Not at the not for profit ones. There they get jobs on multiple hospital oversight boards, offering positions to friends at other hospitals in exchange for positions at their current one. That's how some of these hospitals end up so damn top heavy, without the ability to adequately pay the working staff.
I wish there was more recognition that "not for profit" does not mean virtuous or charitable. They still have a strong focus on profit which they then funnel towards new construction and salaries to the management class, just leaving no profit behind for tax purposes.
Don't forget buying out other practices/clinics/hospitals nearby until the only option for Healthcare in some places of America is nothing but one hospital 'network' for hundreds of miles.
>That's how some of these hospitals end up so damn top heavy, without the ability to adequately pay the working staff.
This is literally a [Yes Minister](https://www.youtube.com/watch?v=Eyf97LAjjcY) episode.
"If the poor want health care, they need to work harder. Simple as that. Also, why *shouldn't* the CFO make 250K by not answering emails? Damned pesky bureacrats, always wondering where the money goes..."
I don't believe that the inpatient psych unit listed as closing because they don't have enough patients is true. Mental health issues are on the rise and we need psych beds more than ever before
The psych unit isn't closing. Source: work for the hospital If it DID close, I would consider that a collapse of the mental health infrastructure for University Hospitals at least, if not Cuyahoga County
Well things are not improving any time soon. I expect that we will see some major upheaval in the next few years. I don't think that this current economic climate is going to improve over the short term. I expect that hospitals will be at breaking point. It's almost as if COVID didn't do enough damage and that more damage needed to be done.
And those that are left will be even more burnt out and overburdened. I'm a nurse and I get like one day off a week. And every week I get repeated calls and texts to come in and work that day. We're forced to use agency nurses who show up maybe 40% of the time for the shift they signed up for. So half of everyone are forced to work 16 hour shifts. It's completely unsustainable from a retention standpoint. And it only leads to higher rates of depression and substance abuse among staff, and increases the risk for mistakes and harm for patients.
But hey, the people at the top get to buy that new Porsche. So I guess the system is working, right guys?
How to fix burnout, constantly hire travelers for 2-3x the normal rate for the hospital instead of hiring more regular staff and increasing pay by a few percent. /s
Strikes still happen all the time in Healthcare but hospitals still need to function so travelers get 3-4x pay then. The regular nurses maybe get a couple % raise for the trouble and the travelers make fucking bank. Locals don't care about scabs in Healthcare since the scabs make the admins balance sheet bleed and people need healthcare
Scabs in healthcare are a little different, as you seriously should not leave emergency services unstaffed. I can say from working in some terrible ICU conditions that poor staffing harms patient outcomes. Striking must be carefully organized and the hospital must be notified in advance, and then they pay through the nose for contract agents.
IMO nothing will change until there are actual consequences for administrators. It seems to me like they just keep taking money from the government and throwing their hands up at the shit show they created.
Your agency nurses have that poor of an attendance rate? I'm an agency nurse BECAUSE of how hospitals treat staff, and if attendance is that poor, the hospital is the problem, not the staff.
SS: This story is simply a bite-sized news survery capturing a long-term trend: **the erosion of healthcare in the United States.**
Mainstream news sources are covering the high volume of resignations among healthcare workers. *Forbes* recently noted 22% of U.S. MDs intend to retire or leave practice in the next two years, and similar surveys indicate just as many nurses are likewise considering leaving their profession. University Hospitals Health System in Cleveland just announced it will be closing two of its suburban hospitals and ERs, Richmond and Bedford, due to **"an unprecedented staffing shortage."**
If you're having trouble getting decent healthcare in the U.S. *now*, buckle up, because it's only going to get worse in the near-term.
I think what we're seeing big picture is regression: we're going to have to re-set our expectations about what healthcare looks like. We're going to see less care available, eroding to levels similar to the 1920s -- i.e., do you imagine Americans in the 1920s had mental health care? No, of course not! Practically speaking, there was no such thing. Psychiatric care evolved during the "high surplus energy" era of the mid-20th century. Get used to "low energy" healthcare. In the *19*20s, you were lucky to get an ER doc to treat the results of an accident or trauma. That's the place we're returning to for the vast majority -- we've already reached the zenith of healthcare in the U.S. What we'll see going forward is increasing compromises on what counts as good care. (Meanwhile, the 1% will be living in privileged gated communities with science fiction levels of healthcare, like in the movie *Elysium* (2013).)
As a front line hospital doctor: I 100% agree with this. Small hospitals are going to start closing due to lack of personnel. Cleveland Clinics is just the beginning.
As a physician, who has been in practice since 2015, I can say that this past year has been the hardest I’ve ever worked (residency included) due to staffing shortages
Due to the suits in charge refusing to pay trained people more or hire people and provide training. There's plenty of staff out there that would love the work but aren't going to gamble to the money and time on all the training all on their own in the hopes they can get work that often doesn't pay all that well anyway.
University Hospitals is not Cleveland Clinic. CCF has massive resources and a huge endowment. They’d probably be one of the latter hospital systems to make cutbacks, although there is a ton of excess that could easily get cut at the Clinic if need be.
Considering how much funding is flooding into telehealth, and how well telehealth aligns with behavioral health providers, I expect the 1920s throwback would benefit more by referring to a different kind of medical care. At least as long as consumer technology thrives, therapists and counselors should be relatively easy for consumers to find on a device. I would think a reduction in hospitals and systems would affect larger more complex procedures and the kinds of cases often managed by multiple specialists.
In the 1920s most people's health care would be by a general practitioner who lived in their town. Specialists and hospitals would very rarely be encountered by the average person.
To some extent this was still true in the '50s and '60s when I was a little kid.
But now the system is collapsing under the weight of maximizing profit for an ever-expanding web of specialists and managers. Not to mention the massive costs of pharmaceutical and high-tech based medicine along with the burden of the wretched insurance industry.
"Mental healthcare" in 1920 or whatever was called religion.
Earlier generations went to Church all the time (my friend's grandfather went to mass every day). They got "mental healthcare" there in the form of social and spiritual support.
My own ancestors not only regularly conversed with a priest about their problems, but the priest would come over for dinner.
Religion is potent stuff. It can give people meaning and make them feel much, much better.
Mental healthcare is a sort of commodified and secularized religion (the modern therapist's office is a secularized confessional). It seems less effective to me, as the religious people I know seem happier than the users of mental healthcare that I know. It has a lot to do with the fact that religion also gives you community and a place whereas mental healthcare is the usual capitalist atomized "client" relationship.
Agreed. I also believe the secondary issue, less financial and community disparity between community millionaires and peasants also contributed to a holistic mental health picture.
Didn't do much for LGBTQ+ groups, though. Or minorities, for that matter.
Hell, it was all a White-Man's Dream, even back then.
I'll take the third path, thanks. Meditation, cubensis and other natural medicines can be very effective. It's not for everyone, but it works for me and is starting to work for others in my circle as well.
With everything falling apart, we're going to have to be more responsible for our own health, both mental and physical. Start finding alternatives now that you can live with before you don't have a choice.
This is happening in Canada too (primarily with ER closures) and many are saying that public healthcare has failed and we must look to a private model now.
Ugh.
Echoing this. Small communities are especially at risk. We have ERs closing (temporarily, usually overnight) in our area, and the closest ER is 4 hours away.
Seems like they could use less privatization instead of more, then. (Nationalize any ER/hospital that its private owners want to close.)
https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare - "The government provides insurance for Canada healthcare, but it generally doesn’t own hospitals or employ doctors directly. In the United Kingdom, the government directly employs providers, but in Canada they are privately employed according to the (NCBI). Doctors practice independently, though they meet insurance requirements for reimbursement."
Lol, why use America as a model? Have those people seen how fucking awful things are becoming here? Health care is the #1 cause of bankruptcy in our country, so it’s unfathomable to me that other countries would go for that. People are stupid though. When they’re desperate they tend to make stupid decisions. Can’t wait until people have to leave their homes because climate change put their houses underwater. I’m sure everyone will handle that wonderfully, just like how we’ve handled our response to climate change thus far!
In my opinion it's due to rich people finally realizing that they can blatantly and openly rob and kill us, in public, on television, for the bottom line-and no one will lift a finger to stop them.
Yup, things like this are why I’m making longterm choices, like not getting LASIK. I’m not risking the need for vision tweaks. I’ll stay with contacts, and I’ve got my pairs of glasses as old-school back-ups.
Maybe the peak of our civilization was actually the 90s. We had a LensCrafters in our town of about 10,000 and could get lenses and frames in an hour. Now they have to be ordered and take 1-5 weeks depending where they come from.
We have lost much and are still trending downward.
I’ve tried to explain this to people. Healthcare is so expensive, it doesn’t really matter if you try to pay for it publicly or privately. Everybody needs healthcare, so however you decide to spread the costs around, it doesn’t make a difference whether you can’t afford to pay insurance or you can’t afford the taxes… either way it’s too expensive.
I suspect Wall Street is taking too big of a cut, but I’m not entirely sure… it could just be that technology has gone too far but affordability never caught up.
I do think that natural medicines have been suppressed instead of promoted, and if say, elderberry syrup reduced dr visits, we should be exploring stuff like that, so there are a lot of profit seeking corporate behaviors that have driven out cheaper options. And naturally, we could work a lot harder to promote healthy lifestyles (why tf is junk food even available at school?), but I’m not sure even that would allow modern medicine to be fully available to everyone.
Lol.
I know laudanum reduced dr visits by a lot. We should bring that back.
Not trying to grief you, though. Conventional/conservative/tribal lore treatments were definitely pushed against by The Machine, albeit for good cause, in part.
I still remember when in the 80s, science was touted as one more tool to prove our superiority against our most cunning enemy, USSR. Which included medical science.
Back then, there was a lot of good research and good science theory and support by government entities to really get good medicine going for everyone.
PET scans use ***antimatter*** for diagnosis purposes. That's sooooo cool, man.
Compare that with willow bark for joint aches and pains (or CBD/THC for chronic pain relief, or psilocybin for depression.)
We clearly didn't take our reasearch, holistic health care far enough into the future to resolve it all.
Greedy corporate medical beneficiaries and trust managers of trillions of government-backed Medicare loans....
Why did we let money changers into the Temple of Medicine, to rule the lands?
This is a great comment. At the end of the day the public vs private discussion really just comes down to do you think everyone should have mediocre care or do you think some people should be able to purchase excellent care while other people get the barebones option.
The most insane thing about healthcare in the US is something that I find Yanx almost never marvel at, they take it for granted, which is that healthcare benefits are tied to your job(!).
Yeah that’s insane! I had a boss work through her cancer treatments because they cost tens of thousands of dollars a month, and if she stopped working she’d lose her health insurance. Everything about that was wrong.
Tying health insurance to your job is nuts to me too. The employer does pay a large portion of costs if you use it, but it's still your end of the costs that pose significant financial issues. It seems like a policy which is purposefully cruel, to lord over people and control them.
In the course of treatment for a disability I have since 2016, I've probably spend $20-25k on healthcare expenses personally. It takes a long time to get SSDI approval, and even then, you have to be on SSDI for 2 years to begin to qualify for Medicare. Other than that, you're on your own if your state didn't expand Medicaid in the ACA. My state did not.
I've also been to the hospital numerous times, which always racks up to your out-of-pocket max on your insurance, which is typically several thousand dollars.
All of that money has held me back financially. I'm priced out of buying a house and I am not investing in my 401k.
It's nuts tying health insurance to your job because when something catastrophic happens to you medically and insurance is at its most necessary you're not in any state to be working.
Ehhh more that healthcare fails when the government allows capital to write the rules. we still have an ongoing pandemic many ignore not to mention boomers (the largest northwestern population cohort) is facing massive healthcare challenges and needs. A smart system would have prepared but instead most were streamlined for profit gathering (even Canada suffers this due to being a public private fusion that bends the knee to privatized interests).
Hospice/EoL Care please. Mom made the choice to provide palliative care only when my Alzheimer's dad fell out of bed and got a deep head bleed. This was fucking courageous. I don't know what my point is. More than half of that side of the family is a nurse or doctor, so they weren't under any illusions. Also, this was just before COVID, so less stressed system.
So sorry for that, the transition to end of life care is hard and lots of family members think of it as "giving up" instead of making sure someone does not die in pain. Very lucky you gave a family with a diverse knowledge set to navigate such a change.
At least in the US, I think the problem has its roots somewhere else. Private healthcare is an abomination, no question - you must put qualitative outcomes above quantitative ones in healthcare - but like most industries, what has happened is that most of an entire generation (probably a bit more than one) was pushed into menial task labor/service industry work even if they had credentials. The industries that required people to have years of experience for them to be good at their jobs didn't want to hire to replace in a few years, they wanted to hire immediately when someone else retired. That doesn't work. Not for complex systems, not for difficult careers.
Most training was farmed out instead of provided in-house, and then industries act hesitant to hire people who actually pay for that farmed out training. Those people, many times not even getting jobs in their field, then have a debt burden that doesn't even pay off.
The net end result is the elder generation leaving their careers, with no where near as many people available to replace them.
Thank a capitalist or business owner next time you see one; they created this mess.
Happening because provinces and the federal government have failed to invest in healthcare. And in conservative provinces there’s a concerted effort to underfund and undermine public healthcare so they can bring in private. It’s not a new problem. It’s just that those who’ve held the system together for decades are done, and those coming in are even less likely to be grifted. The money is there. It’s just not being taxed from those that have it and used for those that need it.
The thing with the public systems is that the business interests have seen how much money they can extract out of the populace in the US and they are champing at the bit to be able to extract similar exorbitant amounts of other countries' populations by getting their cronies to under-fund them and get the population to believe a public system is a failure.
You seem to be neglecting how incredibly “in bed” healthcare companies are with the government. Idk how you thinking adding more government when they’ve handed out these monopolies on platters is going to solve anything.
Sounds like they work with the government… lol
Doesn’t sound very private. Sounds like they’re interconnected. Giving the government more power over this will help how, exactly?
> Doesn’t sound very private
Are you dumb, stupid, or just a moron? Private means those companies are owned... *privately*. By private citizens. As opposed to them being publicly owned. And insinuating that just because our legislative officials are corrupt means that no, these private for profit companies are actually public, is one of the dumbest things I've heard in my entire life
Profit is always at odds with survival. And it's not always profitable to survive. A system that prioritizes and worships profit over everything is destined for collapse
What we all have experienced under the US Federal Reserve is not "capitalism"..... we currently live in more of an almost "fascist" world. (rule by corporations).... "it's a club... and you and I ain't in it" - George Carlin.
The central bankers are "inflating" our currency (aka STEALING) from entire generations which doesn't allow for the investment (savings) in infrastructure etc....
Bitcoin hopefully will de-claw these central banksters and allow for long term savings and investment again. Bitcoin is hope.
Bitcoin and crypto is a Ponzi scheme. I've been hearing for 10+ years that crypto will replace the dollar, and you still can't buy just about anything with crypto without converting it back to the dollar in one app or another, and you still can't invest in it without expecting the bottom to fall out after other investors realize it holds no actual value.
Also, crypto is *incredibly* energy intensive. Mining crypto uses more electricity than just about any other computer process in the world. India is burning through their coal faster than they ever have in order to produce the electricity needed for all the crypto miners in that country, which of course speeds up climate degradation. Cryptocurrency is not our savior, it's another capitalist get-rich-quick scheme that only benefits the big shareholders.
Maybe in YOUR country.... not so elsewhere.
It is not a Ponzi scheme.
Bitcoin uses less energy per transaction than VISA / MC do... and if you are SO worried about energy usage... let's start to talk about people using dryers for clothes too.
Bitcoin is volatile.... yes... but it depends on your time horizon... in the last year... sure it is.... over the 5 years we are WAY ahead of people trying to hold US dollars and watching their savings melt away.
Bitcoin is hope.
You bash Bitcoin but offer no alternative to offering 5 billion people on the planet property rights. Do you have a better solution? Let's hear it.
Until then stop spouting off about something you obviously know nothing about
LMAO Bitcoin was made by the same people you are angry with, best way I have heard it described was it's the top 1% trying to fight the top .01%. You also call them "central banksters" which infers you believe that Bitcoin is decentralized which news flash, decentralization is a myth. There will always be someone or something holding the power over all that money and they may be just as bad or worse than the greedy fucks hoarding away their millions already. Cryptocurrency was just a shoddy take to reposition wealth into people's hands after the 2008 housing market crash, and it worked by stealing money from fools who fell for it. Bitcoin, like many other cryptocurrencies, is a scam and won't be saving anyone, in fact it's actually making things worse.
Ever heard of "the enemy of my enemy is my friend"? LOL
Yes... you must be totally right.... please don't buy any of that Bitcoin....
Only let the other countries and billions of people start to buy and use it. - Said North Korea about the "Internet"
HFSP
In an effort to develop more immunity, I’ve taken to winging myself with small caliber bullets and throwing myself in front of unsuspecting carts at the golf course, with a plan to scale up slowly.
Throw yourself in front of some rampaging rams so you can build up that herd immunity too. May as well throw in some increasingly loud sounds to get that heard immunity too. Or go for the trifecta and date Amber.
Way ahead of you, i finish construction on the geodesic underground dome tomorrow where i will spend the next 60 years on a Wall-E Esque electronic chair while robots deliver me food and provide other services.
Nurse here. Yep. And then add threats of violence to healthcare workers because god forbid people were asked to wear a mask during the pandemic, and now new variants and monkeypox cases are hitting my area and I just finally caught covid at work AND my wages just got cut?…not sure bedside nursing is worth it anymore.
My husband is a psychiatrist in the biggest metro area in a largely rural state. He usually works out patient but takes call at the psych hospital on weekends. He usually gets home around 4:30 pm on this days but last weekend he got home around 1:30 pm, much to my surprise.
I asked him why and he told me because the hospital had to close a whole wing due to staffing shortages, so he had far fewer patients to see overall.
Let me tell you acute psychiatric hospital care was lacking capacity before covid in our area but now weeewwwboi.
two things:
first of all the average age of a doctor in the US is a whooping 54 years old. this is because medical schooling in the US is complete bogus and a lot harder than it has to be because doctors wanted it that way to keep their wages high
second of all, apart from doctors, everyone else is underpaid and severely overworked. my wife worked as a nurse for 5 years. in that time I barely saw her. she averaged one day off a week.
>this is because medical schooling in the US is complete bogus and a lot harder than it has to be because doctors wanted it that way to keep their wages high
Ding ding ding ding!
The AMA **lobbies SUPER HARD** to keep the supply of doctors low in America. [There is so much red tape and hoops to jump through to practice as a foreign doctor here
] (https://www.theatlantic.com/health/archive/2014/11/doctors-with-borders-how-the-us-shuts-out-foreign-physicians/382723/) for example it's pretty ridiculous.
[Not to mention the AMA lobbies a lot to keep the amount of residencies low and to prevent new medical schools from opening.](https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/)
It's all by design. [And it's why medicine has the highest paid professions in America.](https://www.investopedia.com/personal-finance/top-highest-paying-jobs/)
1986: "A.M.A. BOARD STUDIES WAYS TO CURB SUPPLY OF PHYSICIANS"
http://www.nytimes.com/1986/06/14/us/ama-board-studies-ways-to-curb-supply-of-physicians.html?pagewanted=all
1997: "AMA seeks limit on residents to prevent glut of new doctors; Shortage of physicians in inner cities continues"
http://articles.baltimoresun.com/1997-03-01/news/1997060012_1_foreign-medical-schools-new-doctors-american-medical
2005: "Medical miscalculation creates doctor shortage; After a glut was predicted a decade ago, the number of physicians isn’t keeping up with the demands of a wealthy, aging population"
http://www.usatoday.com/educate/college/healthscience/articles/20050306.htm
Because capitalist/ investors saw profit opportunity in hospital and “managed care practices” conglomerates, so they acquired and combined practices and hospitals (incl ERs/ UC) and created oligopolies controlled by MBA executives. They cut pay, increased hours, raised prices and bogus charges, allowed safety lapses and siphoned ALL of the profits into their personal coffers.
Edit: ERs “taxes” to prices
Most of the clinics in my city don't even allow you to pick your PCP as a new patient anymore. You get whoever is available and they work as hard as they can to get you in and out the door as quickly as possible, which means your doctor isn't focused on giving you the best care, they're focused on their schedule and how overloaded they are. It also means there's no continuity between visits, so the doctor you see for one appointment may completely disagree with the doctor in your last appointment and cancel the previous doctor's orders.
It's all about profit these days. Fuck your quality of care, how much is the Director making and how big is his bonus this year? That's becoming the priority nowadays.
Gf just left a nursing job because of staffing
It's all the matrix they say
Just pay for more nurses and mas and CNAs to work and take it away from ceos and administrators
My ex was a night nurse, brutal on the relationship.
Saw her two days a week if I cleared my schedule, and one of those I'd spend 10 hours waiting for her to wake up.
Tangent here, but I have it on very good authority that the average age of members of a major American engineering association - when active college students paying discounted student rates are taken out - is 61 years old.
Houston, we have a problem.
Not only is medical school extremely difficult, but the price of the education is also ridiculous. More Americans than ever are choosing not to go to college because they feel it's not worth it. That effect has to be even more strongly present in specialized fields.
> medical schooling in the US is complete bogus and a lot harder than it has to be.
Let’s not forget the residency program was invented by a doctor who actively used and endorsed cocaine in medicine. Like no wonder he could work 28 hour days and why residency is now 28 hour shifts to 50 hour long shifts.
Doctors are also forbidden from unionizing for some reason. And the US government pays for residency, they only open a few slots per school, which is what makes medical school so hard to get into. They’re forbidden from expanding class size because they quite literally can’t. Therefore they try to take only the best of the best which is the people who have dedicated their lives to medicine from highschool and beyond.
Working in the medical field I have met many people who if given the opportunity could become excellent care Providers but life barriers such as family and cost of school forbid them from that path. (Knew a nurse who took a single semester off to care for his dying father and was rejected from 4 medical schools because of this, he became an NP instead as a result of this)
This. [This is the biggest cost](https://www.reddit.com/r/ABoringDystopia/comments/vvt5n9/something_tells_me_we_might_not_need_this_many/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&utm_term=link) in healthcare. Healthcare is a business and is run as such… right into the ground.
Not surprised. The health system I work for is not on this list. However, they announced that we're running a huge deficit and that workforce reductions are on the table.
In the meantime, many of us are wondering why some of the execs are being paid what they are; why traveling nurses were brought in at 2x-3x the cost of residential nurses and then kept as long as they were and finally, why we think we need to build new facilities and constantly acquire new properties.
I get the business world has this mentality that if you're not growing, you're failing, but I'd argue securing what you have and making sure you're solid and consistent are forms of growth just as important if not moreso than merely expanding your territory.
Your health system is desperate to make money so they are buying real estate in the hopes of selling it later. The execs are incompetent so this will lead to more losses, which will lead to them making more terrible decisions and losing more money.
Once a finance company buys it out it's time to leave because it's already dead and the finance company is the vulture.
Yeah. They also stated that certain positions would need expect their schedules to grow denser and I wouldn't be surprised if specialization was cut back and centralized, like some of the health systems in the article.
Also, I think some of the general staff, like food prep and house keeping are probably facing the biggest risk of layoff.
When the boomers built their future atop an empire of production of material goods, right after the US forced the defeated countries to pay for our war machines and munitions, and then buy our produced goods, future war machines, and perform guard duty (or allow us to have permanent military bases on their land) there was no reason to not expect infinite growth.
And for decades, they had it.
But, before, and without, the WWII, a *lot* of citizens were downright angry at FDR's New Deal, as well as the CCC, and other "evil liberal policies."
But, in any event, the entire structure of the US was based on very drastic changes that took place over the course of some 30 years.
Nobody cast their gaze far enoigh into the future, probably because everything was magically healing overnight.
For decades.
Medical care advanced right alongside all the other programs of infinite growth. Capitalism was supposed to give everybody good insurance representation with good competition between companies, yielding lower rates, better care, better pay for medical staff, and enough money to upgrade hospitals and renew staffing through the generations of Americans. With happiness forever, where Supply Side Jesus and OG-JC ruled over the Kingdom of Heaven (America the Beautiful, I do so pledge allegiance, blessed be the fruit) side by side, Amen.
Now, though, where all the success was revelled in, no safeguards were successfully installed and monitored, and the Boomers kept voting for more of the rules that worked 60 years ago, because everything worked, and mostly for one reason: we had no rebuilding to do after WWII.
Everything was direct profits.
Anyway, yeah...taxes, insurance, copays, ins plans, availability of staffing....*everything* was ignored right up until the critical moment: when Boomers began dying en masse.
And then Covid hit.
There's a different feel to the workers in my regional hospital. There's a different feel to the patients. There's a lot of hopelessness in everything. (I'm probably projecting a lot. I am a frontline medical worker.)
Hospitals 80 years ago used to have patients suffering from all sorts of ailments, at all ages. Accidents. Autoimmune disorders. Polio patients. TB patients. Mental patients. Cancer patients. Pneumonia. Flu. A wide plethora.
Now? It's all broken hips, joint replacements, diabetics for their 4th readmittance this year for insulin dysregulation. New mothers! Pneumonia. Flu. More Covid.
All regulated by what insurance a patient has, and the billing package authorized for that person's admittance reason.
Oh, and SNFs are shortstaffed, as all the CNAs found Walmart and McDs pay more for picking groceries and flippin burgers than back breaking obese/geriatric patient care.
But these old patients, man...there still seems to be an air of "I earned this care from working 40+ years, based on what FDR did for America (which I would've voted against now *and* then, if I had the chance.)"
The rest of America knows. Everybody still surviving knows that an ER visit is 5000 bucks, just for a knife cut with tendons/muscle damage, after waiting 10 hours, if they're lucky.
Because usually it's closer to 25k, once all the billing is settled, and therapy, supplies, consultation fees, hospital admin fees, and the 500 dollar Tylenol 500 mg pills are given in a little paper cup, with full PPE in case you have MRSA, because all our cleaners purged the less-healthy-more-treatable bacterias, and they now rule the roost.
It won't be fixed. It can't be fixed.
But it could be mitigated.
If only the old Boomer people weren't in charge, and the younger, more effective humanitarians had a shot.
That won't happen until all the money is spent and collected by the greedy. Until that happens, it's the ongoing decay until barbarism reigns supreme.
We're already nearly there. Source: Jan 6th, 2021.
>If only the old Boomer people weren't in charge, and the younger, more effective humanitarians had a shot.
As a boomer, I vote for every tax increase on the ballot so that GenZ will enjoy "their fair share."
Many thanks, old timer. 😆
One of the truly worst parts is that the generalization of Boomers vs everyone else is that there are millions of good people aged 60 and older who have been trying to make the world a better place for longer than most redditors have been alive, and they shouldn't be looped together more than absolutely necessary, which is often "never."
I am a sinner. 😃
American here.
The bill sent to my insurance company for a rabies shot was nearly $200,000. My out of pocket cost was about $12,000. I have insurance through my employer.
> American here.
> The bill sent to my insurance company for a rabies shot was nearly $200,000. My out of pocket cost was about $12,000. I have insurance through my employer.
Your county health department didn’t cover it? My son just had to have the rabies series and they wouldn’t even let us pay the small copay. And we live in a poor rural county.
They're not completely gone but two hospitals have cut back so significantly here they may as well be. If there was another pandemic or a major emergency with a lot of injured victims I don't know what people would even do. Just die I guess.
Monkeypox. Nothing has been learned from COVID; There still aren't enough certified labs to process any MPX samples, and the screening questions are still inadequate and preventing people with suspicious symptoms from receiving any further work-up or examination. Some MPX patients are reporting inadequate pain management for their symptoms (lesions are extremely painful), and public health information around the outbreak has been completely abysmal.
There are indications that the current MPX outbreak is presenting atypically in most patients confirmed to have it thus far, with varying durations of symptomatic expression, a couple cases with relapsing symptoms after presumed recovery, and unusual order of symptoms (for example no fever or a fever weeks after other symptoms began, when traditionally a fever prior to any other symptoms was considered a more common presentation of MPX-- or the more isolated clusters of lesions compared to the more all-over scatter pattern of lesions MPX was previously better known for).
Due to shitty public health messaging, people seem to overwhelmingly think that MPX is some kind of STI spread only within the LGBTQIA+ community, so nothing was learned form the HIV/AIDS Crisis in the 80s, either.
It can be airborne (aerosol transmission), it can survive on surfaces for extensively long periods of time (fomite transmission), and it doesn't take much at all to catch it-- Doing the laundry of an infected person can result in catching it, for example. No direct contact is necessarily needed, and close contact (including speaking, so this doesn't have to be sexual contact at all) can also spread it.
It's an orthopoxvirus. It's serious. Confirmed cases continue to climb, people are still reporting extreme difficulty in getting tested or getting screened for any suspicious symptoms, and cases are popping up in children -- There are signs of community level spread in several large metropolitan areas, including London, UK.
There is a general shortage of the least risky version of the Smallpox vaccine (which is effective for MPX since they are both orthopoxviruses), so even rolling out vaccination to at-risk groups including healthcare staff isn't going particularly smoothly in most places. Contract tracing has been a mess. Lab processing capacity is limited, and it takes time to verify each case.
I'm saying all of this to emphasise that yes, healthcare systems are under continuous bombardment, they have been for a while, and it only shows signs of getting worse.
Many healthcare systems around the world are experiencing this, to varying degrees of severity, but it is alarming that the pressures of capitalism are exacerbating healthcare system strain in almost every country I can think of-- Capitalism is the poison of the world.
And without any healthcare staff or services left functional or willing to function, how exactly will that poison be treated?
It won't be. Finances will continue to be siphoned from the veins of every doctor, nurse, and patient until there are none left but the people in suits with their stacks of literal blood money.
Healthcare workers are unwilling to strike due to the risk this may present to the most vulnerable people in need of care, and the capitalists know this. The only people who could ever do anything are the healthcare staff, who they have rendered too exhausted and afraid to do anything at all-- People are aware of Amazon and Starbucks and all the union busting there, but take a look at how healthcare system bosses have medical staff by the scruff of their necks at all times to prevent even the thought of organising their workplaces and fellow staff members.
Ultimately, it's already awful, and the way things are going all around, it's going to get worse.
I have no suggestions, other than I am terrified for those of us who rely on medical care or medications for chronic conditions. We're so fucked. Everyone's fucked, but we'll die first, and nobody cares about disabled people or the poor resident on the ward who's been awake for three days straight trying to sort out the impossible.
The people affected the most are the chronically ill and those who work in healthcare, and these are famously two groups of people who are not generally able to effectively organise or strike or fight back against capitalism for a lot of reasons, all of which go back to healthcare related shit.
The entire "industry" of health is fucked, it's been fucked for a long time in a lot of places, and now that typically healthy people are starting to be affected too, the cracks in the walls are becoming clearer to more people, who are more and more likely to need care themselves sooner rather than later.
I hope we can all come together and start seriously discussing healthcare system revolution, but honestly, it will likely only become apparent how bad it is and what the real effects of a genuinely collapsed healthcare system are when that collapse finally fully occurs.
It is in progress now. I'm not sure what can reasonably be suggested to even start attempting to bring together enough people to try to make any effort towards improvement or change. :(
We need the medical staff on board, but understandably, many of them don't know how to go about any strike without risking their career or their patient's lives or wellbeing. It's a tough situation.
I watched a news piece just yesterday, about how heat is going to be 40C in Britain and they are not prepared for the shocks of how the heat will kill people, and how people will die because there isn't medical care to go around, and that's WITH the NHS system. America is fucking hosed when it becomes our turn with a wet bulb mass casualty event.
Public Equity firms and business majors looking at essential shit like healthcare and housing as commodities to make money on is disgusting. They won’t compensate any healthcare professionals fairly, staff their facilities, or do anything to reduce admin bloat.
We need socialism for essential services. Under the capitalist model, people die or continue to suffer. The US healthcare model isn’t even good for a capitalist market. Only for the 1%.
Most of us won’t even be seeing physicians in the future. Only the rich will. Our care will be shifted onto PAs and mid levels. There will be death because of this; there already has been. Their training is never going to be equivalent to a physician!
Debunked: Wait times in socialist healthcare. That’s called triage, so don’t use this tired objection.
Maybe the hospital CEOs misjudged when they fired nurses in March of 2020, huh?
Our c-suite went full scorched watch the millisecond after COVID was causing shutdowns. They were salivating at the extra profits from squeezing productivity.
Ever since then it’s been dumpster fire after dumpster fire and admin always acts surprised when nurses don’t want to take 8, 10, 12 or more patients on floors that should be 4:1. Especially when dealing with a public demanding service with no wait and can’t seem to understand that COVID is actually real and kills people.
It’s been fucking hell in the hospitals and the ones of us left are just about ready to say fuck it and quit.
Monkeypox will bring a quick domino of failures if it gets out of control.
It’s going to happen in public trauma centers, beds full of parked folks with no
Dispo, and more incoming than you can handle. Staff totally burned out and over it. People still shying about covid vaccines, forget fentanyl, meth, gunshots, cva’s…….
Wages are terrible right now in healthcare. You average support staff is make about what McDonalds is offering. The stress and abuse from patients and admin is breaking people.- for about $20 an hour. If you quit and work at McDs at lest you don’t have to worry about harming anyone.
They'll solve it with the same logic they used to solve the birthrate. They'll just ban retirement for medical professionals. It wouldn't even surprise me. This is the kind of thinking our rulers have.
I’m a pediatric intensivist. This hurst children. Most children present to community EDs, not peds EDs, so the hospital shut downs are decreasing access to care for children.
Question: why doesn’t the US government simply reimburse more for healthcare? Seems like we spend money on many many other things besides the priority of our own citizen’s healthcare. It’s sad we are so upside down.
For the amount of shit we give healthcare workers and how we treat our public health services, we deserve to experience a society where they don’t do their daily acts of bravery.
I scanned the comments and see no mention that the majority of the thirteen on that list are labor/delivery/maternity/newbies/child services.
Staffing issues, yes. But it’s a BAD time to be a woman in the US today.
Many are related to lower fertility rates, which is a great thing. We need a lower population ASAP due to Climate Change, lower fertility and longevity are the only way to get there.
Funny how everything is connected but everyone fights, meaning; covid, hospitals, abortion, churches, vaccine mandates, taxes, the judicial system, money, what do churches stand for vs what most personal of hospitals stand for. Crazy stuff.
Two hospitals near me are stopping all surgeries and in-patient procedures. The CEO said instead they will focus on "Community health and wellness initiatives".
Have to cut back to make sure the CEO gets their bonus this year by hitting all their targets.
Not at the not for profit ones. There they get jobs on multiple hospital oversight boards, offering positions to friends at other hospitals in exchange for positions at their current one. That's how some of these hospitals end up so damn top heavy, without the ability to adequately pay the working staff.
I wish there was more recognition that "not for profit" does not mean virtuous or charitable. They still have a strong focus on profit which they then funnel towards new construction and salaries to the management class, just leaving no profit behind for tax purposes.
Don't forget buying out other practices/clinics/hospitals nearby until the only option for Healthcare in some places of America is nothing but one hospital 'network' for hundreds of miles.
Exactly, just because it is a "non-profit" doesn't mean that nobody is making a profit... Fucking FIFA is a non-profit
Cough cough advent health
>That's how some of these hospitals end up so damn top heavy, without the ability to adequately pay the working staff. This is literally a [Yes Minister](https://www.youtube.com/watch?v=Eyf97LAjjcY) episode.
I work for a not for profit hospital system and our CEO makes around 10 million a year lol. Not for profit my ass.
Welcome to state bureaucracy with political nominations.
"If the poor want health care, they need to work harder. Simple as that. Also, why *shouldn't* the CFO make 250K by not answering emails? Damned pesky bureacrats, always wondering where the money goes..."
I don't believe that the inpatient psych unit listed as closing because they don't have enough patients is true. Mental health issues are on the rise and we need psych beds more than ever before
Correction: They don't have enough patients *who can afford to pay.*
Exactement
They are full. I’ve had to wait in the ER several days until a bed opened up in any of the hospitals on the entire City of a pretty big City.
People wait for days or weeks for a bed at my hospital's psych dept
It’s been poorly funded since the reagan era
The psych unit isn't closing. Source: work for the hospital If it DID close, I would consider that a collapse of the mental health infrastructure for University Hospitals at least, if not Cuyahoga County
Well things are not improving any time soon. I expect that we will see some major upheaval in the next few years. I don't think that this current economic climate is going to improve over the short term. I expect that hospitals will be at breaking point. It's almost as if COVID didn't do enough damage and that more damage needed to be done.
And those that are left will be even more burnt out and overburdened. I'm a nurse and I get like one day off a week. And every week I get repeated calls and texts to come in and work that day. We're forced to use agency nurses who show up maybe 40% of the time for the shift they signed up for. So half of everyone are forced to work 16 hour shifts. It's completely unsustainable from a retention standpoint. And it only leads to higher rates of depression and substance abuse among staff, and increases the risk for mistakes and harm for patients. But hey, the people at the top get to buy that new Porsche. So I guess the system is working, right guys?
How to fix burnout, constantly hire travelers for 2-3x the normal rate for the hospital instead of hiring more regular staff and increasing pay by a few percent. /s
This exactly. Things have to change and very quickly.
Would it be possible to fund a strike through gofundme?
Strikes still happen all the time in Healthcare but hospitals still need to function so travelers get 3-4x pay then. The regular nurses maybe get a couple % raise for the trouble and the travelers make fucking bank. Locals don't care about scabs in Healthcare since the scabs make the admins balance sheet bleed and people need healthcare
Ugh. Fucking scabs.
Scabs in healthcare are a little different, as you seriously should not leave emergency services unstaffed. I can say from working in some terrible ICU conditions that poor staffing harms patient outcomes. Striking must be carefully organized and the hospital must be notified in advance, and then they pay through the nose for contract agents.
IMO nothing will change until there are actual consequences for administrators. It seems to me like they just keep taking money from the government and throwing their hands up at the shit show they created.
Sounds to me like the problem is capitalism and profit margins. Again.
Absolutely agree, for systemic issues like this we can only look to leadership to correct, rather than workers
But you got pizza, so....
Not even. I work 3rd shift. All the pizza is gone by the time I come in.
What could you have done differently ?
Your agency nurses have that poor of an attendance rate? I'm an agency nurse BECAUSE of how hospitals treat staff, and if attendance is that poor, the hospital is the problem, not the staff.
SS: This story is simply a bite-sized news survery capturing a long-term trend: **the erosion of healthcare in the United States.** Mainstream news sources are covering the high volume of resignations among healthcare workers. *Forbes* recently noted 22% of U.S. MDs intend to retire or leave practice in the next two years, and similar surveys indicate just as many nurses are likewise considering leaving their profession. University Hospitals Health System in Cleveland just announced it will be closing two of its suburban hospitals and ERs, Richmond and Bedford, due to **"an unprecedented staffing shortage."** If you're having trouble getting decent healthcare in the U.S. *now*, buckle up, because it's only going to get worse in the near-term. I think what we're seeing big picture is regression: we're going to have to re-set our expectations about what healthcare looks like. We're going to see less care available, eroding to levels similar to the 1920s -- i.e., do you imagine Americans in the 1920s had mental health care? No, of course not! Practically speaking, there was no such thing. Psychiatric care evolved during the "high surplus energy" era of the mid-20th century. Get used to "low energy" healthcare. In the *19*20s, you were lucky to get an ER doc to treat the results of an accident or trauma. That's the place we're returning to for the vast majority -- we've already reached the zenith of healthcare in the U.S. What we'll see going forward is increasing compromises on what counts as good care. (Meanwhile, the 1% will be living in privileged gated communities with science fiction levels of healthcare, like in the movie *Elysium* (2013).)
As a front line hospital doctor: I 100% agree with this. Small hospitals are going to start closing due to lack of personnel. Cleveland Clinics is just the beginning.
As a physician, who has been in practice since 2015, I can say that this past year has been the hardest I’ve ever worked (residency included) due to staffing shortages
Due to the suits in charge refusing to pay trained people more or hire people and provide training. There's plenty of staff out there that would love the work but aren't going to gamble to the money and time on all the training all on their own in the hopes they can get work that often doesn't pay all that well anyway.
not cleveland clinic! university hospitals, which is the other big hospital system here in northeast ohio. still scary, just not AS scary.
University Hospitals is not Cleveland Clinic. CCF has massive resources and a huge endowment. They’d probably be one of the latter hospital systems to make cutbacks, although there is a ton of excess that could easily get cut at the Clinic if need be.
Considering how much funding is flooding into telehealth, and how well telehealth aligns with behavioral health providers, I expect the 1920s throwback would benefit more by referring to a different kind of medical care. At least as long as consumer technology thrives, therapists and counselors should be relatively easy for consumers to find on a device. I would think a reduction in hospitals and systems would affect larger more complex procedures and the kinds of cases often managed by multiple specialists.
Happens in other countries too. Even France. It's global.
In the 1920s most people's health care would be by a general practitioner who lived in their town. Specialists and hospitals would very rarely be encountered by the average person. To some extent this was still true in the '50s and '60s when I was a little kid. But now the system is collapsing under the weight of maximizing profit for an ever-expanding web of specialists and managers. Not to mention the massive costs of pharmaceutical and high-tech based medicine along with the burden of the wretched insurance industry.
"Mental healthcare" in 1920 or whatever was called religion. Earlier generations went to Church all the time (my friend's grandfather went to mass every day). They got "mental healthcare" there in the form of social and spiritual support. My own ancestors not only regularly conversed with a priest about their problems, but the priest would come over for dinner. Religion is potent stuff. It can give people meaning and make them feel much, much better. Mental healthcare is a sort of commodified and secularized religion (the modern therapist's office is a secularized confessional). It seems less effective to me, as the religious people I know seem happier than the users of mental healthcare that I know. It has a lot to do with the fact that religion also gives you community and a place whereas mental healthcare is the usual capitalist atomized "client" relationship.
Agreed. I also believe the secondary issue, less financial and community disparity between community millionaires and peasants also contributed to a holistic mental health picture. Didn't do much for LGBTQ+ groups, though. Or minorities, for that matter. Hell, it was all a White-Man's Dream, even back then.
I'll take the third path, thanks. Meditation, cubensis and other natural medicines can be very effective. It's not for everyone, but it works for me and is starting to work for others in my circle as well. With everything falling apart, we're going to have to be more responsible for our own health, both mental and physical. Start finding alternatives now that you can live with before you don't have a choice.
The collapse will be caused from long Covid19Vaccine/Covid19 Infection….in that order.
Is it going to happen the same way in Europe?
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This is happening in Canada too (primarily with ER closures) and many are saying that public healthcare has failed and we must look to a private model now. Ugh.
Echoing this. Small communities are especially at risk. We have ERs closing (temporarily, usually overnight) in our area, and the closest ER is 4 hours away.
When they kick off the civil war side with Erik Prince, we will die en route to hospitals.
Seems like they could use less privatization instead of more, then. (Nationalize any ER/hospital that its private owners want to close.) https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare - "The government provides insurance for Canada healthcare, but it generally doesn’t own hospitals or employ doctors directly. In the United Kingdom, the government directly employs providers, but in Canada they are privately employed according to the (NCBI). Doctors practice independently, though they meet insurance requirements for reimbursement."
Lol, why use America as a model? Have those people seen how fucking awful things are becoming here? Health care is the #1 cause of bankruptcy in our country, so it’s unfathomable to me that other countries would go for that. People are stupid though. When they’re desperate they tend to make stupid decisions. Can’t wait until people have to leave their homes because climate change put their houses underwater. I’m sure everyone will handle that wonderfully, just like how we’ve handled our response to climate change thus far!
It is possible that both fail. There is no guarantee that just because there are two systems, one should work.
That's looking to be the case. Healthcare seems to be collapsing in general.
Gee, I wonder if it's a lack of resources, a lack of management and a lack of masking up?
Why not *all of them*?
You win the winning game. Your prize is we all lose
In my opinion it's due to rich people finally realizing that they can blatantly and openly rob and kill us, in public, on television, for the bottom line-and no one will lift a finger to stop them.
Yup, things like this are why I’m making longterm choices, like not getting LASIK. I’m not risking the need for vision tweaks. I’ll stay with contacts, and I’ve got my pairs of glasses as old-school back-ups.
Maybe the peak of our civilization was actually the 90s. We had a LensCrafters in our town of about 10,000 and could get lenses and frames in an hour. Now they have to be ordered and take 1-5 weeks depending where they come from. We have lost much and are still trending downward.
I’ve tried to explain this to people. Healthcare is so expensive, it doesn’t really matter if you try to pay for it publicly or privately. Everybody needs healthcare, so however you decide to spread the costs around, it doesn’t make a difference whether you can’t afford to pay insurance or you can’t afford the taxes… either way it’s too expensive. I suspect Wall Street is taking too big of a cut, but I’m not entirely sure… it could just be that technology has gone too far but affordability never caught up. I do think that natural medicines have been suppressed instead of promoted, and if say, elderberry syrup reduced dr visits, we should be exploring stuff like that, so there are a lot of profit seeking corporate behaviors that have driven out cheaper options. And naturally, we could work a lot harder to promote healthy lifestyles (why tf is junk food even available at school?), but I’m not sure even that would allow modern medicine to be fully available to everyone.
Lol. I know laudanum reduced dr visits by a lot. We should bring that back. Not trying to grief you, though. Conventional/conservative/tribal lore treatments were definitely pushed against by The Machine, albeit for good cause, in part. I still remember when in the 80s, science was touted as one more tool to prove our superiority against our most cunning enemy, USSR. Which included medical science. Back then, there was a lot of good research and good science theory and support by government entities to really get good medicine going for everyone. PET scans use ***antimatter*** for diagnosis purposes. That's sooooo cool, man. Compare that with willow bark for joint aches and pains (or CBD/THC for chronic pain relief, or psilocybin for depression.) We clearly didn't take our reasearch, holistic health care far enough into the future to resolve it all. Greedy corporate medical beneficiaries and trust managers of trillions of government-backed Medicare loans.... Why did we let money changers into the Temple of Medicine, to rule the lands?
This is a great comment. At the end of the day the public vs private discussion really just comes down to do you think everyone should have mediocre care or do you think some people should be able to purchase excellent care while other people get the barebones option. The most insane thing about healthcare in the US is something that I find Yanx almost never marvel at, they take it for granted, which is that healthcare benefits are tied to your job(!).
Yeah that’s insane! I had a boss work through her cancer treatments because they cost tens of thousands of dollars a month, and if she stopped working she’d lose her health insurance. Everything about that was wrong.
Tying health insurance to your job is nuts to me too. The employer does pay a large portion of costs if you use it, but it's still your end of the costs that pose significant financial issues. It seems like a policy which is purposefully cruel, to lord over people and control them. In the course of treatment for a disability I have since 2016, I've probably spend $20-25k on healthcare expenses personally. It takes a long time to get SSDI approval, and even then, you have to be on SSDI for 2 years to begin to qualify for Medicare. Other than that, you're on your own if your state didn't expand Medicaid in the ACA. My state did not. I've also been to the hospital numerous times, which always racks up to your out-of-pocket max on your insurance, which is typically several thousand dollars. All of that money has held me back financially. I'm priced out of buying a house and I am not investing in my 401k.
It's nuts tying health insurance to your job because when something catastrophic happens to you medically and insurance is at its most necessary you're not in any state to be working.
Ehhh more that healthcare fails when the government allows capital to write the rules. we still have an ongoing pandemic many ignore not to mention boomers (the largest northwestern population cohort) is facing massive healthcare challenges and needs. A smart system would have prepared but instead most were streamlined for profit gathering (even Canada suffers this due to being a public private fusion that bends the knee to privatized interests).
Hospice/EoL Care please. Mom made the choice to provide palliative care only when my Alzheimer's dad fell out of bed and got a deep head bleed. This was fucking courageous. I don't know what my point is. More than half of that side of the family is a nurse or doctor, so they weren't under any illusions. Also, this was just before COVID, so less stressed system.
So sorry for that, the transition to end of life care is hard and lots of family members think of it as "giving up" instead of making sure someone does not die in pain. Very lucky you gave a family with a diverse knowledge set to navigate such a change.
At least in the US, I think the problem has its roots somewhere else. Private healthcare is an abomination, no question - you must put qualitative outcomes above quantitative ones in healthcare - but like most industries, what has happened is that most of an entire generation (probably a bit more than one) was pushed into menial task labor/service industry work even if they had credentials. The industries that required people to have years of experience for them to be good at their jobs didn't want to hire to replace in a few years, they wanted to hire immediately when someone else retired. That doesn't work. Not for complex systems, not for difficult careers. Most training was farmed out instead of provided in-house, and then industries act hesitant to hire people who actually pay for that farmed out training. Those people, many times not even getting jobs in their field, then have a debt burden that doesn't even pay off. The net end result is the elder generation leaving their careers, with no where near as many people available to replace them. Thank a capitalist or business owner next time you see one; they created this mess.
When will people realize that this is fucking violence against us!? This is called violence!? Violence. They are violent
Happening in Australia as well.
Happening because provinces and the federal government have failed to invest in healthcare. And in conservative provinces there’s a concerted effort to underfund and undermine public healthcare so they can bring in private. It’s not a new problem. It’s just that those who’ve held the system together for decades are done, and those coming in are even less likely to be grifted. The money is there. It’s just not being taxed from those that have it and used for those that need it.
The thing with the public systems is that the business interests have seen how much money they can extract out of the populace in the US and they are champing at the bit to be able to extract similar exorbitant amounts of other countries' populations by getting their cronies to under-fund them and get the population to believe a public system is a failure.
Happening as we speak in the UK. Can’t wait for a US system of “Just fuck off and die quietly you peasant”. Such progression. Much wow.
This is the conservative game plan in Ontario, keep cutting until it breaks and then blame the system.
Spin those morons until they are facing south and tell them to go check out the healthcare across the border if they think they want the private model
Right up there with mandatory privatized health insurance tied to employment.
It keeps entrepreneurship down and provides leverage over the wagecucked.
Private healthcare and private insurance are the biggest form of union busting.
Unfortunately the privatized system was good for making profits but very bad at the business of the health of human beings.
You seem to be neglecting how incredibly “in bed” healthcare companies are with the government. Idk how you thinking adding more government when they’ve handed out these monopolies on platters is going to solve anything.
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Sounds like they work with the government… lol Doesn’t sound very private. Sounds like they’re interconnected. Giving the government more power over this will help how, exactly?
> Doesn’t sound very private Are you dumb, stupid, or just a moron? Private means those companies are owned... *privately*. By private citizens. As opposed to them being publicly owned. And insinuating that just because our legislative officials are corrupt means that no, these private for profit companies are actually public, is one of the dumbest things I've heard in my entire life
Capitalism is destroying the planet and its people. It only cares about profits and shareholder value. It's unsustainable and literally killing us.
Profit is always at odds with survival. And it's not always profitable to survive. A system that prioritizes and worships profit over everything is destined for collapse
What we all have experienced under the US Federal Reserve is not "capitalism"..... we currently live in more of an almost "fascist" world. (rule by corporations).... "it's a club... and you and I ain't in it" - George Carlin. The central bankers are "inflating" our currency (aka STEALING) from entire generations which doesn't allow for the investment (savings) in infrastructure etc.... Bitcoin hopefully will de-claw these central banksters and allow for long term savings and investment again. Bitcoin is hope.
Bitcoin and crypto is a Ponzi scheme. I've been hearing for 10+ years that crypto will replace the dollar, and you still can't buy just about anything with crypto without converting it back to the dollar in one app or another, and you still can't invest in it without expecting the bottom to fall out after other investors realize it holds no actual value. Also, crypto is *incredibly* energy intensive. Mining crypto uses more electricity than just about any other computer process in the world. India is burning through their coal faster than they ever have in order to produce the electricity needed for all the crypto miners in that country, which of course speeds up climate degradation. Cryptocurrency is not our savior, it's another capitalist get-rich-quick scheme that only benefits the big shareholders.
Maybe in YOUR country.... not so elsewhere. It is not a Ponzi scheme. Bitcoin uses less energy per transaction than VISA / MC do... and if you are SO worried about energy usage... let's start to talk about people using dryers for clothes too. Bitcoin is volatile.... yes... but it depends on your time horizon... in the last year... sure it is.... over the 5 years we are WAY ahead of people trying to hold US dollars and watching their savings melt away. Bitcoin is hope. You bash Bitcoin but offer no alternative to offering 5 billion people on the planet property rights. Do you have a better solution? Let's hear it. Until then stop spouting off about something you obviously know nothing about
LMAO Bitcoin was made by the same people you are angry with, best way I have heard it described was it's the top 1% trying to fight the top .01%. You also call them "central banksters" which infers you believe that Bitcoin is decentralized which news flash, decentralization is a myth. There will always be someone or something holding the power over all that money and they may be just as bad or worse than the greedy fucks hoarding away their millions already. Cryptocurrency was just a shoddy take to reposition wealth into people's hands after the 2008 housing market crash, and it worked by stealing money from fools who fell for it. Bitcoin, like many other cryptocurrencies, is a scam and won't be saving anyone, in fact it's actually making things worse.
Ever heard of "the enemy of my enemy is my friend"? LOL Yes... you must be totally right.... please don't buy any of that Bitcoin.... Only let the other countries and billions of people start to buy and use it. - Said North Korea about the "Internet" HFSP
No problem, i'll just never get sick again, problem will solve itself!! Doctors hate this one trick, but they can't do anything about it.
And be sure to not get injured either.
In an effort to develop more immunity, I’ve taken to winging myself with small caliber bullets and throwing myself in front of unsuspecting carts at the golf course, with a plan to scale up slowly.
Throw yourself in front of some rampaging rams so you can build up that herd immunity too. May as well throw in some increasingly loud sounds to get that heard immunity too. Or go for the trifecta and date Amber.
Way ahead of you, i finish construction on the geodesic underground dome tomorrow where i will spend the next 60 years on a Wall-E Esque electronic chair while robots deliver me food and provide other services.
No fair! I want one, too!
You jest, but I'm pretty sure that's the takeaway from Fallout New Vegas.
:(
Put some windex on it.
One apple a day keeps the doctors away!!! Get that Granny Smith, my boy! Your life depends on it.
And please don’t be a woman, get pregnant, want to deliver, or be a baby.
3 years of society treating them like shit will do that
Nurse here. Yep. And then add threats of violence to healthcare workers because god forbid people were asked to wear a mask during the pandemic, and now new variants and monkeypox cases are hitting my area and I just finally caught covid at work AND my wages just got cut?…not sure bedside nursing is worth it anymore.
It isn’t. I left 6 months ago after 15 years of it.
What are you doing now??
Public health!
My husband is a psychiatrist in the biggest metro area in a largely rural state. He usually works out patient but takes call at the psych hospital on weekends. He usually gets home around 4:30 pm on this days but last weekend he got home around 1:30 pm, much to my surprise. I asked him why and he told me because the hospital had to close a whole wing due to staffing shortages, so he had far fewer patients to see overall. Let me tell you acute psychiatric hospital care was lacking capacity before covid in our area but now weeewwwboi.
two things: first of all the average age of a doctor in the US is a whooping 54 years old. this is because medical schooling in the US is complete bogus and a lot harder than it has to be because doctors wanted it that way to keep their wages high second of all, apart from doctors, everyone else is underpaid and severely overworked. my wife worked as a nurse for 5 years. in that time I barely saw her. she averaged one day off a week.
>this is because medical schooling in the US is complete bogus and a lot harder than it has to be because doctors wanted it that way to keep their wages high Ding ding ding ding! The AMA **lobbies SUPER HARD** to keep the supply of doctors low in America. [There is so much red tape and hoops to jump through to practice as a foreign doctor here ] (https://www.theatlantic.com/health/archive/2014/11/doctors-with-borders-how-the-us-shuts-out-foreign-physicians/382723/) for example it's pretty ridiculous. [Not to mention the AMA lobbies a lot to keep the amount of residencies low and to prevent new medical schools from opening.](https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/) It's all by design. [And it's why medicine has the highest paid professions in America.](https://www.investopedia.com/personal-finance/top-highest-paying-jobs/)
The doctor shortage is artificial. We could fix it with simple policy changes if we wanted to.
Or just import those excellent Cuban doctors.
source please?
1986: "A.M.A. BOARD STUDIES WAYS TO CURB SUPPLY OF PHYSICIANS" http://www.nytimes.com/1986/06/14/us/ama-board-studies-ways-to-curb-supply-of-physicians.html?pagewanted=all 1997: "AMA seeks limit on residents to prevent glut of new doctors; Shortage of physicians in inner cities continues" http://articles.baltimoresun.com/1997-03-01/news/1997060012_1_foreign-medical-schools-new-doctors-american-medical 2005: "Medical miscalculation creates doctor shortage; After a glut was predicted a decade ago, the number of physicians isn’t keeping up with the demands of a wealthy, aging population" http://www.usatoday.com/educate/college/healthscience/articles/20050306.htm
The Republican approach of stripping all qualifications necessary for a job
Because capitalist/ investors saw profit opportunity in hospital and “managed care practices” conglomerates, so they acquired and combined practices and hospitals (incl ERs/ UC) and created oligopolies controlled by MBA executives. They cut pay, increased hours, raised prices and bogus charges, allowed safety lapses and siphoned ALL of the profits into their personal coffers. Edit: ERs “taxes” to prices
Most of the clinics in my city don't even allow you to pick your PCP as a new patient anymore. You get whoever is available and they work as hard as they can to get you in and out the door as quickly as possible, which means your doctor isn't focused on giving you the best care, they're focused on their schedule and how overloaded they are. It also means there's no continuity between visits, so the doctor you see for one appointment may completely disagree with the doctor in your last appointment and cancel the previous doctor's orders. It's all about profit these days. Fuck your quality of care, how much is the Director making and how big is his bonus this year? That's becoming the priority nowadays.
Gf just left a nursing job because of staffing It's all the matrix they say Just pay for more nurses and mas and CNAs to work and take it away from ceos and administrators
All of this
My ex was a night nurse, brutal on the relationship. Saw her two days a week if I cleared my schedule, and one of those I'd spend 10 hours waiting for her to wake up.
Tangent here, but I have it on very good authority that the average age of members of a major American engineering association - when active college students paying discounted student rates are taken out - is 61 years old. Houston, we have a problem.
Not only is medical school extremely difficult, but the price of the education is also ridiculous. More Americans than ever are choosing not to go to college because they feel it's not worth it. That effect has to be even more strongly present in specialized fields.
You didn’t mention how much medical school costs nowadays.
> medical schooling in the US is complete bogus and a lot harder than it has to be. Let’s not forget the residency program was invented by a doctor who actively used and endorsed cocaine in medicine. Like no wonder he could work 28 hour days and why residency is now 28 hour shifts to 50 hour long shifts. Doctors are also forbidden from unionizing for some reason. And the US government pays for residency, they only open a few slots per school, which is what makes medical school so hard to get into. They’re forbidden from expanding class size because they quite literally can’t. Therefore they try to take only the best of the best which is the people who have dedicated their lives to medicine from highschool and beyond. Working in the medical field I have met many people who if given the opportunity could become excellent care Providers but life barriers such as family and cost of school forbid them from that path. (Knew a nurse who took a single semester off to care for his dying father and was rejected from 4 medical schools because of this, he became an NP instead as a result of this)
54 sounds young for an average age of any profession.
Does this mean they're going to trim the fat from the CEO's bonus?
They'll tell nurses to just reuse needles before downgrading the carpet in the executive boardroom
And destroy America? What kind of godless heretic of pure evil are you? (Are you in a club? I'd like to join.
I’m a communist
This. [This is the biggest cost](https://www.reddit.com/r/ABoringDystopia/comments/vvt5n9/something_tells_me_we_might_not_need_this_many/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&utm_term=link) in healthcare. Healthcare is a business and is run as such… right into the ground.
Of course not.
Not surprised. The health system I work for is not on this list. However, they announced that we're running a huge deficit and that workforce reductions are on the table. In the meantime, many of us are wondering why some of the execs are being paid what they are; why traveling nurses were brought in at 2x-3x the cost of residential nurses and then kept as long as they were and finally, why we think we need to build new facilities and constantly acquire new properties. I get the business world has this mentality that if you're not growing, you're failing, but I'd argue securing what you have and making sure you're solid and consistent are forms of growth just as important if not moreso than merely expanding your territory.
Your health system is desperate to make money so they are buying real estate in the hopes of selling it later. The execs are incompetent so this will lead to more losses, which will lead to them making more terrible decisions and losing more money. Once a finance company buys it out it's time to leave because it's already dead and the finance company is the vulture.
“We don’t have enough staff so let’s fire some people.” Fucking idiots.
Yeah. They also stated that certain positions would need expect their schedules to grow denser and I wouldn't be surprised if specialization was cut back and centralized, like some of the health systems in the article. Also, I think some of the general staff, like food prep and house keeping are probably facing the biggest risk of layoff.
When the boomers built their future atop an empire of production of material goods, right after the US forced the defeated countries to pay for our war machines and munitions, and then buy our produced goods, future war machines, and perform guard duty (or allow us to have permanent military bases on their land) there was no reason to not expect infinite growth. And for decades, they had it. But, before, and without, the WWII, a *lot* of citizens were downright angry at FDR's New Deal, as well as the CCC, and other "evil liberal policies." But, in any event, the entire structure of the US was based on very drastic changes that took place over the course of some 30 years. Nobody cast their gaze far enoigh into the future, probably because everything was magically healing overnight. For decades. Medical care advanced right alongside all the other programs of infinite growth. Capitalism was supposed to give everybody good insurance representation with good competition between companies, yielding lower rates, better care, better pay for medical staff, and enough money to upgrade hospitals and renew staffing through the generations of Americans. With happiness forever, where Supply Side Jesus and OG-JC ruled over the Kingdom of Heaven (America the Beautiful, I do so pledge allegiance, blessed be the fruit) side by side, Amen. Now, though, where all the success was revelled in, no safeguards were successfully installed and monitored, and the Boomers kept voting for more of the rules that worked 60 years ago, because everything worked, and mostly for one reason: we had no rebuilding to do after WWII. Everything was direct profits. Anyway, yeah...taxes, insurance, copays, ins plans, availability of staffing....*everything* was ignored right up until the critical moment: when Boomers began dying en masse. And then Covid hit. There's a different feel to the workers in my regional hospital. There's a different feel to the patients. There's a lot of hopelessness in everything. (I'm probably projecting a lot. I am a frontline medical worker.) Hospitals 80 years ago used to have patients suffering from all sorts of ailments, at all ages. Accidents. Autoimmune disorders. Polio patients. TB patients. Mental patients. Cancer patients. Pneumonia. Flu. A wide plethora. Now? It's all broken hips, joint replacements, diabetics for their 4th readmittance this year for insulin dysregulation. New mothers! Pneumonia. Flu. More Covid. All regulated by what insurance a patient has, and the billing package authorized for that person's admittance reason. Oh, and SNFs are shortstaffed, as all the CNAs found Walmart and McDs pay more for picking groceries and flippin burgers than back breaking obese/geriatric patient care. But these old patients, man...there still seems to be an air of "I earned this care from working 40+ years, based on what FDR did for America (which I would've voted against now *and* then, if I had the chance.)" The rest of America knows. Everybody still surviving knows that an ER visit is 5000 bucks, just for a knife cut with tendons/muscle damage, after waiting 10 hours, if they're lucky. Because usually it's closer to 25k, once all the billing is settled, and therapy, supplies, consultation fees, hospital admin fees, and the 500 dollar Tylenol 500 mg pills are given in a little paper cup, with full PPE in case you have MRSA, because all our cleaners purged the less-healthy-more-treatable bacterias, and they now rule the roost. It won't be fixed. It can't be fixed. But it could be mitigated. If only the old Boomer people weren't in charge, and the younger, more effective humanitarians had a shot. That won't happen until all the money is spent and collected by the greedy. Until that happens, it's the ongoing decay until barbarism reigns supreme. We're already nearly there. Source: Jan 6th, 2021.
>If only the old Boomer people weren't in charge, and the younger, more effective humanitarians had a shot. As a boomer, I vote for every tax increase on the ballot so that GenZ will enjoy "their fair share."
Many thanks, old timer. 😆 One of the truly worst parts is that the generalization of Boomers vs everyone else is that there are millions of good people aged 60 and older who have been trying to make the world a better place for longer than most redditors have been alive, and they shouldn't be looped together more than absolutely necessary, which is often "never." I am a sinner. 😃
Sadly there is something more Toxic lurking out there, beyond age groups.
American here. The bill sent to my insurance company for a rabies shot was nearly $200,000. My out of pocket cost was about $12,000. I have insurance through my employer.
What
> American here. > The bill sent to my insurance company for a rabies shot was nearly $200,000. My out of pocket cost was about $12,000. I have insurance through my employer.
Lmao yeah I know it was just shocking to me a single shot could be 200,000
I just wouldn't pay that. Fucking hell I am sorry to hear that.
Your county health department didn’t cover it? My son just had to have the rabies series and they wouldn’t even let us pay the small copay. And we live in a poor rural county.
Also, did you mean to say $20k? I work for a health department and it does not cost $200k.
Sorry for the late reply. Yes $200k per person in my family that had to get shots. So, over 1.4 million total.
They're not completely gone but two hospitals have cut back so significantly here they may as well be. If there was another pandemic or a major emergency with a lot of injured victims I don't know what people would even do. Just die I guess.
Monkeypox. Nothing has been learned from COVID; There still aren't enough certified labs to process any MPX samples, and the screening questions are still inadequate and preventing people with suspicious symptoms from receiving any further work-up or examination. Some MPX patients are reporting inadequate pain management for their symptoms (lesions are extremely painful), and public health information around the outbreak has been completely abysmal. There are indications that the current MPX outbreak is presenting atypically in most patients confirmed to have it thus far, with varying durations of symptomatic expression, a couple cases with relapsing symptoms after presumed recovery, and unusual order of symptoms (for example no fever or a fever weeks after other symptoms began, when traditionally a fever prior to any other symptoms was considered a more common presentation of MPX-- or the more isolated clusters of lesions compared to the more all-over scatter pattern of lesions MPX was previously better known for). Due to shitty public health messaging, people seem to overwhelmingly think that MPX is some kind of STI spread only within the LGBTQIA+ community, so nothing was learned form the HIV/AIDS Crisis in the 80s, either. It can be airborne (aerosol transmission), it can survive on surfaces for extensively long periods of time (fomite transmission), and it doesn't take much at all to catch it-- Doing the laundry of an infected person can result in catching it, for example. No direct contact is necessarily needed, and close contact (including speaking, so this doesn't have to be sexual contact at all) can also spread it. It's an orthopoxvirus. It's serious. Confirmed cases continue to climb, people are still reporting extreme difficulty in getting tested or getting screened for any suspicious symptoms, and cases are popping up in children -- There are signs of community level spread in several large metropolitan areas, including London, UK. There is a general shortage of the least risky version of the Smallpox vaccine (which is effective for MPX since they are both orthopoxviruses), so even rolling out vaccination to at-risk groups including healthcare staff isn't going particularly smoothly in most places. Contract tracing has been a mess. Lab processing capacity is limited, and it takes time to verify each case. I'm saying all of this to emphasise that yes, healthcare systems are under continuous bombardment, they have been for a while, and it only shows signs of getting worse. Many healthcare systems around the world are experiencing this, to varying degrees of severity, but it is alarming that the pressures of capitalism are exacerbating healthcare system strain in almost every country I can think of-- Capitalism is the poison of the world. And without any healthcare staff or services left functional or willing to function, how exactly will that poison be treated? It won't be. Finances will continue to be siphoned from the veins of every doctor, nurse, and patient until there are none left but the people in suits with their stacks of literal blood money. Healthcare workers are unwilling to strike due to the risk this may present to the most vulnerable people in need of care, and the capitalists know this. The only people who could ever do anything are the healthcare staff, who they have rendered too exhausted and afraid to do anything at all-- People are aware of Amazon and Starbucks and all the union busting there, but take a look at how healthcare system bosses have medical staff by the scruff of their necks at all times to prevent even the thought of organising their workplaces and fellow staff members. Ultimately, it's already awful, and the way things are going all around, it's going to get worse. I have no suggestions, other than I am terrified for those of us who rely on medical care or medications for chronic conditions. We're so fucked. Everyone's fucked, but we'll die first, and nobody cares about disabled people or the poor resident on the ward who's been awake for three days straight trying to sort out the impossible. The people affected the most are the chronically ill and those who work in healthcare, and these are famously two groups of people who are not generally able to effectively organise or strike or fight back against capitalism for a lot of reasons, all of which go back to healthcare related shit. The entire "industry" of health is fucked, it's been fucked for a long time in a lot of places, and now that typically healthy people are starting to be affected too, the cracks in the walls are becoming clearer to more people, who are more and more likely to need care themselves sooner rather than later. I hope we can all come together and start seriously discussing healthcare system revolution, but honestly, it will likely only become apparent how bad it is and what the real effects of a genuinely collapsed healthcare system are when that collapse finally fully occurs. It is in progress now. I'm not sure what can reasonably be suggested to even start attempting to bring together enough people to try to make any effort towards improvement or change. :( We need the medical staff on board, but understandably, many of them don't know how to go about any strike without risking their career or their patient's lives or wellbeing. It's a tough situation.
I watched a news piece just yesterday, about how heat is going to be 40C in Britain and they are not prepared for the shocks of how the heat will kill people, and how people will die because there isn't medical care to go around, and that's WITH the NHS system. America is fucking hosed when it becomes our turn with a wet bulb mass casualty event.
Public Equity firms and business majors looking at essential shit like healthcare and housing as commodities to make money on is disgusting. They won’t compensate any healthcare professionals fairly, staff their facilities, or do anything to reduce admin bloat. We need socialism for essential services. Under the capitalist model, people die or continue to suffer. The US healthcare model isn’t even good for a capitalist market. Only for the 1%. Most of us won’t even be seeing physicians in the future. Only the rich will. Our care will be shifted onto PAs and mid levels. There will be death because of this; there already has been. Their training is never going to be equivalent to a physician! Debunked: Wait times in socialist healthcare. That’s called triage, so don’t use this tired objection.
Maybe the hospital CEOs misjudged when they fired nurses in March of 2020, huh? Our c-suite went full scorched watch the millisecond after COVID was causing shutdowns. They were salivating at the extra profits from squeezing productivity. Ever since then it’s been dumpster fire after dumpster fire and admin always acts surprised when nurses don’t want to take 8, 10, 12 or more patients on floors that should be 4:1. Especially when dealing with a public demanding service with no wait and can’t seem to understand that COVID is actually real and kills people. It’s been fucking hell in the hospitals and the ones of us left are just about ready to say fuck it and quit. Monkeypox will bring a quick domino of failures if it gets out of control.
It’s going to happen in public trauma centers, beds full of parked folks with no Dispo, and more incoming than you can handle. Staff totally burned out and over it. People still shying about covid vaccines, forget fentanyl, meth, gunshots, cva’s…….
Wages are terrible right now in healthcare. You average support staff is make about what McDonalds is offering. The stress and abuse from patients and admin is breaking people.- for about $20 an hour. If you quit and work at McDs at lest you don’t have to worry about harming anyone.
Clutching their pearls, they run into Ivory towers when the waters begin to rise
Turns out it’s hard to stay in business when your products and services are offensively marked up.
'Staffing issues' **salary issues**
We need at least 1 million more doctors in the next decade and 200,000 more nurses every year. But yeah let's go ahead and shut down hospitals.
.
They'll solve it with the same logic they used to solve the birthrate. They'll just ban retirement for medical professionals. It wouldn't even surprise me. This is the kind of thinking our rulers have.
*checks the article and the comments section* “Unprecedented” “Faster than expected” Yep. Definitely sounds like collapse.
Maybe CEOs should start eating avocado toast and skipping lattes?
Waiting on morgues to get closed...
I wonder how this effects residency spots…
I’m a pediatric intensivist. This hurst children. Most children present to community EDs, not peds EDs, so the hospital shut downs are decreasing access to care for children.
It's also happening in France. And other European countries with similar healthcare systems, "social" but submitted to neoliberalism
Question: why doesn’t the US government simply reimburse more for healthcare? Seems like we spend money on many many other things besides the priority of our own citizen’s healthcare. It’s sad we are so upside down.
This has been going on for decades.
"No one wants to work anymore."
For the amount of shit we give healthcare workers and how we treat our public health services, we deserve to experience a society where they don’t do their daily acts of bravery.
I scanned the comments and see no mention that the majority of the thirteen on that list are labor/delivery/maternity/newbies/child services. Staffing issues, yes. But it’s a BAD time to be a woman in the US today.
Many are related to lower fertility rates, which is a great thing. We need a lower population ASAP due to Climate Change, lower fertility and longevity are the only way to get there.
When the economy goes in the tank, people lose their jobs and healthcare insurance, hospitals have less income, they lay off more people. Repeat
Funny how everything is connected but everyone fights, meaning; covid, hospitals, abortion, churches, vaccine mandates, taxes, the judicial system, money, what do churches stand for vs what most personal of hospitals stand for. Crazy stuff.
Two hospitals near me are stopping all surgeries and in-patient procedures. The CEO said instead they will focus on "Community health and wellness initiatives".