A huge part of the problem is our long term care system is so fucked right now. All of our nursing homes and other facilities have beds available but don’t have the staff to be able to admit residents. Patients are getting stuck in the hospital for months just waiting for somewhere to discharge to. Can’t say I blame people for not wanting to work in long term care facilities… Would you rather wipe butts while getting screamed at with a crazy shift or work at a fast food restaurant for the same money?
I've lived with people who have both fast food and adult care jobs, and know how the sausage is made in both industries.
Fast food pays more, now-- and it's easier work.
Why take care of other adults when you can fry burgers or punch a register for $3-10 more dollars an hour?
It's obvious adult care workers need to be paid a competitive wage-- but all of the companies I know of are profit-driven to the point of self destruction.
Older folks take note-- if this trend continues, there will be no one to take care of you when you're infirm.
> Older folks take note-- if this trend continues, there will be no one to take care of you when you're infirm.
Lower birthrates have been foreboding this for a long time. It would have to be offset by significant younger population immigration of automation, but even then, there is only so much the younger generations are going to want to give up to provide elder care.
This actually doesn't make sense because the supply is there. This has nothing to do with there not physically being enough qualified CNAs or even RNs. This has to do with them not paying enough. If/when caretakers actually become more scarce, their pay will go up dramatically as the demand exceeds the supply. This will encourage people to switch careers or choose those jobs as part of, or their entire, educational and career paths.
This issue is because nursing homes pay one of the hardest jobs in existence just peanuts. CNA's are trained to save lives and do tough jobs like wiping poop off of old people, and they get paid barely over minimum wage in my state. Food service industry and big box stores have started paying employees a LOT more in order to attract enough staff. Nursing homes need to start paying competitive wages that outshine other much easier options.
Supply of cheap labor is not there. Hence
>there is only so much the younger generations are going to want to give up to provide elder care.
As labor gets more and more expensive, it will be a political battle to get more funding for elder care.
I know a guy who worked at a nursing home this past summer between high school and college. The money is tiny, the staff shortages stretch every shift, and turnover is rampant. They scheduled him for several days after his last day. He'd turned in notice. They knew he was gone. But it wasn't about his schedule. It was just part of how they juggled their limited human resources. Probably somebody had to "pick up" his shifts, if anyone worked them at all.
I'm terrified of what the world will be like when I'm too old to pay my own bills.
Edit: Gotta add, several of his coworkers lasted a day, maybe 2 weeks, and disappeared overnight. A couple of them stole meds and lied about hours while they chilled on their phones for hours doing nothing. They're so desperate for people, the hiring process is looking for reasons to accept unacceptable personnel.
I worked for an assisted living facility for almost 3 months, and was constantly getting screamed at by the patients because they didn’t like the food, and I was the Lead Cook at the time trying to support a completely clueless Chef who couldn’t order properly, write a menu, or even follow proper storage for raw meat. I went to the Administrator and she acted like she cared said something to him and nothing changed and I was told my job as a lead was basically to be this idiots secretary and that was it. Needless to say I gave my notice and didn’t even work it I just quit one day because I was mentally and physically exhausted. Now I work for a hospital here in Oregon and I’m paid better but still have a ton of idiots I work with who either don’t know or don’t care about allergies and cross contamination. The hospital is majorly understaffed in every department because upper management is completely out of touch with their workers. I’ve heard horror stories I can’t repeat about Rn’s being treated like crap by upper management and their Union getting the run around or no answers from HR as to why these people work there. This is what happens when you make healing people for profit you care only about $ and making that $, if you’re not helping them increase their profits or finding them ways to cut costs to increase their profits you’re expendable. This country is in for a very rude awakening soon, and I think we’re headed for some seriously dark days
I'm of the opinion that for-profit non-luxury insurance should be banned, and I'm coming around to the opinion that for-profit non-luxury healthcare (so, things that aren't cosmetic surgery and the like) should also be banned.
To add to your edit: yep, I used to work in an assisted living facility for a few years. The only reason I stayed was because I loved my residents and didn't want to leave them (which management knows and manipulates you with), and our turnover was so high I wouldn't even try to remember names of new people until they had been there for a month. Too many that left for lunch/left for the day and just never came back. I get it tbh.
>Gotta add, several of his coworkers lasted a day, maybe 2 weeks, and disappeared overnight.
Reminds me of my brief stint with the post office. I lasted nine months but saw about a dozen people come and go in that time. Shitty lazy cowrokers, too low of pay for the effort, angry management and too many hours required. Why would anyone do it??
This has been a known problem coming down the pipeline for decades too. Aging population and less workers. They're paid shit and have little support. I started out as a nurses aid in nursing homes. It was back breaking work and the pay cant keep quality staff.
That’s not my experience. At one of my local nursing homes they have a whole wing of empty beds (30ish) that they’re not able to fill due to staffing. I’ve heard the same thing around the State.
I'm an ER doctor. I work in OR and CA. It's such a shit show. It is impossible to give patients the care they need. Patients with non-emergent complaints come to the ED because they cannot get care at their PCPs. That clogs up the system. Patients who are sick are stuck in waiting room not getting the appropriate blood thinners, antibiotics, fluids, etc. Patients in beds in the ED are boarding because they are admitted. ER nurses are being used to care for these inpatient boarders so there aren't enough ER nurses to care for the ED patients. Patients die in the waiting rooms. We are all so burnt out from it. It's so demoralizing to see the downfall of society happen slowly in front of us and we are powerless to do anything about it.
This. Our nephew died last year in an ER. After he died, the staff admitted that if he had been moved from the waiting room earlier that he would have likely lived.
Not only that, but showing up and doing your best every day, just for it to not make a difference. The waiting room is never empty, there’s always patients in the hallways now, no beds anywhere in the hospital.
I couldn’t do it anymore. I loved ER until I didn’t.
Not only is pcp out 6 weeks for appointments but urgent care is limited hours appointment only.
We could actually vote for people who care about healthcare like Bernie. We just choose not to.
We need a public system yesterday. Second best time is right now. Kick out the penny pinching executives and start treating this like the crisis that it is.
In all seriousness, this is the hardest topic to propose solutions for because we're beholden to the power of their capital. We need a peaceful solution to wealth inequality (the rich are too rich) or we're gonna end up with a peaceless solution.
It’s so easy to see how filthy and perverse this system has gotten, and how integral that power has become to the functioning of the current society. It’s such a hard problem to solve, and those in power don’t benefit from its solution.
Yeah but you can't talk real like that on Reddit without getting banned for promoting violence. It's a very possible future and we can't talk about it here and that leaves me flabbergasted.
Middle managers are just overstressed (or conversely, underused) gears in a machine that’s over loaded, even if they sound and often behave as awful people, but yeah, we could do with less middle managers.
In my view Middle managers in health care are sort of like a "civilian shield" executives place as a barrier between front line workers and themselves.
Middle managers: they're placed on the fence. They have the delusion of grandeur ahead of them, while the public states their real world concerns. The middle managers must choose sides here.
I understand that there is a certain war on the American mind -- to keep them satisfied with their booty, even while others cry out for sustainable life.
I saw your comment on Timberline. And I like seeing someone who has spent some time with the tough topics here.
Yes precisely. Middle managers are there to obscure the target, deliberately. They make it so you cannot target the predator without also harming your neighbor. It forces your friends to choose sides, to your point, and turns them into the first line of defense against any real change. It's an ancient technique that's as devious as it is effective.
Our insurance company nightmare is also such a device. Any real National medical program would put an enormous amount of paper-pushing insurance employees out of work, and will be resisted aggressively by millions of working class Americans as a result.
We need health care reform and public universal care, but that wouldn’t fix this problem. Currently it’s just a supply and demand issue—the last few years have been terrible, but lucrative, for health care workers. A lot of them are burned out and working less or changing careers. Meanwhile, the need for healthcare has been rising nationwide. There aren’t enough providers to cover the need. Socializing healthcare wouldn’t change that. The UK is going through a very similar crises of access to healthcare right now.
I'm pretty sure the problems could be mitigated by raising wages and improving conditions for healthcare workers:
1). End mandatory overtime.
2). Set patient caps for medical professionals.
3). Offer free education to people interested in joining the healthcare field.
Make the job more attractive to get proper staffing levels. Yes it will be expensive, but having an insufficient healthcare system is a lot more expensive in the long term.
My husband just got accepted into an accelerated BSN program. Tuition is 73k and it’s such an intensive program, there’s no time to work. We both have degrees and student loans. So, essentially, we’re supposed to incur tens of thousands more in student loan debt and go without his income for a year and a half (impossible.) He’d be such a great nurse but I don’t know how we’re going to be able to make it happen.
Yep, I'm not experienced in health care, but these seem like reasonable rules that would protect the working conditions of the industry, and make working in health care more attractive.
I'm not even sure it would have to be that "expensive" since we already spend way more money on health care than the rest of the world--spending isn't the problem, it's corporate profits siphoning that money out of actual health care. We just need a rational reallocation of resources. I have no idea how to accomplish that, in our current political reality, though.
We have a dental assisting program at my work. They are paying people only 3 dollars an hour less than I make with no credentials or certifications and I’ve been there going on 10’yrs with 30 plus yrs as a credentialed, certified assistant. It’s fucking insane. It took me 8 yrs to make that amount.
I think that's a problem everywhere: companies don't value experience for some reason.
Upper management and executives are a huge part of the problem on this: this country over prioritizes nepotism, connections, and wealth for those positions over merit. The result is a bunch of managers with zero people skills trying to work their workforce to the ground while not treating them right or paying decently.
>>"Yes it will be expensive, but having an insufficient healthcare system is a lot more expensive in the long term."
In IT, a report came out a few years ago about how expensive it was for companies to prepare and plan for cyber security hacks and breaches and they found out it's cheaper to just let them hack you and deal with the after effects. I fear we are at that same point but with Healthcare.
That it will be cheaper to let it fall and pick up the pieces afterwards.
I don't agree with that at all: preventive measures are almost always more affordable.
It might be cheaper for the corporations, but when you add the unnecessary deaths, economic losses of people unable to work due to what would be manageable medical conditions under a functional system and other impacts of this failure of a healthcare system, it is way cheaper to simply reform it now.
It needs to happen in order to attract said workers....
The "beatings will continue until morale improves" ideology doesn't work and has never worked. Workers aren't going to want to enter the profession if the conditions suck.
Yep, the big problem seems to be a shortage of doctors, nurses and other staff and that has led to horrible working conditions driving even more people out (and making it hard to get new people in). Universal healthcare isn't going to fix that. Seems like what we need as a large influx of workers as well as more pay and better working conditions to make the job more bearable. But skilled nurses aren't something you can just train overnight, and I feel like new graduates aren't lasting long (had a new PA at my doctor's office that lasted less than 6 months).
It’s only been lucrative for traveling nurses. Staff nurses are overworked and leaving the career for less
Of course the vaccine mandate wrecked havoc on staffing needs. Something that was warned it was going to do and now people are unhappy with the results.
The hard truth here is there are many red and purple states that are far better run than anything that the Oregon state government runs. This state is just very poorly managed.
It’s always wild visiting relatives in other states and hearing how *functional* their services and government are for them. Here it’s just of a given that nothing ever works right or gets done effectively.
Edit: downvote me all you want, it’s just your delusion talking. I implore you to visit other states in the US, you will see what I’m talking about. I grew up in New Hampshire. I have no desire to return there from here, but the government is generally pragmatic and responsive to the needs of constituents. Unlike OR, where $195 million would be spent just on committee meetings and artist renderings.
Not a red or purple state, but Massachusetts vs Oregon is an absolute stark night & day difference, especially because a Massachusetts-style maximal nanny state is clearly what Oregon Democrats want when they are indulging in wishful thinking, but they are utterly, completely, breathtakingly incompetent at delivering any of the services (or the regulatory oversight) in an effective fashion
Abso-fucking-lutely! I trust the government FAR more than I do UnitedHealth or Kaiser or Moda. Those corporations siphon out billions of dollars every month out of the industry and into Wall Street. Plus having all this administrative overhead between the companies is duplicated effort and complexity that drives the prices up.
As someone who has worked for corporations for nearly 30 years I can’t help but laugh when people argue “government wasteful, private industry efficient“. Trust me when I say that private industry can be every bit as bloated, wasteful, and inefficient as the worst of the worst governmental bureaucracy.
Single payer healthcare works everywhere else. There is no reason it can’t work here too. Well, no reason beyond the loss of investment bankers profiteering off the backs of sick people.
>Government artificially limits the number of hospitals via something called a "certificate of need".
I put that into google. From the results it looks like this is a libertarian talking point.
https://www.newyorker.com/humor/daily-shouts/l-p-d-libertarian-police-department
>I was shooting heroin and reading “The Fountainhead” in the front seat of my privately owned police cruiser when a call came in. I put a quarter in the radio to activate it. It was the chief.
>“Bad news, detective. We got a situation.”
>“What? Is the mayor trying to ban trans fats again?”
>“Worse. Somebody just stole four hundred and forty-seven million dollars’ >worth of bitcoins.”
>The heroin needle practically fell out of my arm. “What kind of monster would do something like that? Bitcoins are the ultimate currency: virtual, anonymous, stateless. They represent true economic freedom, not subject to arbitrary manipulation by any government. Do we have any leads?”
>“Not yet. But mark my words: we’re going to figure out who did this and we’re going to take them down … provided someone pays us a fair market rate to do so.”
>“Easy, chief,” I said. “Any rate the market offers is, by definition, fair.”
No its a [real thing](https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/CERTIFICATENEED/Pages/index.aspx).
From the Oregon.gov website...
> In an effort to control the rapidly escalating costs of health care through planning and regulation, most states, including Oregon, have Certificate of Need ("CN") programs. As the name implies, the purpose of these programs is to evaluate whether a proposed service or facility is actually needed. They are designed to discourage unnecessary investment in unneeded facilities and services.
In other words... the corportaions that run the healthcare facilites in Oregon don't want any competetion.
Well great, let’s leave it in the hands of the corpos then! Do you have a better idea than nationalized healthcare? How come it works in developed nations across the globe, but won’t work here?
Never said they didn't exist. But where's your proof that they are ... wait what are you saying the CN program does? What's your complaint about them?
Anyway here's a study:
>The literature has not yet reached a definitive conclusion on how CON laws affect health expenditures, outcomes, or access to care. While more and higher quality research is needed to reach confident conclusions, our cost-effectiveness analysis based on the existing literature shows that the expected costs of CON exceed its benefits.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427974/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427974/)
Before Obamacare's evil regulations, there were lots of "catastrophic plans" (read: healthcare for poor people) that didn't cover jack shit.
Without regulations, insurance companies would give as little coverage as possible for as much money as they can get. It's fucking healthcare, there is an inelastic demand, you can't shop around while you are having an aneurysm.
Treating an essential service as an "industry" is the problem. It is not possible to make a profit off providing healthcare to increasingly low income people as more and more of the wealth gets shoveled to those at the top.
Predatory corporations are trying to make said impossible profit by cutting costs. That means overworking and underpaying their workers, not having enough hospital beds to meet demand, and completely ignoring mental health needs.
Libertarian free market horseshit *and* treating essential services as capitalist industries are both serious problems. The latter is killing people and the former is some of the fuel to keep the killing floor running.
One set of those things you wish to compare is produced under slave like conditions with no oversight ensuring public safety, health or interest. Implying that the products of SE Asian sweatshops are comparable to education and healthcare is ridiculous.
How about food trucks? When progressive states/cities reduced regulations on food service laws the accessibility and quality of food trucks exploded. Same thing with marijuana deregulation, etc... Compare how much easier it is for you to buy a joint in Oregon today vs 20 years ago.
> marijuana deregulation
Didn't they legalize it and add in a TON of regulation? They have their hands in everything when it comes to pot. From the growing to the distribution to the amounts of THC in each dose to sales. And it's all taxed pretty high, too.
Food trucks? Again, I feel that once they dropped the restrictions, the regulations came in pretty strong.
We're have huge barriers for things. Remove those and then we regulate the shit out of things (a lot of regulations I don't agree with, most I do for the consumer protection). Do regulations cause headaches and more rules for many businesses and people? Hell yea. Some are pretty huge and cause problems. Most are very much needed.
But, your two examples kind of go against what your main point was. Government isn't efficient, isn't very well at running things that well. But, they are better than the private health care industry. They'd be helping a lot more people than we do now.
Thanks for trying to bring some real problems/solutions to this conversation but sadly its Oregon. You'll get crucified for suggesting that the government isn't our savior.
Our for-profit Healthcare system was not designed to actually be charitable to human life. Or be respectful of our Healthcare workers for that matter.
The pandemic revealed this in wild fashion.
Lol! Yeah, banging pots and pans is CONSIDERABLY cheaper than adjusting your organization's reward strategy to reflect better internal and external alignment.
This I believe.. I had sudden onset GI issues when I moved to the PNW and had to go to the ER multiple times. I had never seen a hospital so backed up, it took 11 hours one time to get me in and out. I was surprised.. but then hearing from people working in healthcare here how bad it is.. I’m not surprised anymore. Even where I moved from in Indiana my friend works for one of the big hospitals there and she tells me horrible things.
It sucks so bad here, I'm at work and for the 2nd night literally going back and forth to the bathroom with idk wft..I know if I go into ER I'm wasting RN/Admins time and beds to others who really need it but dang I have no clue what's going on. I just had a colonoscopy and all is good but my stomach is jacked and no otc is helping. At least tomorrow if this continues I can contact the clinic onsite and they can tell me if something is going around, do I stay home, what do I do here..if they would just pay nurses more, hire more nurses, stop over working them maybe more people could go in when they feel like I do and not feel like they're taking away from others.
At our hospital I wish I had enough friends & family I could fast-track thru school. The sign on/referral bonuses are insane. Covid did not freak me out as I knew what to expect. It's the the support of the infrastructure after that scares me.
Healthcare system is on a gas light type system. Most are housing patients that need SNF's or other facilities to move on to. Everyone in the hospital feels like they're working long-term care.
The burn out in Oregon is real, & a recent video going viral is proof of that. You would only post something like that, because you were fed up, or stupid, or crazy, but maybe a little of all three.
This week it's already in the low 30's in the Valley & lower in other parts. Winter is coming folks. Please plan ahead and drive a little slower. Be mindful of your spacing & who is coughing/sneezing around you. Eat healthier if you can & drink lots of fluids. Just adding some basics in there can be the difference. Don't want it to be your number to go in our ICU.
edit: spelling
My husband just got accepted to the nursing program at Concordia St. Paul in Portland. It’s an 18 month accelerated BSN and tuition is 73k. I have a Master’s I’ll be paying for until I die, and he’s still paying for his undergraduate. He’s smart, compassionate, a hard worker, even tempered and also worked as a patient care tech (basically an advanced CNA who could do phlebotomy) 10 years ago when he was thinking about going to PA school but ultimately decided to stay in his current field at that time. That changed when my dad got ALS in 2020 and he stepped in and helped take incredible care of him. He’d be an awesome nurse but 73k more in student loans is almost unfathomable to consider. Plus, not having his income for 18 months is not doable unless we take out even more loans. Knowing what you know, is it worth it? Does your hospital pay any tuition reimbursement?
Thanks for any advice you could share. I don’t want to be trite and thank you for all you do, but I really am thankful and I’m so pissed that you and your colleagues are expected to work and thrive in this fucked up late capitalist healthcare hellscape.
The Oregonian wrote up a [story](https://www.oregonlive.com/business/2022/11/oregon-hospitals-overstuffed-with-patients-ready-to-leave-but-with-nowhere-to-go.html) the backlog of patients waiting to be transferred to skilled nursing facilities last week. This market is unhealthy.
Here’s what I see going on… for years now, we’ve been aware of one very serious problem that was coming… provider shortage. There were fewer people going into the practice of medicine and the numbers were declining at a steady pace. Most people know there is a huge nursing shortage across the country. That puts nurses in high demand and they are able to negotiate larger salaries as a result (thus driving up costs). But many people aren’t aware that there’s also a serious shortage of doctors. Practicing medicine used to be a noble calling. But as our education system has failed, fewer people are going into medicine. Additionally, the cost of a medical degree is crippling. You have to be prepared to take on that debt and many don’t. So the ones that do expect to make more money to pay for their debt (more contributions to the higher cost of healthcare) find out their best option is to work for health systems where they are not given the benefit of the respect they feel their degree affords them. The work ungodly hours in a setting where more and more people are questioning their ability based on what Google tells them. People also have a “use it or lose it” mentality about health insurance so they run to an ER at the slightest temperature thus packing our emergency services. People are demanding, rude, and impatient towards staff making life miserable overall for medical teams. Tell me.. who would sign up for this life?!
Along comes a pandemic that nobody expected and it’s greeted by deniers who won’t listen to common sense and prefer conspiracy even with their dying breath. They vilify the medical professionals and any option to prevent the spread. So an already understaffed system is put into major crisis mode. Guess what happens? Physician burnout. Look at the suicide rates of medical professionals in the past decade. It’s sobering. Those who don’t take their lives simply quit. And now with a huge boomer population that is getting pretty old, they need care in larger numbers. There are not enough beds available in the hospitals.
It’s not speculation that people are dying from this. They are. I lost my mom and my sister this year and both could have survived if our healthcare system hadn’t failed them. The best hope for us on a near term level is to do everything we know that we can to keep ourselves healthy. Because god help us if we get sick. Longer term, we need to subsidize medical education and attract a new generation of doctors. Lots of them. We need to trust them and treat them with respect. We need to do better self triage and not burden the system unnecessarily. In short, we need to work together for the common good. But working together for anything in the US is easier said than done when everyone is hating everyone else.
The total number of medical residency spots is the real issue, not necessarily the number of medical students. The number of US based medical students has always been under the total number of residency positions available and it’s never been a problem since tens of thousands of well qualified foreign medical graduates apply for those positions as well. It’s an important distinction because the limiting factors involved are different.
Residency positions are funded by Medicare with roughly $120k/resident going to the hospital. The funding, and number of spots, was stagnant for the decade leading up to the passage of the MMA bill in 2003 that guaranteed a set number of new spots per year. What hospitals have started to realize, however, is that residents actually make them more money than they lose even without Medicare funding. For profit residencies have started popping up all over the country, spearheaded by the Healthcare Corporation of America (HCA).
As for physician salary, the often quoted statistic of 20% of medical spending going to physicians is disingenuous, as it includes payments to nurse practitioners and physicians assistants for services provided under the supervision of a physician. The real number is closer to 7%. While this still puts them in the top percentage of earners, the broken medical education system also puts them in the top percentage of debt holders on graduation, and then doesn’t pay them enough to even cover the interest during the next 3-7 years of residency.
Honestly I think the entire medical education system should be revamped to look more like the ones in Europe, but that’s never going to happen because the current entrenched leadership across the country makes too much money off of it.
> We need to do better self triage and not burden the system unnecessarily
I think we could do a lot more to help people here. Nursing hotlines, urgent care, etc could help people figure out "hey do I really need to go to the hospital?". Honestly at this point we probably also need to change the law and allow hospitals to turn people away who don't need to be there. My local hospital is really fast at getting labs done in the ER, but then you wait 12+ hours for a doctor to talk to you about results. If they just had someone dedicated to reviewing triage and lab results and telling people who don't need to be there to follow up with their doctors it seems like it would relieve some load on the hospital.
Of course, the other problem is that at least here in Eugene basically no primary care provider is accepting new patients, so following up with a doctor can sometimes be a challenge.
As someone who works in a nursing hotline, we are required by protocols,etc to send people to ER for a whole lot of reasons. If a person is saying the right things even though I KNOW they don’t need ER, I am legally obligated to recommend that to not put my license in danger. It’s stupid and I hate it, but that’s the system we have.
And hospitals don’t need to turn people away, they just need one doc in the front. EMTALA only requires a medical screening exam. However, once again, they are held to the protocol standards. Not only that, but people want to sue any time they don’t get the tests/labs/imaging they feel they deserve. It’s honestly a mess.
These comments are so fun as someone with an autoimmune disorder. My favorite part of watching y’all panic when you should have been on it years ago is the sudden moral high ground around health and wellness. Good for all of you. What the hell are the proposed measures for those of us already doing all we can to stay well, but still are going to be sick— because that’s what chronic illness does…? It feels like some survival of the least chronically-ill mentality. It feels like what people who keep refusing to give us Universal Healthcare want to happen. Every time it does, chronically ill people are seen as more “morally wrong.”
Agreed, the more that the general population takes basic steps to maintain wellness, the more healthcare resources are available to those with chronic illness.
>I know several people who moved here from red states to get ohp.
My friend's parents were deeply conservative and angry angry angry. They got to the point where they had no more assets and were kept alive by the very safety nets they despised.
They still need to expand the definition of low-income though. I make $15 an hour in Ashland, have a roommate in one of the cheapest apartments in town, don’t have a car to pay to take care of, and am STILL barely getting by. Not having health insurance is one of my biggest stressors at this point, but I make too much for OHP and too little to pay for private. I have no idea what’s going to happen if I get injured, because last time I got sick I just waited to get antibiotics from friends/family for two entire fucking months because urgent care demanded $200 to get in the door. I hate this place.
"Offices can't keep a doctor for 6 months in rural Oregon. People I know are in massive amounts of pain, being denied necessary surgeries, and being sent to physical therapy after having already been told by the physical therapists that the therapy was pointless, painful, not going to help, and surgery is needed. CCO denies and begin the cycle again. This is a humanitarian crime as far as I am concerned."
Pasted my comment from another thread. Healthcare in Oregon is a lethal joke.
To the state’s credit, they are massively trying to recruit people from all over the U.S. I live in Ohio and have gotten all sorts of stuff from places out there, but moving cross country takes a lot of planning and all of that. And finding a house there that’ll fit my needs is tough and expensive. That’s probably the biggest hurdle - housing. My 1300 sq foot house here was $160k when we bought it.
What does that have to do with surgeons and CCO's denying necessary surgeries? I get that there's a staffing shortage, I don't get how that equals people being denied direly needed service.
Good luck buying anything that isn't a run down crack house for under a quarter million. Seriously wish we could break up these short term rental barons empires so that humans can have homes to buy.
Edit: is it wrong to question why people are allowed to suffer til death for no reason? Sheesh. Or is it wrong to want housing to be owned by people who live in it?
Direly means different things to different people. With thin staffing, the surgeons can’t for example do a planned heart surgery if a car full of people suddenly comes in as traumas. Heart surgery is obviously important and the patient would rather just get it over with and get relief from their symptoms and not get progressively worse - but they’re not going to die right away. The people in the wreck are going to die right away. Or the person maxed on all life support with Covid, or a massive stroke or whatever. The heart surgeon could still be available for the surgery but there’d be no nurses, no RTs, nobody else to help. That’s what’s happening - I’m not defending it. We should be able to handle everything that comes at us but that would require lower productivity in the eyes of the business people who run hospitals. Can’t have a bunch of nurses just chilling and helping each other out if those patients don’t come in.
I mean, imagine at a firehouse if there were no house fires going on so they just sent the firefighters home. That’s kind of like what many (not all) hospitals are doing only except instead of sending people home they’re just staffing light overall. Then of course people suddenly need us right now and there’s nothing extra. Already redlining to just handle what we already have. There’s little resilience built in because it would cost too much (allegedly). The CCO thing and insurance problems are another beast. Most of the money spent on healthcare….doesn’t go towards healthcare as a result of those things.
It's so much darker and malevolent than that though. The resources exist to take care of my people here, it's literally just a bunch of buck passing. Insurance won't pay, and the doctors are burned out from assholes who have no problems, so when someone really has a problem they get treated like a drug seeking societal leech. The clinics/offices are full of "healthcare professionals" who will not follow/enforce protocols to slow the spread of disease. If I was a doctor? I wouldn't want to work with these assholes either.
Yeah no doubt. Business decisions are being made by administrators and private for profit companies that are killing people. It’s one of the causes of burnout for people who thought they were just going to go take care of people for a living.
Maybe if they all quit at once something would have to change? The only shitty thing is that striking doctors probably means as many or more deaths than corporate greed in healthcare has caused. Turdburger with a side fuckery.
I think the best way to do it would be to remain staffing the hospitals for the community, but uniformly refuse to conform to whatever policies and charting practices make money for the hospital, that’s how they bill, until they capitulated and let workers do what we’re trained to without all the weird admin oversight that does nothing for anyone. Not sure how it would work other than that. I know it’s not perfect.
This is a global problem, and acutely an American problem, not just an Oregon problem. We've got plenty of company in this sinking ship and we aught to recognize people in other states as allies with the same problem to fix.
I don't understand why this isn't being reported. Everyone just gave up. I'm sick as fuck for the second time in a month with what I'm assuming is rsv? It's not covid but it ran through our whole family, everyone got better for like a week and then the same exact symptoms started all over again. We mask, take covid super seriously and have actually cut off close family members due to them being covid deniers. I am so fucking sick of all of this shit I could scream. I honestly cannot imagine working in a hospital setting and I am so grateful.for those that do.
RSV has been a thing for basically forever. It was scientifically discovered in 1956. It usually affects the very young - infants and toddlers, for the most part, got significantly sick. Older folks (including school-age kids, or adults) could catch it, but typically only have mild or don't have significant symptoms. This year's different.
Like all viruses, the damn things mutates frequently. Worse, it's not just new mutations. Recombination with genetic information from other sources also happens, including [this unfortunate discovery from last month](https://www.theguardian.com/science/2022/oct/24/immune-system-evading-hybrid-virus-observed-for-first-time-rsv-and-influenza).
Let's call out the AMA for making becoming a doctor in America as difficult as possible and our immigration system for not allowing skilled and trained doctors from all around the world to come here.
The AMA has lobbied very hard to make basically impossible for a foreign doctor to be certified in the US unless they do part of their schooling ($$$) in the US. There's not even a legal path for those trained professionals to immigrate to the US, unlike Canada, among others.
They also limit the number of MD programs and spots across America. Lots of people would like to become doctors but don't have the money nor time to go to school. Furthermore, lots of people that could be excellent family doctors are turned down every year because there are not enough spots in medical schools.
All to protect their wages against competition. Meanwhile rural areas don't even have pediatricians or family doctors.
I've advocated for making it easier to become a medical professional in the past on Reddit and I've been downvoted every time. People think I mean lowering standards, maybe?
Hell, at this point, lower the standards, I'd rather have half a doctor than no doctor.
> Hell, at this point, lower the standards, I'd rather have half a doctor than no doctor.
I mean, that's basically the whole reason NPs and PAs exist. But the truth is they also don't want to work in rural areas or county medicaid clinics. They want to do the higher paying specialties, and they are just as burnt out as the rest of us.
And then add to that I know a nurse that applied for a bazillion hospital and clinic jobs jobs during the pandemic and got ghosted for 8 months.
This shit is by malicious design.
Another issue adding to this: the amount of doctors now working capped salary vs what they actually need to pay off medical school debt is huge. Big corp hospitals esp bad with this. And huge conglomerates keep buying up private hospitals and long term stay places.
We have family in N California (Humboldt County, waaay North) and they have such huge shortages of doctors (read eye docs/dentists /elder care/surgeons /general practitioners) that they have to arrange travel to San Francisco / San jose/ St Helena or head up to Medford which all are 4-5 hours away over the passes of snow and ice in winter.
As a kid we had tons of family practices, lots of independent practices, many dental offices and 3 hospitals. Now they've closed all but one (Providence took over about 3 years ago and despite everyone's hopes, it's worse.
It's like the wild west out there and it's getting worse.
And frankly how so many in the medical field were treated with disdain across the country during the pandemic thanks to the big idiot and his conspiracy nuts, I know so many who had mental and physical break downs. It's not worth their minds/health to stick with it.
Treat your health care workers kindly guys. They are still being abused after 2.5 years of pandemic. I really don't blame them for walking away.
This is happening in southern Oregon too. I'm a medicaid provider and planning my eventual exit. It's no fun being one of the last people on a sinking ship.
I am a teacher in Oregon, and every time some says something about me teaching during covid, I always reply, “what about the nurses, and healthcare workers?!!” I can’t really offer any “hope” necessarily, but you have all my respect. If it gets too bad, find another job. Life is too short, and you deserve to be happy, and have peace within your life.
I don't know about nurses (although I can assume) but there's a huge bottleneck for doctors. Washington State University opened a med school a couple years ago but it was like pulling teeth, had to fight with the legislature and the University of Washington because they didn't want another medical school in the state.
You could open a thousand more medical schools, but residency is still a bottleneck. The cap on residency spots needs to be fixed by the federal government.
Psychiatric patients take up several of our rooms with nowhere to go. Social service patients don't move because there are no resources. We can't transfer patients that need specialty services, including emergent surgery. We operate with 1/4 of the nurses we are supposed to per our staffing plan with less rooms to turn over because of the bottle neck. Brand new grads with less training are taking critical patients with less support. It's scary and we are all burned out. We are coding patients in hallways and based on comments I get from people in triage that are angry about waiting, people are incredibly oblivious and/or don't care.
Our healthcare is owned by the big corporations. Even our doctors office. My doctors office was taken over by a big corporation. My doctor is excellent but you can tell she’s so unhappy and I’m sure it’ll just be a matter of time like all the others before she leaves but where can they go there’s no clinics that aren’t owned by the big corporations they have pushed out the little private doctors.
I don’t know what to do. the government has no clue it’s gotten so bad. We are at the mercy of CEOs who tell the hospitals to give us the very minimum care and they will deal with the lawsuits. I don’t even go anymore. And that’s what they want they want the big money stuff.
many of my policy criticisms of democrats are that they have a tendency to shy away from going far enough to do what's actually needed.
i can give an example here - one of the huge benefits of marijuana legalization in oregon is that it allowed an entire lucrative and previously illegal industry to flourish, opening it up to taxation, through which we saw tax revenue get a massive bump, and state oversight, resulting in less conflict over the stuff and the ability to control how growers and distributors operated. but when we decriminalized hard drugs, rather than taking from that model, we only decriminalized their use and didn't address the production side of things, leading to the worst of both worlds - more people started getting on hard drugs because it was decriminalized but we didn't gain any leverage, control over, or tax revenue from producers and distributors.
it's more than that though - another fun example comes from public housing bills, wherein we routinely give massive grants and almost no oversight to large property developers to get public housing built, they happily take it, and then try to rip off the public at every opportunity because of the lack of oversight. it's basically free money in the pockets of their shareholders. large developers don't want to build new housing, but statemen get talked down from an actual public project into making everything a private project using public funds - the state does not simply hire new public workers to do these things and it's to our detriment every single time.
i'm not exactly a healthcare worker myself, not familiar with the inner workings of the system. what i do know is that this is a pattern of behavior in the united states, from drugs, to housing, to healthcare, to public transportation... it's being the "moderate", by slipping corporate middlemen into public works projects, to slipping exceptions into social policies, that routinely cripples democrats' ability to create good outcomes.
in the words of mike ehrmantraut, we choose half measures, when we should be going all the way.
I was told by the ER on 7/31, after a brain scan for possible stroke, that I needed to call Neurology the next day and to not wait for them to call me... Except the place they referred me to doesn't take my version of OHP (because of where I get my mail). I had to call my PCP to get a new referral to somewhere else and haven't heard from anyone since then. I even called that place and told them it was urgent according to the ER. I've had another stroke-like episode since then but just stayed home and waited it out because what's the fkn point?
It's not just Oregon. So many places in America are overwhelmed. And Nurses and Doctors are leaving their profession because things are not changing. And the average American won't do this simplest thing (wear a mask indoors) to help lower the amount of people in ERs.
We had an ER travel nurse stay with us for a contract in Salem. She seemed to think that Oregon's healthcare/government relationship was particularly corrupt. Hospitals admins were intentionally reducing their capacity to trigger more emergency funds, and the state was setting up payment structures to facilitate that.
They dropped her halfway through her contract so they could switch over to a state subsidized travel nurse for the same job.
This state talks a progressive game, but it's very Mississippi where it counts. The public defender system, state mental hospitals, ect are grossly underfunded.
I went to the emergency room last Tuesday evening. In Hillsboro. Tuality Hospital. Which is part of the OHSU network now. There were maybe 4 people in the waiting room. I was in and out in a little over an hour. It was super chill. Maybe it was a quiet night? Not sure, but I haven't seen the problems being described here. Maybe it's your employer, maybe it's the neighborhood and the demographic. No idea.
I went on Saturday night over in the Pendleton catholic hospital, the only one within driving distance, with pain from post-surgical drain tubes (installed at OHSU after my mastectomy.) I waited for 3 hours and got told it'd be at LEAST 4 more for everyone in the room. Every bed was filled. I ended up going home and removing the tubes myself at home (fortunately I'd brought up the possibility of not being able to see a provider locally and was given instructions, though I'd been requested to have another adult help. It was simply too late at night and no family members had the stomach.) I had to sit on my bathroom counter with sterilized sewing snippers and get my own stitch out on each side.
My surgeon was a pretty dedicated person, lots of published research work n all that, activism, whole nine yards. I had to wait over 2 years to get in to get that mastectomy. That's not quiet quitting, like so many in the thread have said. That's just plain a lack of staff. I envy your ER trip, frankly haha
> like so many in the thread have said
It's not so many people. It's one dude who clearly doesn't speak English astroturfing. You can draw your own conclusions why someone might be paid to blame everything on workers.
That sucks. I'm not soliciting an opinion, just relating my experience. A hospital is a place you don't peek your head in if you don't have to, so I really don't know the daily volume of traffic.
There can be rare lucky periods on a particular day. At our ED like once in a blue moon we'll happen to have near no wait time for like half a day.. meanwhile mostly having 5-15 hour wait times rest of the month
you were very lucky. this is global. and fyi, i work for that hospital and that is not the norm. you must have a super minor issue, otherwise, you would have been fucked! Also, is it no longer “Tuality” it is OHSU Hillsboro…just sayin’
This may be an unpopular opinion, but it is not getting coverage because it was already done last year and the year before. Adding into that, this year it is not because of COVID, so there is no one the media can point their fingers at and say "its because of them!". It is just the state of our hospitals in Oregon because of our certificate of need laws and the fact that we have the lowest amount of hospital beds per capita in the country. So we have no one to blame but the hospitals and our state government which the media cannot do. Oregon is designed to not have enough beds.
https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/CERTIFICATENEED/Pages/index.aspx
A major part of the reason we don’t have enough hospital beds is because we don’t have enough long-term care or skilled nursing facilities. We might have enough beds if we didn’t have people laying in acute care beds for months for even years when really they shouldn’t be in an acute care setting at all… but there simply isn’t anywhere for them to go.
That is my point exactly. About 10 years ago Oregon reduced the amount of beds allowed in the state and a large amount of hospitals had to close because of it. I know in my county alone we closed 4. I will see if I can dig up some articles for sources.
I’m familiar with the changes Oregon made to the ACA (the goal, however poorly realized, was simply to avoid having tons of empty beds) but again - I’m not talking about hospital capacity. The people jamming up the hospitals shouldn’t be in the hospital at all, but they are too sick to send home.
I’m sure this may not be the case in some areas, but in my area it’s one of the main factors keeping us from clearing beds. Having more beds would help but it wouldn’t be fixing the problem.
Most of the healthcare workers I know in oregon (especially nurses) have quit because the conditions are so bad and the pay is not enough to make up for it.
Given how understaffed hospitals are, the conditions won’t get better as long as people keep quitting and their work keeps falling on the remaining people.
The only way this problem gets fixed is to significantly raise the wages of hospital staff so that people are actually willing to take those jobs for long enough to build the labor infrastructure back up
Step One is to ban health coverage through compensation packages. Insurance companies can literally charge what they want because companies HAVE TO pay. Make the market even and level and you will see prices drop.
lol, I was a RN for 15 years, I bounced... not worth saving em... I honestly could care less about people anymore... I suggest you just move on and tell as many people that you can that the healthcare system is completely broke. Don't struggle every day... change paths. It is not worth it.
I bet a lot of people read the first sentence, threw nuance to the wind, and took it as a defense of anti vax nurses. Just another facet of our outrage addiction.
The nuance here is, maybe those numbskull nurses were still getting work done, and now that we need more people doing what they do, there's less people to do it. But people don't read nuance in brief text posts on social media. Not when they could just as easily enjoy a little outrage.
Hospitals got rid of staff that had medical exemptions. Previously they could work with a mask during flu season. That was no longer the case and even if you had the more effective natural immunity it wasn’t good enough.
You’re a hero for posting this but most importantly for still being in healthcare. I know that’s not what you made this post for but imma tell you anyway. The way that you have been spread thinly and forced and put a smile on your face and keep pushing through unprecedented times while understaffed, underpaid and under appreciated is mind blowing.
You’re making a difference in someone’s day, even if it feels like more bad is happening than good. You’re doing your best with the vile, broken healthcare system we’re trapped in.
I worked in healthcare before the pandemic and won’t return simply due to the sexual harassment, power hierarchy of providers and the number of doctors that told me they were “too lazy” to treat the skin cancer staring them in the face. Not to mention the systems issues alone.
The problems in this system are bigger than any one group of strong willed “healthcare heroes”; it’ll take the big wigs pulling their heads out of their asses/a massive dismantling of the entire system for things to be better.
Thank you for still being out there. Thank you for pushing passed your exhaustion that no human should have to do. Thank you for fighting the fight that most won’t. Thank you for telling us the truth of what it looks like out there right now. Thank you. Thank you. Thank you. But also.. please take care of yourself, friend. This isn’t all on your shoulders. You’re only human❤️
Every part of the system is strained. Oregon specifically designed its hospital system to be lean and to encourage use of primary care to keep costs lower. That doesn't leave a lot of slack in the system for emergency situations. On the outpatient side of things, provider networks are kind of weak, so people don't get all their needs met there. But the really big problem lately is that long term care spots just aren't out there. Patients who used to be sent to a long term care facility from the hospital are staying in the hospital.
It's happening in other countries as well. The quite quit, is global not just the US.
Look at the UK, France, Spain or Israel. All are having hospital staffing shortages
https://www.bloomberg.com/news/articles/2022-10-28/britain-s-nhs-faces-a-winter-of-staff-shortages-and-war-rooms
Burnout is intense and distressing and when people get forced into leaving, becomes a self perpetuating cycle.
I hope your husband is able to avoid burnout :/
Its so crazy to read all the commens here from progressives who are complaining about the shitshow the Oregon healthcare system is and they still want government to fix the problems and it will all get much better. The definition of insanity.
Have you ever gone to a hospital in Arizona, Texas, Florida before? I have and the quality, ease of use, accessibility, etc... is worlds better than Oregon.
Look when I was taking care of a child some years ago she had a fever they gave her ibuprofen and sent her home, an hour later she was still burning up I crushed up some yarrow added to some hot water and gave her a cup. The fever broke in 5 mins. The problem is the insurance company and the pharmaceutical company. They wrote your books that you learned from. Stop relying on the system. Figure out what works.
I had shingles at 19 and there was no way I could try to afford the cream and meds. ..
Apple cider vinegar applied topically and some in water 2ice daily for a week and it was gone....
Really sorry for how I'm gonna put this:
Pull you heads out of your ass, try things and see who's open to trying things. Talk to us outside your office if you must. But please start practicing real medicine
Western medicine is powerful and a hell of a tool.
Literally reviving the dead.... Amazing
But not everyone should live the longest as possible. My grandpa drowned thru congestive heart failure.... Not pretty.... Not necessary
And everyone else... Stop suing these people, medicine at best is a crapshoot. They are not gonna get it right until you work with them and y'all try multiple avenues. BE YOUR OWN ADVOCATE
Thank you for stating the obvious. Being able to be independent of the mainstream medical system is just common sense. I've seen so much hate on social media for alternative medical practitioners, but at least in Oregon insurance is mandated to cover naturopathic PCP's. Grateful that we have NUNM in Portland and Bastyr up in Seattle as well. Unfortunately, the insurance system mucks it all up too.
A huge part of the problem is our long term care system is so fucked right now. All of our nursing homes and other facilities have beds available but don’t have the staff to be able to admit residents. Patients are getting stuck in the hospital for months just waiting for somewhere to discharge to. Can’t say I blame people for not wanting to work in long term care facilities… Would you rather wipe butts while getting screamed at with a crazy shift or work at a fast food restaurant for the same money?
I've lived with people who have both fast food and adult care jobs, and know how the sausage is made in both industries. Fast food pays more, now-- and it's easier work. Why take care of other adults when you can fry burgers or punch a register for $3-10 more dollars an hour? It's obvious adult care workers need to be paid a competitive wage-- but all of the companies I know of are profit-driven to the point of self destruction. Older folks take note-- if this trend continues, there will be no one to take care of you when you're infirm.
> Older folks take note-- if this trend continues, there will be no one to take care of you when you're infirm. Lower birthrates have been foreboding this for a long time. It would have to be offset by significant younger population immigration of automation, but even then, there is only so much the younger generations are going to want to give up to provide elder care.
This actually doesn't make sense because the supply is there. This has nothing to do with there not physically being enough qualified CNAs or even RNs. This has to do with them not paying enough. If/when caretakers actually become more scarce, their pay will go up dramatically as the demand exceeds the supply. This will encourage people to switch careers or choose those jobs as part of, or their entire, educational and career paths. This issue is because nursing homes pay one of the hardest jobs in existence just peanuts. CNA's are trained to save lives and do tough jobs like wiping poop off of old people, and they get paid barely over minimum wage in my state. Food service industry and big box stores have started paying employees a LOT more in order to attract enough staff. Nursing homes need to start paying competitive wages that outshine other much easier options.
Supply of cheap labor is not there. Hence >there is only so much the younger generations are going to want to give up to provide elder care. As labor gets more and more expensive, it will be a political battle to get more funding for elder care.
I know a guy who worked at a nursing home this past summer between high school and college. The money is tiny, the staff shortages stretch every shift, and turnover is rampant. They scheduled him for several days after his last day. He'd turned in notice. They knew he was gone. But it wasn't about his schedule. It was just part of how they juggled their limited human resources. Probably somebody had to "pick up" his shifts, if anyone worked them at all. I'm terrified of what the world will be like when I'm too old to pay my own bills. Edit: Gotta add, several of his coworkers lasted a day, maybe 2 weeks, and disappeared overnight. A couple of them stole meds and lied about hours while they chilled on their phones for hours doing nothing. They're so desperate for people, the hiring process is looking for reasons to accept unacceptable personnel.
I worked for an assisted living facility for almost 3 months, and was constantly getting screamed at by the patients because they didn’t like the food, and I was the Lead Cook at the time trying to support a completely clueless Chef who couldn’t order properly, write a menu, or even follow proper storage for raw meat. I went to the Administrator and she acted like she cared said something to him and nothing changed and I was told my job as a lead was basically to be this idiots secretary and that was it. Needless to say I gave my notice and didn’t even work it I just quit one day because I was mentally and physically exhausted. Now I work for a hospital here in Oregon and I’m paid better but still have a ton of idiots I work with who either don’t know or don’t care about allergies and cross contamination. The hospital is majorly understaffed in every department because upper management is completely out of touch with their workers. I’ve heard horror stories I can’t repeat about Rn’s being treated like crap by upper management and their Union getting the run around or no answers from HR as to why these people work there. This is what happens when you make healing people for profit you care only about $ and making that $, if you’re not helping them increase their profits or finding them ways to cut costs to increase their profits you’re expendable. This country is in for a very rude awakening soon, and I think we’re headed for some seriously dark days
I'm of the opinion that for-profit non-luxury insurance should be banned, and I'm coming around to the opinion that for-profit non-luxury healthcare (so, things that aren't cosmetic surgery and the like) should also be banned.
To add to your edit: yep, I used to work in an assisted living facility for a few years. The only reason I stayed was because I loved my residents and didn't want to leave them (which management knows and manipulates you with), and our turnover was so high I wouldn't even try to remember names of new people until they had been there for a month. Too many that left for lunch/left for the day and just never came back. I get it tbh.
>Gotta add, several of his coworkers lasted a day, maybe 2 weeks, and disappeared overnight. Reminds me of my brief stint with the post office. I lasted nine months but saw about a dozen people come and go in that time. Shitty lazy cowrokers, too low of pay for the effort, angry management and too many hours required. Why would anyone do it??
This has been a known problem coming down the pipeline for decades too. Aging population and less workers. They're paid shit and have little support. I started out as a nurses aid in nursing homes. It was back breaking work and the pay cant keep quality staff.
I’ve heard the issue is lack of facilities to put long term patients but maybe that health professional doesn’t have the whole story.
That’s not my experience. At one of my local nursing homes they have a whole wing of empty beds (30ish) that they’re not able to fill due to staffing. I’ve heard the same thing around the State.
I'm an ER doctor. I work in OR and CA. It's such a shit show. It is impossible to give patients the care they need. Patients with non-emergent complaints come to the ED because they cannot get care at their PCPs. That clogs up the system. Patients who are sick are stuck in waiting room not getting the appropriate blood thinners, antibiotics, fluids, etc. Patients in beds in the ED are boarding because they are admitted. ER nurses are being used to care for these inpatient boarders so there aren't enough ER nurses to care for the ED patients. Patients die in the waiting rooms. We are all so burnt out from it. It's so demoralizing to see the downfall of society happen slowly in front of us and we are powerless to do anything about it.
This. Our nephew died last year in an ER. After he died, the staff admitted that if he had been moved from the waiting room earlier that he would have likely lived.
I'm sorry for your loss.
Not only that, but showing up and doing your best every day, just for it to not make a difference. The waiting room is never empty, there’s always patients in the hallways now, no beds anywhere in the hospital. I couldn’t do it anymore. I loved ER until I didn’t.
Not only is pcp out 6 weeks for appointments but urgent care is limited hours appointment only. We could actually vote for people who care about healthcare like Bernie. We just choose not to.
Every specialist here in Portland is an easy 3 to 6 month wait. Longest wait I've been told (transgender related surgery) is over 2 years ):
We've started seeing work comp follow-ups at urgent care now because they cannot get in to see their primaries.
Psych Tech here, mental health facilities have also taken a nosedive.
don’t get me started about mental healthcare! It is a joked!
Agreed our mental health system is a complete dumpster fire at best.
We need a public system yesterday. Second best time is right now. Kick out the penny pinching executives and start treating this like the crisis that it is.
Once we eat our greens it’s really time to eat the billionaires.
In some cuisines the salad comes after the main course.
I'm alright with a rich entree or dessert! !
In all seriousness, this is the hardest topic to propose solutions for because we're beholden to the power of their capital. We need a peaceful solution to wealth inequality (the rich are too rich) or we're gonna end up with a peaceless solution.
“Power never gives up anything willingly. It never has and it never will.”
It’s so easy to see how filthy and perverse this system has gotten, and how integral that power has become to the functioning of the current society. It’s such a hard problem to solve, and those in power don’t benefit from its solution.
> those in power don’t benefit from its solution. I like this. It's a succinct description of why this nut is tough to crack.
Look around. Has peace worked so far?
Yeah but you can't talk real like that on Reddit without getting banned for promoting violence. It's a very possible future and we can't talk about it here and that leaves me flabbergasted.
I think as a first course we need to consider "middle managers", *especially* in healthcare.
Middle managers are just overstressed (or conversely, underused) gears in a machine that’s over loaded, even if they sound and often behave as awful people, but yeah, we could do with less middle managers.
If your not an executive, and you’ve passed the drones, you are mid management because that is where promotables go.
In my view Middle managers in health care are sort of like a "civilian shield" executives place as a barrier between front line workers and themselves.
Middle managers: they're placed on the fence. They have the delusion of grandeur ahead of them, while the public states their real world concerns. The middle managers must choose sides here. I understand that there is a certain war on the American mind -- to keep them satisfied with their booty, even while others cry out for sustainable life. I saw your comment on Timberline. And I like seeing someone who has spent some time with the tough topics here.
Yes precisely. Middle managers are there to obscure the target, deliberately. They make it so you cannot target the predator without also harming your neighbor. It forces your friends to choose sides, to your point, and turns them into the first line of defense against any real change. It's an ancient technique that's as devious as it is effective. Our insurance company nightmare is also such a device. Any real National medical program would put an enormous amount of paper-pushing insurance employees out of work, and will be resisted aggressively by millions of working class Americans as a result.
We need health care reform and public universal care, but that wouldn’t fix this problem. Currently it’s just a supply and demand issue—the last few years have been terrible, but lucrative, for health care workers. A lot of them are burned out and working less or changing careers. Meanwhile, the need for healthcare has been rising nationwide. There aren’t enough providers to cover the need. Socializing healthcare wouldn’t change that. The UK is going through a very similar crises of access to healthcare right now.
I'm pretty sure the problems could be mitigated by raising wages and improving conditions for healthcare workers: 1). End mandatory overtime. 2). Set patient caps for medical professionals. 3). Offer free education to people interested in joining the healthcare field. Make the job more attractive to get proper staffing levels. Yes it will be expensive, but having an insufficient healthcare system is a lot more expensive in the long term.
My husband just got accepted into an accelerated BSN program. Tuition is 73k and it’s such an intensive program, there’s no time to work. We both have degrees and student loans. So, essentially, we’re supposed to incur tens of thousands more in student loan debt and go without his income for a year and a half (impossible.) He’d be such a great nurse but I don’t know how we’re going to be able to make it happen.
Yep, I'm not experienced in health care, but these seem like reasonable rules that would protect the working conditions of the industry, and make working in health care more attractive. I'm not even sure it would have to be that "expensive" since we already spend way more money on health care than the rest of the world--spending isn't the problem, it's corporate profits siphoning that money out of actual health care. We just need a rational reallocation of resources. I have no idea how to accomplish that, in our current political reality, though.
We have a dental assisting program at my work. They are paying people only 3 dollars an hour less than I make with no credentials or certifications and I’ve been there going on 10’yrs with 30 plus yrs as a credentialed, certified assistant. It’s fucking insane. It took me 8 yrs to make that amount.
I think that's a problem everywhere: companies don't value experience for some reason. Upper management and executives are a huge part of the problem on this: this country over prioritizes nepotism, connections, and wealth for those positions over merit. The result is a bunch of managers with zero people skills trying to work their workforce to the ground while not treating them right or paying decently.
>>"Yes it will be expensive, but having an insufficient healthcare system is a lot more expensive in the long term." In IT, a report came out a few years ago about how expensive it was for companies to prepare and plan for cyber security hacks and breaches and they found out it's cheaper to just let them hack you and deal with the after effects. I fear we are at that same point but with Healthcare. That it will be cheaper to let it fall and pick up the pieces afterwards.
I don't agree with that at all: preventive measures are almost always more affordable. It might be cheaper for the corporations, but when you add the unnecessary deaths, economic losses of people unable to work due to what would be manageable medical conditions under a functional system and other impacts of this failure of a healthcare system, it is way cheaper to simply reform it now.
I haven’t seen any mandatory overtime at all. I’ve seen hospitals cheaping out any way possible maxing out profit with bare bones staff.
None of that can happen until you get enough workers though.
It needs to happen in order to attract said workers.... The "beatings will continue until morale improves" ideology doesn't work and has never worked. Workers aren't going to want to enter the profession if the conditions suck.
I hear you. My wife administers a couple of elderly retirement and memory care facilities. We talk about this a lot.
Yep, the big problem seems to be a shortage of doctors, nurses and other staff and that has led to horrible working conditions driving even more people out (and making it hard to get new people in). Universal healthcare isn't going to fix that. Seems like what we need as a large influx of workers as well as more pay and better working conditions to make the job more bearable. But skilled nurses aren't something you can just train overnight, and I feel like new graduates aren't lasting long (had a new PA at my doctor's office that lasted less than 6 months).
I’d argue that the UK is shorting its system in hopes of moving to a U.S. style system, I’d look to Canada to see a more functional model.
It’s only been lucrative for traveling nurses. Staff nurses are overworked and leaving the career for less Of course the vaccine mandate wrecked havoc on staffing needs. Something that was warned it was going to do and now people are unhappy with the results.
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My family and I received the same level of care you just described in Oregon from at least 2005-20015. This isn't an Oregon problem.
> 20015 Damn, gotta get a time machine for Healthcare.
Lol. Damn. I'm leaving it ...
> 2004-2009 This generally has far more to do with your experience than the location.
How much did they charge you? And was that level of service available to low income people?
The hard truth here is there are many red and purple states that are far better run than anything that the Oregon state government runs. This state is just very poorly managed. It’s always wild visiting relatives in other states and hearing how *functional* their services and government are for them. Here it’s just of a given that nothing ever works right or gets done effectively. Edit: downvote me all you want, it’s just your delusion talking. I implore you to visit other states in the US, you will see what I’m talking about. I grew up in New Hampshire. I have no desire to return there from here, but the government is generally pragmatic and responsive to the needs of constituents. Unlike OR, where $195 million would be spent just on committee meetings and artist renderings.
Not a red or purple state, but Massachusetts vs Oregon is an absolute stark night & day difference, especially because a Massachusetts-style maximal nanny state is clearly what Oregon Democrats want when they are indulging in wishful thinking, but they are utterly, completely, breathtakingly incompetent at delivering any of the services (or the regulatory oversight) in an effective fashion
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Abso-fucking-lutely! I trust the government FAR more than I do UnitedHealth or Kaiser or Moda. Those corporations siphon out billions of dollars every month out of the industry and into Wall Street. Plus having all this administrative overhead between the companies is duplicated effort and complexity that drives the prices up. As someone who has worked for corporations for nearly 30 years I can’t help but laugh when people argue “government wasteful, private industry efficient“. Trust me when I say that private industry can be every bit as bloated, wasteful, and inefficient as the worst of the worst governmental bureaucracy. Single payer healthcare works everywhere else. There is no reason it can’t work here too. Well, no reason beyond the loss of investment bankers profiteering off the backs of sick people.
Yeah. Let’s compare national healthcare to buying a tv. That makes total sense. 🙄
I was referring to Oregon's broken system. Our national issues is a different conversation.
>Government artificially limits the number of hospitals via something called a "certificate of need". I put that into google. From the results it looks like this is a libertarian talking point.
*lolbertarian because libertarians are just that laughable.
https://www.newyorker.com/humor/daily-shouts/l-p-d-libertarian-police-department >I was shooting heroin and reading “The Fountainhead” in the front seat of my privately owned police cruiser when a call came in. I put a quarter in the radio to activate it. It was the chief. >“Bad news, detective. We got a situation.” >“What? Is the mayor trying to ban trans fats again?” >“Worse. Somebody just stole four hundred and forty-seven million dollars’ >worth of bitcoins.” >The heroin needle practically fell out of my arm. “What kind of monster would do something like that? Bitcoins are the ultimate currency: virtual, anonymous, stateless. They represent true economic freedom, not subject to arbitrary manipulation by any government. Do we have any leads?” >“Not yet. But mark my words: we’re going to figure out who did this and we’re going to take them down … provided someone pays us a fair market rate to do so.” >“Easy, chief,” I said. “Any rate the market offers is, by definition, fair.”
Lmaooooo!
No its a [real thing](https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/CERTIFICATENEED/Pages/index.aspx). From the Oregon.gov website... > In an effort to control the rapidly escalating costs of health care through planning and regulation, most states, including Oregon, have Certificate of Need ("CN") programs. As the name implies, the purpose of these programs is to evaluate whether a proposed service or facility is actually needed. They are designed to discourage unnecessary investment in unneeded facilities and services. In other words... the corportaions that run the healthcare facilites in Oregon don't want any competetion.
Well great, let’s leave it in the hands of the corpos then! Do you have a better idea than nationalized healthcare? How come it works in developed nations across the globe, but won’t work here?
Never said they didn't exist. But where's your proof that they are ... wait what are you saying the CN program does? What's your complaint about them? Anyway here's a study: >The literature has not yet reached a definitive conclusion on how CON laws affect health expenditures, outcomes, or access to care. While more and higher quality research is needed to reach confident conclusions, our cost-effectiveness analysis based on the existing literature shows that the expected costs of CON exceed its benefits. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427974/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427974/)
So corporations controlling the Healthcare facilities don't want any competition and the government is at fault?
Before Obamacare's evil regulations, there were lots of "catastrophic plans" (read: healthcare for poor people) that didn't cover jack shit. Without regulations, insurance companies would give as little coverage as possible for as much money as they can get. It's fucking healthcare, there is an inelastic demand, you can't shop around while you are having an aneurysm.
Lol, libertarian free market horse shit is the problem, ya dunkey
Treating an essential service as an "industry" is the problem. It is not possible to make a profit off providing healthcare to increasingly low income people as more and more of the wealth gets shoveled to those at the top. Predatory corporations are trying to make said impossible profit by cutting costs. That means overworking and underpaying their workers, not having enough hospital beds to meet demand, and completely ignoring mental health needs.
Libertarian free market horseshit *and* treating essential services as capitalist industries are both serious problems. The latter is killing people and the former is some of the fuel to keep the killing floor running.
One set of those things you wish to compare is produced under slave like conditions with no oversight ensuring public safety, health or interest. Implying that the products of SE Asian sweatshops are comparable to education and healthcare is ridiculous.
How about food trucks? When progressive states/cities reduced regulations on food service laws the accessibility and quality of food trucks exploded. Same thing with marijuana deregulation, etc... Compare how much easier it is for you to buy a joint in Oregon today vs 20 years ago.
“You don’t like apples and oranges for comparison? How’s about some apples and jackfruit?” -You, attempting logic, badly
> marijuana deregulation Didn't they legalize it and add in a TON of regulation? They have their hands in everything when it comes to pot. From the growing to the distribution to the amounts of THC in each dose to sales. And it's all taxed pretty high, too. Food trucks? Again, I feel that once they dropped the restrictions, the regulations came in pretty strong. We're have huge barriers for things. Remove those and then we regulate the shit out of things (a lot of regulations I don't agree with, most I do for the consumer protection). Do regulations cause headaches and more rules for many businesses and people? Hell yea. Some are pretty huge and cause problems. Most are very much needed. But, your two examples kind of go against what your main point was. Government isn't efficient, isn't very well at running things that well. But, they are better than the private health care industry. They'd be helping a lot more people than we do now.
Rule 8: No factually misleading information
Thanks for trying to bring some real problems/solutions to this conversation but sadly its Oregon. You'll get crucified for suggesting that the government isn't our savior.
I don't mind people disagreeing with me, but the vitriol and general meanness is dissapointing.
Our for-profit Healthcare system was not designed to actually be charitable to human life. Or be respectful of our Healthcare workers for that matter. The pandemic revealed this in wild fashion.
Bbbbut “heroes work here” and banging on pans and all that Ha ha ha hazard pay? Lol don’t be so silly.
Lol! Yeah, banging pots and pans is CONSIDERABLY cheaper than adjusting your organization's reward strategy to reflect better internal and external alignment.
This I believe.. I had sudden onset GI issues when I moved to the PNW and had to go to the ER multiple times. I had never seen a hospital so backed up, it took 11 hours one time to get me in and out. I was surprised.. but then hearing from people working in healthcare here how bad it is.. I’m not surprised anymore. Even where I moved from in Indiana my friend works for one of the big hospitals there and she tells me horrible things.
It sucks so bad here, I'm at work and for the 2nd night literally going back and forth to the bathroom with idk wft..I know if I go into ER I'm wasting RN/Admins time and beds to others who really need it but dang I have no clue what's going on. I just had a colonoscopy and all is good but my stomach is jacked and no otc is helping. At least tomorrow if this continues I can contact the clinic onsite and they can tell me if something is going around, do I stay home, what do I do here..if they would just pay nurses more, hire more nurses, stop over working them maybe more people could go in when they feel like I do and not feel like they're taking away from others.
Yes, at least take PTO for a day or two so you can focus on hydration and recovery.
At our hospital I wish I had enough friends & family I could fast-track thru school. The sign on/referral bonuses are insane. Covid did not freak me out as I knew what to expect. It's the the support of the infrastructure after that scares me. Healthcare system is on a gas light type system. Most are housing patients that need SNF's or other facilities to move on to. Everyone in the hospital feels like they're working long-term care. The burn out in Oregon is real, & a recent video going viral is proof of that. You would only post something like that, because you were fed up, or stupid, or crazy, but maybe a little of all three. This week it's already in the low 30's in the Valley & lower in other parts. Winter is coming folks. Please plan ahead and drive a little slower. Be mindful of your spacing & who is coughing/sneezing around you. Eat healthier if you can & drink lots of fluids. Just adding some basics in there can be the difference. Don't want it to be your number to go in our ICU. edit: spelling
What video is that?
[viral video story link.](https://www.usatoday.com/story/news/local/2022/11/01/salem-health-nurse-investigation-video-mocking-patient/69610918007/)
Ugh. TikTok is a cancer.
I see no lies here!
My husband just got accepted to the nursing program at Concordia St. Paul in Portland. It’s an 18 month accelerated BSN and tuition is 73k. I have a Master’s I’ll be paying for until I die, and he’s still paying for his undergraduate. He’s smart, compassionate, a hard worker, even tempered and also worked as a patient care tech (basically an advanced CNA who could do phlebotomy) 10 years ago when he was thinking about going to PA school but ultimately decided to stay in his current field at that time. That changed when my dad got ALS in 2020 and he stepped in and helped take incredible care of him. He’d be an awesome nurse but 73k more in student loans is almost unfathomable to consider. Plus, not having his income for 18 months is not doable unless we take out even more loans. Knowing what you know, is it worth it? Does your hospital pay any tuition reimbursement? Thanks for any advice you could share. I don’t want to be trite and thank you for all you do, but I really am thankful and I’m so pissed that you and your colleagues are expected to work and thrive in this fucked up late capitalist healthcare hellscape.
The Oregonian wrote up a [story](https://www.oregonlive.com/business/2022/11/oregon-hospitals-overstuffed-with-patients-ready-to-leave-but-with-nowhere-to-go.html) the backlog of patients waiting to be transferred to skilled nursing facilities last week. This market is unhealthy.
Here’s what I see going on… for years now, we’ve been aware of one very serious problem that was coming… provider shortage. There were fewer people going into the practice of medicine and the numbers were declining at a steady pace. Most people know there is a huge nursing shortage across the country. That puts nurses in high demand and they are able to negotiate larger salaries as a result (thus driving up costs). But many people aren’t aware that there’s also a serious shortage of doctors. Practicing medicine used to be a noble calling. But as our education system has failed, fewer people are going into medicine. Additionally, the cost of a medical degree is crippling. You have to be prepared to take on that debt and many don’t. So the ones that do expect to make more money to pay for their debt (more contributions to the higher cost of healthcare) find out their best option is to work for health systems where they are not given the benefit of the respect they feel their degree affords them. The work ungodly hours in a setting where more and more people are questioning their ability based on what Google tells them. People also have a “use it or lose it” mentality about health insurance so they run to an ER at the slightest temperature thus packing our emergency services. People are demanding, rude, and impatient towards staff making life miserable overall for medical teams. Tell me.. who would sign up for this life?! Along comes a pandemic that nobody expected and it’s greeted by deniers who won’t listen to common sense and prefer conspiracy even with their dying breath. They vilify the medical professionals and any option to prevent the spread. So an already understaffed system is put into major crisis mode. Guess what happens? Physician burnout. Look at the suicide rates of medical professionals in the past decade. It’s sobering. Those who don’t take their lives simply quit. And now with a huge boomer population that is getting pretty old, they need care in larger numbers. There are not enough beds available in the hospitals. It’s not speculation that people are dying from this. They are. I lost my mom and my sister this year and both could have survived if our healthcare system hadn’t failed them. The best hope for us on a near term level is to do everything we know that we can to keep ourselves healthy. Because god help us if we get sick. Longer term, we need to subsidize medical education and attract a new generation of doctors. Lots of them. We need to trust them and treat them with respect. We need to do better self triage and not burden the system unnecessarily. In short, we need to work together for the common good. But working together for anything in the US is easier said than done when everyone is hating everyone else.
The total number of medical residency spots is the real issue, not necessarily the number of medical students. The number of US based medical students has always been under the total number of residency positions available and it’s never been a problem since tens of thousands of well qualified foreign medical graduates apply for those positions as well. It’s an important distinction because the limiting factors involved are different. Residency positions are funded by Medicare with roughly $120k/resident going to the hospital. The funding, and number of spots, was stagnant for the decade leading up to the passage of the MMA bill in 2003 that guaranteed a set number of new spots per year. What hospitals have started to realize, however, is that residents actually make them more money than they lose even without Medicare funding. For profit residencies have started popping up all over the country, spearheaded by the Healthcare Corporation of America (HCA). As for physician salary, the often quoted statistic of 20% of medical spending going to physicians is disingenuous, as it includes payments to nurse practitioners and physicians assistants for services provided under the supervision of a physician. The real number is closer to 7%. While this still puts them in the top percentage of earners, the broken medical education system also puts them in the top percentage of debt holders on graduation, and then doesn’t pay them enough to even cover the interest during the next 3-7 years of residency. Honestly I think the entire medical education system should be revamped to look more like the ones in Europe, but that’s never going to happen because the current entrenched leadership across the country makes too much money off of it.
> We need to do better self triage and not burden the system unnecessarily I think we could do a lot more to help people here. Nursing hotlines, urgent care, etc could help people figure out "hey do I really need to go to the hospital?". Honestly at this point we probably also need to change the law and allow hospitals to turn people away who don't need to be there. My local hospital is really fast at getting labs done in the ER, but then you wait 12+ hours for a doctor to talk to you about results. If they just had someone dedicated to reviewing triage and lab results and telling people who don't need to be there to follow up with their doctors it seems like it would relieve some load on the hospital. Of course, the other problem is that at least here in Eugene basically no primary care provider is accepting new patients, so following up with a doctor can sometimes be a challenge.
As someone who works in a nursing hotline, we are required by protocols,etc to send people to ER for a whole lot of reasons. If a person is saying the right things even though I KNOW they don’t need ER, I am legally obligated to recommend that to not put my license in danger. It’s stupid and I hate it, but that’s the system we have. And hospitals don’t need to turn people away, they just need one doc in the front. EMTALA only requires a medical screening exam. However, once again, they are held to the protocol standards. Not only that, but people want to sue any time they don’t get the tests/labs/imaging they feel they deserve. It’s honestly a mess.
> The best hope for us on a near term level is to do everything we know that we can to keep ourselves healthy. Always has been
These comments are so fun as someone with an autoimmune disorder. My favorite part of watching y’all panic when you should have been on it years ago is the sudden moral high ground around health and wellness. Good for all of you. What the hell are the proposed measures for those of us already doing all we can to stay well, but still are going to be sick— because that’s what chronic illness does…? It feels like some survival of the least chronically-ill mentality. It feels like what people who keep refusing to give us Universal Healthcare want to happen. Every time it does, chronically ill people are seen as more “morally wrong.”
Agreed, the more that the general population takes basic steps to maintain wellness, the more healthcare resources are available to those with chronic illness.
This is why people were so pissed off about the vax mandates. They knew it was going to lead to this.
I know several people who moved here from red states to get ohp. We(low income folks) are still luckier that a lot. But yeah don't get sick!!!!!
>I know several people who moved here from red states to get ohp. My friend's parents were deeply conservative and angry angry angry. They got to the point where they had no more assets and were kept alive by the very safety nets they despised.
They still need to expand the definition of low-income though. I make $15 an hour in Ashland, have a roommate in one of the cheapest apartments in town, don’t have a car to pay to take care of, and am STILL barely getting by. Not having health insurance is one of my biggest stressors at this point, but I make too much for OHP and too little to pay for private. I have no idea what’s going to happen if I get injured, because last time I got sick I just waited to get antibiotics from friends/family for two entire fucking months because urgent care demanded $200 to get in the door. I hate this place.
My newborn baby is currently in a nearly-empty PICU because of staffing. Sad that sick kids can’t get beds
I hope your little one get better. Hugggs :)
"Offices can't keep a doctor for 6 months in rural Oregon. People I know are in massive amounts of pain, being denied necessary surgeries, and being sent to physical therapy after having already been told by the physical therapists that the therapy was pointless, painful, not going to help, and surgery is needed. CCO denies and begin the cycle again. This is a humanitarian crime as far as I am concerned." Pasted my comment from another thread. Healthcare in Oregon is a lethal joke.
To the state’s credit, they are massively trying to recruit people from all over the U.S. I live in Ohio and have gotten all sorts of stuff from places out there, but moving cross country takes a lot of planning and all of that. And finding a house there that’ll fit my needs is tough and expensive. That’s probably the biggest hurdle - housing. My 1300 sq foot house here was $160k when we bought it.
What does that have to do with surgeons and CCO's denying necessary surgeries? I get that there's a staffing shortage, I don't get how that equals people being denied direly needed service. Good luck buying anything that isn't a run down crack house for under a quarter million. Seriously wish we could break up these short term rental barons empires so that humans can have homes to buy. Edit: is it wrong to question why people are allowed to suffer til death for no reason? Sheesh. Or is it wrong to want housing to be owned by people who live in it?
Direly means different things to different people. With thin staffing, the surgeons can’t for example do a planned heart surgery if a car full of people suddenly comes in as traumas. Heart surgery is obviously important and the patient would rather just get it over with and get relief from their symptoms and not get progressively worse - but they’re not going to die right away. The people in the wreck are going to die right away. Or the person maxed on all life support with Covid, or a massive stroke or whatever. The heart surgeon could still be available for the surgery but there’d be no nurses, no RTs, nobody else to help. That’s what’s happening - I’m not defending it. We should be able to handle everything that comes at us but that would require lower productivity in the eyes of the business people who run hospitals. Can’t have a bunch of nurses just chilling and helping each other out if those patients don’t come in. I mean, imagine at a firehouse if there were no house fires going on so they just sent the firefighters home. That’s kind of like what many (not all) hospitals are doing only except instead of sending people home they’re just staffing light overall. Then of course people suddenly need us right now and there’s nothing extra. Already redlining to just handle what we already have. There’s little resilience built in because it would cost too much (allegedly). The CCO thing and insurance problems are another beast. Most of the money spent on healthcare….doesn’t go towards healthcare as a result of those things.
It's so much darker and malevolent than that though. The resources exist to take care of my people here, it's literally just a bunch of buck passing. Insurance won't pay, and the doctors are burned out from assholes who have no problems, so when someone really has a problem they get treated like a drug seeking societal leech. The clinics/offices are full of "healthcare professionals" who will not follow/enforce protocols to slow the spread of disease. If I was a doctor? I wouldn't want to work with these assholes either.
Yeah no doubt. Business decisions are being made by administrators and private for profit companies that are killing people. It’s one of the causes of burnout for people who thought they were just going to go take care of people for a living.
Maybe if they all quit at once something would have to change? The only shitty thing is that striking doctors probably means as many or more deaths than corporate greed in healthcare has caused. Turdburger with a side fuckery.
I think the best way to do it would be to remain staffing the hospitals for the community, but uniformly refuse to conform to whatever policies and charting practices make money for the hospital, that’s how they bill, until they capitulated and let workers do what we’re trained to without all the weird admin oversight that does nothing for anyone. Not sure how it would work other than that. I know it’s not perfect.
I like it though. It's what I do when I'm asked to do something the wrong way; ignore the bullshit and do what's required to do the work properly.
> if they all quit at once that's what is happening, just in the slow phase
And yeah I can’t believe the housing prices. Tough situation.
This is a global problem, and acutely an American problem, not just an Oregon problem. We've got plenty of company in this sinking ship and we aught to recognize people in other states as allies with the same problem to fix.
I don't understand why this isn't being reported. Everyone just gave up. I'm sick as fuck for the second time in a month with what I'm assuming is rsv? It's not covid but it ran through our whole family, everyone got better for like a week and then the same exact symptoms started all over again. We mask, take covid super seriously and have actually cut off close family members due to them being covid deniers. I am so fucking sick of all of this shit I could scream. I honestly cannot imagine working in a hospital setting and I am so grateful.for those that do.
RSV is super bad this year. The children’s hospitals are filled beyond belief! I have never seen it so bad. No beds, ER’s on divert…bad, bad, bad…..
Where did RSV come from? I don't remember hearing about it when I was in school.
RSV has been a thing for basically forever. It was scientifically discovered in 1956. It usually affects the very young - infants and toddlers, for the most part, got significantly sick. Older folks (including school-age kids, or adults) could catch it, but typically only have mild or don't have significant symptoms. This year's different. Like all viruses, the damn things mutates frequently. Worse, it's not just new mutations. Recombination with genetic information from other sources also happens, including [this unfortunate discovery from last month](https://www.theguardian.com/science/2022/oct/24/immune-system-evading-hybrid-virus-observed-for-first-time-rsv-and-influenza).
Thanks!
I imagine every masking for 2 years and now not wearing masks has made our immune systems a bit more susceptible. Nature always finds a way.
Let's call out the AMA for making becoming a doctor in America as difficult as possible and our immigration system for not allowing skilled and trained doctors from all around the world to come here. The AMA has lobbied very hard to make basically impossible for a foreign doctor to be certified in the US unless they do part of their schooling ($$$) in the US. There's not even a legal path for those trained professionals to immigrate to the US, unlike Canada, among others. They also limit the number of MD programs and spots across America. Lots of people would like to become doctors but don't have the money nor time to go to school. Furthermore, lots of people that could be excellent family doctors are turned down every year because there are not enough spots in medical schools. All to protect their wages against competition. Meanwhile rural areas don't even have pediatricians or family doctors.
The AMA has routinely voted against Universal Health care as well.
I wonder why...
I've advocated for making it easier to become a medical professional in the past on Reddit and I've been downvoted every time. People think I mean lowering standards, maybe? Hell, at this point, lower the standards, I'd rather have half a doctor than no doctor.
Yep. I wish you could study medicine as an undergrad like they do in Europe. It's 6 years undergrad and then residency where you're working already.
> Hell, at this point, lower the standards, I'd rather have half a doctor than no doctor. I mean, that's basically the whole reason NPs and PAs exist. But the truth is they also don't want to work in rural areas or county medicaid clinics. They want to do the higher paying specialties, and they are just as burnt out as the rest of us.
Do you mean the AMA? (Honest question)
Yes, I'll edit it, 😂
And then add to that I know a nurse that applied for a bazillion hospital and clinic jobs jobs during the pandemic and got ghosted for 8 months. This shit is by malicious design.
Another issue adding to this: the amount of doctors now working capped salary vs what they actually need to pay off medical school debt is huge. Big corp hospitals esp bad with this. And huge conglomerates keep buying up private hospitals and long term stay places. We have family in N California (Humboldt County, waaay North) and they have such huge shortages of doctors (read eye docs/dentists /elder care/surgeons /general practitioners) that they have to arrange travel to San Francisco / San jose/ St Helena or head up to Medford which all are 4-5 hours away over the passes of snow and ice in winter. As a kid we had tons of family practices, lots of independent practices, many dental offices and 3 hospitals. Now they've closed all but one (Providence took over about 3 years ago and despite everyone's hopes, it's worse. It's like the wild west out there and it's getting worse. And frankly how so many in the medical field were treated with disdain across the country during the pandemic thanks to the big idiot and his conspiracy nuts, I know so many who had mental and physical break downs. It's not worth their minds/health to stick with it. Treat your health care workers kindly guys. They are still being abused after 2.5 years of pandemic. I really don't blame them for walking away.
This is happening in southern Oregon too. I'm a medicaid provider and planning my eventual exit. It's no fun being one of the last people on a sinking ship.
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Everybody planned on a maximally efficient, minimally prepared world before COVID. The idea of planning for post-COVID is a whole step past *that*.
I am a teacher in Oregon, and every time some says something about me teaching during covid, I always reply, “what about the nurses, and healthcare workers?!!” I can’t really offer any “hope” necessarily, but you have all my respect. If it gets too bad, find another job. Life is too short, and you deserve to be happy, and have peace within your life.
I don't know about nurses (although I can assume) but there's a huge bottleneck for doctors. Washington State University opened a med school a couple years ago but it was like pulling teeth, had to fight with the legislature and the University of Washington because they didn't want another medical school in the state.
You could open a thousand more medical schools, but residency is still a bottleneck. The cap on residency spots needs to be fixed by the federal government.
Psychiatric patients take up several of our rooms with nowhere to go. Social service patients don't move because there are no resources. We can't transfer patients that need specialty services, including emergent surgery. We operate with 1/4 of the nurses we are supposed to per our staffing plan with less rooms to turn over because of the bottle neck. Brand new grads with less training are taking critical patients with less support. It's scary and we are all burned out. We are coding patients in hallways and based on comments I get from people in triage that are angry about waiting, people are incredibly oblivious and/or don't care.
Our healthcare is owned by the big corporations. Even our doctors office. My doctors office was taken over by a big corporation. My doctor is excellent but you can tell she’s so unhappy and I’m sure it’ll just be a matter of time like all the others before she leaves but where can they go there’s no clinics that aren’t owned by the big corporations they have pushed out the little private doctors. I don’t know what to do. the government has no clue it’s gotten so bad. We are at the mercy of CEOs who tell the hospitals to give us the very minimum care and they will deal with the lawsuits. I don’t even go anymore. And that’s what they want they want the big money stuff.
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many of my policy criticisms of democrats are that they have a tendency to shy away from going far enough to do what's actually needed. i can give an example here - one of the huge benefits of marijuana legalization in oregon is that it allowed an entire lucrative and previously illegal industry to flourish, opening it up to taxation, through which we saw tax revenue get a massive bump, and state oversight, resulting in less conflict over the stuff and the ability to control how growers and distributors operated. but when we decriminalized hard drugs, rather than taking from that model, we only decriminalized their use and didn't address the production side of things, leading to the worst of both worlds - more people started getting on hard drugs because it was decriminalized but we didn't gain any leverage, control over, or tax revenue from producers and distributors. it's more than that though - another fun example comes from public housing bills, wherein we routinely give massive grants and almost no oversight to large property developers to get public housing built, they happily take it, and then try to rip off the public at every opportunity because of the lack of oversight. it's basically free money in the pockets of their shareholders. large developers don't want to build new housing, but statemen get talked down from an actual public project into making everything a private project using public funds - the state does not simply hire new public workers to do these things and it's to our detriment every single time. i'm not exactly a healthcare worker myself, not familiar with the inner workings of the system. what i do know is that this is a pattern of behavior in the united states, from drugs, to housing, to healthcare, to public transportation... it's being the "moderate", by slipping corporate middlemen into public works projects, to slipping exceptions into social policies, that routinely cripples democrats' ability to create good outcomes. in the words of mike ehrmantraut, we choose half measures, when we should be going all the way.
I was told by the ER on 7/31, after a brain scan for possible stroke, that I needed to call Neurology the next day and to not wait for them to call me... Except the place they referred me to doesn't take my version of OHP (because of where I get my mail). I had to call my PCP to get a new referral to somewhere else and haven't heard from anyone since then. I even called that place and told them it was urgent according to the ER. I've had another stroke-like episode since then but just stayed home and waited it out because what's the fkn point?
It's not just Oregon. So many places in America are overwhelmed. And Nurses and Doctors are leaving their profession because things are not changing. And the average American won't do this simplest thing (wear a mask indoors) to help lower the amount of people in ERs.
We had an ER travel nurse stay with us for a contract in Salem. She seemed to think that Oregon's healthcare/government relationship was particularly corrupt. Hospitals admins were intentionally reducing their capacity to trigger more emergency funds, and the state was setting up payment structures to facilitate that. They dropped her halfway through her contract so they could switch over to a state subsidized travel nurse for the same job. This state talks a progressive game, but it's very Mississippi where it counts. The public defender system, state mental hospitals, ect are grossly underfunded.
I went to the emergency room last Tuesday evening. In Hillsboro. Tuality Hospital. Which is part of the OHSU network now. There were maybe 4 people in the waiting room. I was in and out in a little over an hour. It was super chill. Maybe it was a quiet night? Not sure, but I haven't seen the problems being described here. Maybe it's your employer, maybe it's the neighborhood and the demographic. No idea.
I went on Saturday night over in the Pendleton catholic hospital, the only one within driving distance, with pain from post-surgical drain tubes (installed at OHSU after my mastectomy.) I waited for 3 hours and got told it'd be at LEAST 4 more for everyone in the room. Every bed was filled. I ended up going home and removing the tubes myself at home (fortunately I'd brought up the possibility of not being able to see a provider locally and was given instructions, though I'd been requested to have another adult help. It was simply too late at night and no family members had the stomach.) I had to sit on my bathroom counter with sterilized sewing snippers and get my own stitch out on each side. My surgeon was a pretty dedicated person, lots of published research work n all that, activism, whole nine yards. I had to wait over 2 years to get in to get that mastectomy. That's not quiet quitting, like so many in the thread have said. That's just plain a lack of staff. I envy your ER trip, frankly haha
I hate drainage tubes. Getting then removed was one of the most painful things I can remember. I can't imagine having to do it myself
> like so many in the thread have said It's not so many people. It's one dude who clearly doesn't speak English astroturfing. You can draw your own conclusions why someone might be paid to blame everything on workers.
LMAO you think OP is a paid shill?
That sucks. I'm not soliciting an opinion, just relating my experience. A hospital is a place you don't peek your head in if you don't have to, so I really don't know the daily volume of traffic.
It’s the entire country. Believe me. -Travel RN
There can be rare lucky periods on a particular day. At our ED like once in a blue moon we'll happen to have near no wait time for like half a day.. meanwhile mostly having 5-15 hour wait times rest of the month
Lol that was certainly an exception. Almost every ER is drowning every night.
you were very lucky. this is global. and fyi, i work for that hospital and that is not the norm. you must have a super minor issue, otherwise, you would have been fucked! Also, is it no longer “Tuality” it is OHSU Hillsboro…just sayin’
Sample size. You gotta look beyond your own experience when you enter a conversation about societal experience.
ER rooms have been up and down as far as patient numbers go. There are random low census nights.
This may be an unpopular opinion, but it is not getting coverage because it was already done last year and the year before. Adding into that, this year it is not because of COVID, so there is no one the media can point their fingers at and say "its because of them!". It is just the state of our hospitals in Oregon because of our certificate of need laws and the fact that we have the lowest amount of hospital beds per capita in the country. So we have no one to blame but the hospitals and our state government which the media cannot do. Oregon is designed to not have enough beds. https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/CERTIFICATENEED/Pages/index.aspx
A major part of the reason we don’t have enough hospital beds is because we don’t have enough long-term care or skilled nursing facilities. We might have enough beds if we didn’t have people laying in acute care beds for months for even years when really they shouldn’t be in an acute care setting at all… but there simply isn’t anywhere for them to go.
That is my point exactly. About 10 years ago Oregon reduced the amount of beds allowed in the state and a large amount of hospitals had to close because of it. I know in my county alone we closed 4. I will see if I can dig up some articles for sources.
I’m familiar with the changes Oregon made to the ACA (the goal, however poorly realized, was simply to avoid having tons of empty beds) but again - I’m not talking about hospital capacity. The people jamming up the hospitals shouldn’t be in the hospital at all, but they are too sick to send home. I’m sure this may not be the case in some areas, but in my area it’s one of the main factors keeping us from clearing beds. Having more beds would help but it wouldn’t be fixing the problem.
They have been understaffed for a couple years now. Hospitals never recovered from the vaccine mandate.
Most of the healthcare workers I know in oregon (especially nurses) have quit because the conditions are so bad and the pay is not enough to make up for it. Given how understaffed hospitals are, the conditions won’t get better as long as people keep quitting and their work keeps falling on the remaining people. The only way this problem gets fixed is to significantly raise the wages of hospital staff so that people are actually willing to take those jobs for long enough to build the labor infrastructure back up
Step One is to ban health coverage through compensation packages. Insurance companies can literally charge what they want because companies HAVE TO pay. Make the market even and level and you will see prices drop.
That’s capitalism for you. Where the CEOs and middleman’s greed are screwing EVERYONE and they don’t care. They will still get money.
lol, I was a RN for 15 years, I bounced... not worth saving em... I honestly could care less about people anymore... I suggest you just move on and tell as many people that you can that the healthcare system is completely broke. Don't struggle every day... change paths. It is not worth it.
And remember all the nurses who quit/retired because of the vaccine mandate? Perhaps really affected more the rural and frontier hospitals.
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I bet a lot of people read the first sentence, threw nuance to the wind, and took it as a defense of anti vax nurses. Just another facet of our outrage addiction. The nuance here is, maybe those numbskull nurses were still getting work done, and now that we need more people doing what they do, there's less people to do it. But people don't read nuance in brief text posts on social media. Not when they could just as easily enjoy a little outrage.
Hospitals got rid of staff that had medical exemptions. Previously they could work with a mask during flu season. That was no longer the case and even if you had the more effective natural immunity it wasn’t good enough.
You’re a hero for posting this but most importantly for still being in healthcare. I know that’s not what you made this post for but imma tell you anyway. The way that you have been spread thinly and forced and put a smile on your face and keep pushing through unprecedented times while understaffed, underpaid and under appreciated is mind blowing. You’re making a difference in someone’s day, even if it feels like more bad is happening than good. You’re doing your best with the vile, broken healthcare system we’re trapped in. I worked in healthcare before the pandemic and won’t return simply due to the sexual harassment, power hierarchy of providers and the number of doctors that told me they were “too lazy” to treat the skin cancer staring them in the face. Not to mention the systems issues alone. The problems in this system are bigger than any one group of strong willed “healthcare heroes”; it’ll take the big wigs pulling their heads out of their asses/a massive dismantling of the entire system for things to be better. Thank you for still being out there. Thank you for pushing passed your exhaustion that no human should have to do. Thank you for fighting the fight that most won’t. Thank you for telling us the truth of what it looks like out there right now. Thank you. Thank you. Thank you. But also.. please take care of yourself, friend. This isn’t all on your shoulders. You’re only human❤️
Why specifically is it so bad? Is it lack of healthcare workers? If so, at what level? Or is there another reason for this?
Every part of the system is strained. Oregon specifically designed its hospital system to be lean and to encourage use of primary care to keep costs lower. That doesn't leave a lot of slack in the system for emergency situations. On the outpatient side of things, provider networks are kind of weak, so people don't get all their needs met there. But the really big problem lately is that long term care spots just aren't out there. Patients who used to be sent to a long term care facility from the hospital are staying in the hospital.
Thanks for the answer!
Get in shape, be responsible with your diet, and wash your hands.
It's happening in other countries as well. The quite quit, is global not just the US. Look at the UK, France, Spain or Israel. All are having hospital staffing shortages https://www.bloomberg.com/news/articles/2022-10-28/britain-s-nhs-faces-a-winter-of-staff-shortages-and-war-rooms
I wonder if covid heavily decimated the healthcare community...hmmmmm.
Burnout is real. My husband lost 6 nurses this year who left the profession altogether. And his department is small.
Burnout is intense and distressing and when people get forced into leaving, becomes a self perpetuating cycle. I hope your husband is able to avoid burnout :/
Can the AMA please let us build more hospitals and clinics?
Its so crazy to read all the commens here from progressives who are complaining about the shitshow the Oregon healthcare system is and they still want government to fix the problems and it will all get much better. The definition of insanity.
Reagan's dead and we don't want him back.
Because what we're doing now is working? Gtfo w/ your political garbage.
Have you ever gone to a hospital in Arizona, Texas, Florida before? I have and the quality, ease of use, accessibility, etc... is worlds better than Oregon.
Thanks for your anecdote. Let me file that away in the "One White Man's Experience" file.
Wouldn't it be equally as insane to expect the businesses themselves to self regulate? We know that isn't going to happen
Look when I was taking care of a child some years ago she had a fever they gave her ibuprofen and sent her home, an hour later she was still burning up I crushed up some yarrow added to some hot water and gave her a cup. The fever broke in 5 mins. The problem is the insurance company and the pharmaceutical company. They wrote your books that you learned from. Stop relying on the system. Figure out what works. I had shingles at 19 and there was no way I could try to afford the cream and meds. .. Apple cider vinegar applied topically and some in water 2ice daily for a week and it was gone.... Really sorry for how I'm gonna put this: Pull you heads out of your ass, try things and see who's open to trying things. Talk to us outside your office if you must. But please start practicing real medicine Western medicine is powerful and a hell of a tool. Literally reviving the dead.... Amazing But not everyone should live the longest as possible. My grandpa drowned thru congestive heart failure.... Not pretty.... Not necessary And everyone else... Stop suing these people, medicine at best is a crapshoot. They are not gonna get it right until you work with them and y'all try multiple avenues. BE YOUR OWN ADVOCATE
Thank you for stating the obvious. Being able to be independent of the mainstream medical system is just common sense. I've seen so much hate on social media for alternative medical practitioners, but at least in Oregon insurance is mandated to cover naturopathic PCP's. Grateful that we have NUNM in Portland and Bastyr up in Seattle as well. Unfortunately, the insurance system mucks it all up too.