentially through my wife's career, and the stories she brought home. In the ER, you at least have a doctor on staff. I can't imagine what it's like to be an understaffed floor nurse. Given the oncoming Tsunami of hospital closures and funding cuts, it's going to get much, much worse here in the US.
- tperdos 1y agoSituation probably will get much worse since Europe decided to enter an endless arms race.... Dark days for Europe, very sad progression. Regarding healthcare workers, at my country, Greece, double-shifts without intermediate break has become the new normal in the last 10-15 years. I think Europe has the most awful leadership ever.
- avipars 1y agohttps://archive.md/KdEbK https://archive.md/KdEbK for non-paywalled version
- Barryospena 1y ago[dead]
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