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I know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s"
] |
>
It's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!
/s | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing."
] |
>
Yup. Very noticeable with ISPs.
The major companies don't overlap significantly and I feel that's totally by design.
"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!" | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s"
] |
>
The issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion
In reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\""
] |
>
Yeah, and they assume every industry being abused by a monopoly can just have another startup come in and "fix" things by adding competition while ignoring the potentially massive startup costs. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition."
] |
>
This article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs."
] |
>
And it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut.
It turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist). | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse"
] |
>
I have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, "I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box." We were semiconductor field engineers making around $120k/yr at the time.
They were high school sweethearts. He worked and put her through medical school, now they live the dream. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist)."
] |
>
Similarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.
Thank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream."
] |
>
Though I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.
And to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high."
] |
>
What you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.
Regardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.
But, well, money. So no. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for."
] |
>
The AMA doesn't control medical school accreditation; the LCME does.
The AMA has nothing to do with the LCME. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no."
] |
>
The collapse is here. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME."
] |
>
And it’s not just healthcare. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here."
] |
>
100%. Safe staffing and better pay reduce burnout. It's well known. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare."
] |
>
Yeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known."
] |
>
Been a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.
Then I got to see it for myself.
I hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.
I thought covid would do it. I really hoped it would.
Don't even get me started on long term care facilities/nursing homes.
The general public has no clue how toe-to-tip fucked everything is. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes."
] |
>
Former RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level.
It all boils down to privatization and entities like private equity squeezing every penny consequences be damned.
Universal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is."
] |
>
I agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents."
] |
>
I hadn't thought of it that way before, but I don't disagree with you!
Patients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.
I found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers."
] |
>
Patients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service.
Down here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass.
I don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes."
] |
>
I'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.
Education? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.
Internet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)
Hospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to.
In every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.
Profitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen."
] |
>
I agree with you 100%! | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor."
] |
>
And who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!"
] |
>
Likely, considering privatization is the problem but that can never be admitted in any sector | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare."
] |
>
This past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance.
Once I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while.
After an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me.
They wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor.
About 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector"
] |
>
A buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.
Then no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.
This was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked."
] |
>
People keep voting republican. If that doesn't stop, this entire country is going to collapse | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection."
] |
>
I’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse"
] |
>
Dems talk a lot and get nothing done
And a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked."
] |
>
Yup.
Go back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway.
It's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous."
] |
>
“This is not the expectation that the public expects...” from Time writers and editors. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017."
] |
>
Wince-inducing, indeed. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors."
] |
>
Well put. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed."
] |
>
they are a little late to the party. been there done that.
around these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put."
] |
>
Or divided up into a bunch of Urgent Care centers scattered around with some private doctors in between.
Here, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated."
] |
>
great point.
we've have had urgent care center closures.
one was one we've used and the only doctor had it.
another one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days."
] |
>
Meanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies."
] |
>
They can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits."
] |
>
What that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government.
They need costs to go up or their 20% goes down. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores."
] |
>
This is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients.
Enormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).
Insurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down."
] |
>
Insurance companies benefit the most from healthy patients who pay their premiums
If everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?
And by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.
Fact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap."
] |
>
If everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?
No? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways.
And by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.
Typically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%.
Fact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.
This continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.
I honestly don’t think you know how percentages work. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare."
] |
>
That’s impossible to know and such an oversimplification of reality
It's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their "profit" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work."
] |
>
It’s not at all basic math, and the fact you think it is is wildly concerning.
Assuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.
Edit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down."
] |
>
And this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in "unethical treatments" such as those related to abortion or trans affirming care from ever receiving a license. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs."
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Don't give them any ideas! | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license."
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The USA is the richest nation not only in the world, but in the history of the world.
Americans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.
Year after year, American ProfitCare is one of the most profitable industries in the world.
Shame on us. Shame on us all. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!"
] |
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And the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all."
] |
>
Those loonies are in charge because a bunch of other loonies voted for them.
I think that root cause is too often overlooked.
We're getting the results we vote for. We're getting the results we deserve. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge."
] |
>
I’m getting the results I never voted for. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve."
] |
>
I agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits? | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for."
] |
>
Some are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?"
] |
>
I would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known."
] |
>
For being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time."
] |
>
Wait another 10 years when the boomers need to go to hospital it will be a catastrophe. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years."
] |
>
Boomers are already 70+, it’s already happening | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe."
] |
>
Yeah, in 10 years it'll be gen x rocking up. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening"
] |
>
They're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up."
] |
>
We saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor."
] |
>
A lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less."
] |
>
“Coming collapse” … lol listen. This things been fucked for like 2 years. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators."
] |
>
Longer. Especially in rural communities where hospitals have been closing years before covid. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years."
] |
>
Adding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions.
Lost me here. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid."
] |
>
There were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here."
] |
>
Sorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service."
] |
>
I hope more nurses strike around the country. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified."
] |
>
Will it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country."
] |
>
This iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more.
Unfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then."
] |
>
Wait...
You mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???
[/s] | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need."
] |
>
It felt like the article was rushed and ended early. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]"
] |
>
And not well written. There were at least a few misspelled words. All which detract from its credibility. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early."
] |
>
I’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.
Staff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility."
] |
>
Coming? It's going to get worse? | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted."
] |
>
I've been watching things get worse since the 90s. It's not letting up anytime soon. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?"
] |
>
We have a health care system? It's more like an insurance company system - matching bank accounts to company profits. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon."
] |
>
Exactly as Republicans planned. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits."
] |
>
Coming? | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned."
] |
>
That level of dramatic hyperbole is why no one on the right trusts journalists anymore.
A nursing strike is not “collapse of the healthcare system”.
And even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer.
The healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse” | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?"
] |
>
health care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”"
] |
>
My understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses."
] |
>
thanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it."
] |
>
The coming collapse of the U.S. economy is what we should be worried about. Health care is a tiny fraction of the overall economy. | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it.",
">\n\nthanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy."
] |
>
Tiny fraction? US healthcare is one of the largest parts of the overall economy | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it.",
">\n\nthanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy.",
">\n\nThe coming collapse of the U.S. economy is what we should be worried about. Health care is a tiny fraction of the overall economy."
] |
>
As a nurse
Yes | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it.",
">\n\nthanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy.",
">\n\nThe coming collapse of the U.S. economy is what we should be worried about. Health care is a tiny fraction of the overall economy.",
">\n\nTiny fraction? US healthcare is one of the largest parts of the overall economy"
] |
>
Yep! | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it.",
">\n\nthanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy.",
">\n\nThe coming collapse of the U.S. economy is what we should be worried about. Health care is a tiny fraction of the overall economy.",
">\n\nTiny fraction? US healthcare is one of the largest parts of the overall economy",
">\n\nAs a nurse \nYes"
] |
> | [
"One of the most important aspects in the shift was the introduction of massive numbers of temporary workers during the pandemic which continues today. Temporary workers (typically known as Locums) are a major contribution to staffing issues. As regular hospital staff learn about the financial rewards that locum providers receive, it only leads to more individuals questioning, “why do I still work here?”.\n\nI'm shocked it wasn't sooner. Seeing someone doing the same job you are but are making 4x-7x more than you is going to make you question things.",
">\n\nAnd this is why companies of all stripes do everything they can to discourage discussions of pay: because then you and your co-workers will realize how badly you're all being fucked over, and your employer hates the idea of you being armed with that kind of knowledge.",
">\n\nAlso why they dissuade forming unions too. Unions won't allow outsiders to come in to work the same job for more pay than that of their members who have seniority",
">\n\nIf the cattle organizes, the herd can’t be led to slaughter.",
">\n\nI'm just waiting for more nurses around the country to go on strike.",
">\n\nDepends on those nurses being unionized...",
">\n\nDon't need to be in a union to stroke. There are things called general strikes where just everyone stops working in solidarity of a cause.",
">\n\nSolidarity of a cause in a nation of rugged individuals?\nThe “growth” of capitalism is merely the extraction of energy from a vast underclass converted to wealth for a small upper class. \nKeeping the underclass working against itself keeps it from freeing itself from the parasite of the upper class.",
">\n\nLooks like the picket line at Mount Sinai is getting longer than the wait time at a DMV. The nurses aren't even getting a 'sorry for the wait' bonus. Talk about a rough day at the office. But in all seriousness, this is just a symptom of the larger issue of the U.S. healthcare system's impending collapse. Who's bringing the beer to the picket line, because this is going to be a long strike",
">\n\nIt's almost like this industry is so important it shouldn't be left up to private companies, and a publicly owned entity should step in to regulate costs and ensure services!! Like in literally every other country but... Madagascar!!",
">\n\nBut the free market will fix it! We just have to reduce government interference in hospital operations and healthcare!\n/s",
">\n\nI know that libertarian types would argue that a free market would lead to cheaper healthcare because competition drives down prices. But in reality in a totally free unregulated market competitors have a strong incentive to have similar but inflated pricing.",
">\n\nIt's the same as 'competing' prices with ISPs. They're not legally colluding, but if they all have elevated prices, than everybody wins, right?!\n/s",
">\n\nYup. Very noticeable with ISPs.\nThe major companies don't overlap significantly and I feel that's totally by design.\n\"You have your turf and I have mine, we don't need to fight and lower pricing in contested areas!\"",
">\n\nThe issue with most libertarians is they assume everyone’s motivations are logical ie if you are an isp, your goal is to provide the most coverage/best product, thus you make money and beat out the competetion\nIn reality their goal is to make as much as profit as possible, thus have as many as customers as possible with the worst product and the least amount of competition.",
">\n\nYeah, and they assume every industry being abused by a monopoly can just have another startup come in and \"fix\" things by adding competition while ignoring the potentially massive startup costs.",
">\n\nThis article is a bit trash. No mention of the increased violence against health care workers. No mention of unsafe working conditions and unsafe patient ratios. No mention of exorbitant ceo pay. No mention of increased litigation against nurses or anyone that makes a mistake after being worked to death and overloaded. The system has collapsed already and the system deserves to collapse",
">\n\nAnd it ain’t just CEO pay. Even at “non profit” hospitals, most of the doctors are in Doctor Groups, which are very much for-profit (doctor groups are akin to barbers renting a chair in a salon). These groups pay dividends to members, have their own executives hoovering up money, and are increasingly being purchased by investment groups who also want a cut. \nIt turns out that having a market where customers can either pay or die is very profitable and everyone wants a piece (the technical term is “inelastic market”, which even Adam Smith agreed needed intervention. Homie also hated landlords. The rare based capitalist).",
">\n\nI have a friend whose wife is an anesthesiologist and belongs to a group. She works out of MCV in Richmond, VA. You wouldn't believe the pay and benefits. They paid off her student loans. He told me one time, \"I'm not going to tell you her salary, but I will tell you that her Federal Withholding box is bigger than my Gross Pay box.\" We were semiconductor field engineers making around $120k/yr at the time.\nThey were high school sweethearts. He worked and put her through medical school, now they live the dream.",
">\n\nSimilarly have a friend whose wife is an anesthesiologist. Pulls around 550k and works maybe 20-30 hours/week. But yeah, can’t afford nurses.\nThank goodness the AMA stopped accrediting med schools for 30 years to keep the supply of docs low and demand high.",
">\n\nThough I understand my position may be inherently biased as I am headed into residency, but physician's salaries only account for \\~10% of healthcare costs. Also, if I'm going to put in a combined 14 years of schooling and $400k of student debt at 8% interest, then I'd like to be compensated appropriately. I'm not saying you should feel bad for doctors, but as is with the nursing strike, pay isn't the motivating factor. In their case, unsafe staffing ratios jeopardizes patient safety with nurses being held liable.\n\nAnd to touch on the AMA point, they only represent about 15-18% of physicians. Poor representation is something they're notorious for.",
">\n\nWhat you’re describing is part of the problem: they can only charge what they do for med school because of the expectation that you can pay it back. They charge what they can because they can. The same is generally true for universities in general over the last 20-30 years. “Charge what the market will sustain”.\nRegardless of how many people are AMA members, they control accreditation. They control the tap for creating MD’s in the USA and have historically made sure demand outstrips supply through both accreditation and making sure Congress doesn’t free up more money for more resident or or OR advocating for simply removing the federal government from funding residents.\nBut, well, money. So no.",
">\n\nThe AMA doesn't control medical school accreditation; the LCME does. \nThe AMA has nothing to do with the LCME.",
">\n\nThe collapse is here.",
">\n\nAnd it’s not just healthcare.",
">\n\n100%. Safe staffing and better pay reduce burnout. It's well known.",
">\n\nYeah but that reduces profits so we can't have that. Executive and shareholder pay is the number one priority for these assholes.",
">\n\nBeen a nurse for 5 years, CNA/hospice aide for 8 before that, and everyone in my family is a doctor or NP. My whole life my parents have been saying how fundamentally broken the system is.\nThen I got to see it for myself.\nI hope it collapses. I hope the entire system we have is razed to the ground. It'll be terrible, but at this point - after working through the enduring cluster fuck that was covid and watching so so so so many people die in my icu, and lumping that on top of the endless institutional and systemic injustices and the terrible way this system grinds up providers and patients - I have no faith or confidence we'll ever be able to legislate a better system.\nI thought covid would do it. I really hoped it would.\nDon't even get me started on long term care facilities/nursing homes.\nThe general public has no clue how toe-to-tip fucked everything is.",
">\n\nFormer RN here. In my eyes it has already collapsed. Just when I think it can't get any worse, it does. Profiteering is rampant leading to ever increasing shortfalls in staffing including PCPs and other physicians as their autonomy lost to the demands of assholes who have never walked the halls of a hospital or understand the requirements of care at every level. \nIt all boils down to privatization and entities like private equity squeezing every penny consequences be damned. \nUniversal health care is the answer but spineless politicians won't act as their financial portfolios would probably be negatively affected or fear that Saint.Ronnie Regan's 'no rules just capitalism' would offend their clueless constituents.",
">\n\nI agree with you. It can't really support a capitalistic/for-profit model any longer. We have run into a problem of scalability. Something drastic needs to happen but I don't think anyone is going to want to take those first steps because of worries over stock prices or worries over losing campaign donations. What's sad is that in our current system, the patents aren't really even the customers--it's the insurers.",
">\n\nI hadn't thought of it that way before, but I don't disagree with you!\nPatients are the commodities that insurers have. Hospitals want the patients for the money. Insurers want 'high prices they can negotiate down' to justify their existence, but really its just for the money.\nI found out a while back that hospitals get to claim the difference between their advertised rates and the negotiated rates as losses on their taxes. So they have incentive to post rates that aren't actually what they expect for payment. It's all designed to cheat at taxes.",
">\n\nPatients are like the coal in the mine. The current system is in place to exploit that resource but at some point, that resource is no longer exploitable for profit either because the supply has been exhausted or the costs exceed whatever threshold determined it to be profitable in the first place. Sooner or later, those services will go away but society would then be left with the end result: no providers of that service. \nDown here in Georgia, they stopped recycling glass because it costs them more to recycle it than the value that was derived from it. This is capitalism working as intended but now society is left with what to do about discarded glass. \nI don’t want to imply I am anti-Capitalism but with healthcare, we are approaching the point where Capitalism will fail here unless some drastic innovations happen.",
">\n\nI'm not inherently anti-capitalism, but I certainly am against the privatization of things that genuinely impact a country's citizens.\nEducation? It should be important for a country that their citizens are well educated. Private schools can exist, but the public schools should be damn good. Make private school actually compete with the public option.\nInternet access is the same. A connected population has better tools than an isolated population. (I'm glossing over disinformation and misinformation because they are perpetual risks. A good education helps combat falling for bad info)\nHospitals and pharmaceuticals? A dead population doesn't help a country. Make good living standards accessible and affordable so people have the safety to actually grow into the fields that they want to. \nIn every single country, it's biggest actual resource is it's population. Without people, any other resources are worthless because you can't do anything with it.\nProfitability has a place at the table, but it shouldn't be the head of the table. Profitability at the expense of your citizens should be opposed with a constant amount of vigor.",
">\n\nI agree with you 100%!",
">\n\nAnd who wants to bet when it collapses the right wing narrative will be because democrats socialist policies in healthcare.",
">\n\nLikely, considering privatization is the problem but that can never be admitted in any sector",
">\n\nThis past Monday I was taken to the hospital in Tucson, Arizona by ambulance. When I arrived I was in terrible pain (kidney stones) and had been given a shot of morphine in the ambulance. \nOnce I arrived at the hospital, the paramedics handed me over to hospital staff and picked me up off of the gurney. Instead of the hospital having me lie down in a bed or sit down on a chair they had me lay down on the tile floor of the hallway with nothing under me. When I complained they told me it would only be for a little while. \nAfter an hour passed they took me into triage where I explained that my pain was getting worse and I need something for the pain. “We cannot give you anything until you have been seen by a doctor and right now your wait will be approximately 24-32 hours,” was the response they gave me. \nThey wanted me to lay back on the floor until “a chair became available.” I had a friend come get me and drive me two hours north to the Phoenix area to go to an emergency room where I might be seen sooner, and where I didn’t have to lay on the floor. \nAbout 10 hours after the whole ordeal started, I was taken care of and released from the excellent care at Scottsdale Osborn. 6 wasted hours of excruciating pain because the Tucson hospital was understaffed and overwhelmed. That sucked.",
">\n\nA buddy just went through something similar but for a bad kidney infection. He was actually at one of the “better” hospitals in our area. Thankfully he had a chair but he was there for 12 hours before being admitted. People had been there longer and were losing their minds.\nThen no doctor saw him until he threatened to walk out and go to another hospital. This is all while in pain, high fever, and terrible nausea. And it still took around 4 hours for a doctor to actually see him after his mom showed up to jailbreak him.\nThis was something like a 24+ hr ordeal for them to only call him after he was discharged to say he needed different medication than what they gave him. What they gave him apparently wouldn’t treat the underlying infection.",
">\n\nPeople keep voting republican. If that doesn't stop, this entire country is going to collapse",
">\n\nI’m finally disillusioned enough to think neither party is actually willing to do anything about it. The Republicans are just open about it. Dems talk a lot and get nothing done. The whole shit is fucked.",
">\n\n\nDems talk a lot and get nothing done\n\nAnd a big reason why is that Republicans stonewall everything that they try to do. The Democrats are far from perfect, but a both sides perspective is incredibly disingenuous.",
">\n\nYup. \nGo back to the ACA. Democrats sat down and negotiated with Republicans to determine an acceptable bill, and then the Republicans all voted against it anyway. \nIt's not that the parties agree with what needs done for America (the end goal), but disagree on the path forward. The Republican platform is just the opposite of the Democrats. We've been waiting for the Republican replacement of ACA since January 2017.",
">\n\n“This is not the expectation that the public expects...” from Time writers and editors.",
">\n\nWince-inducing, indeed.",
">\n\nWell put.",
">\n\nthey are a little late to the party. been there done that.\naround these parts its already done deal. can't get an ambulance. no nurses, no aides, no doctors. they wont get tested / vaccinated / quit / left. hospitals went from non profit to bought out by dark money and theyve cut staff to the bone. now they are for profit. walmartization/mcdonaldsization of healthcare. people gone and left/quit/laidoff/fired. go in can't find doctors. we now have fake doctors. pa andor residents running the place, but not real doctors. outcomes very bad. you will be hurt/killed go home untreated/mistreated.",
">\n\nOr divided up into a bunch of Urgent Care centers scattered around with some private doctors in between. \nHere, the few doctors who are willing to stay on and work with low income patients are in different offices in different towns on certain days.",
">\n\ngreat point.\nwe've have had urgent care center closures.\none was one we've used and the only doctor had it.\nanother one wont do house calls anymore so in this county and surrounding counties we dont have doctors/pa or even nurses that want to service us because of all the right wing covid crazies.",
">\n\nMeanwhile, the vampiric insurance companies that require the lion's share of every profit, continue to make ever increasing profits.",
">\n\nThey can only take 20% total. Not just profit but all their expenses as well. Health insurance profit margins are about 3%. About the same as grocery stores.",
">\n\nWhat that means is they have no incentive to lower costs. Look at the covid vaccine which is going to increase in price astronomically now that for-profit insurance is paying instead of the government. \nThey need costs to go up or their 20% goes down.",
">\n\nThis is just wildly incorrect. Insurance companies benefit the most from healthy patients who pay their premiums. These low cost patients pay for high cost patients. \nEnormous amounts of legislation specifically targets and prevents insurance companies from dropping high cost patients (pre-existing conditions being a huge one from Obamacare).\nInsurance companies absolutely do not want covid vaccine costs to go up. Most of them fully cover preventative care like vaccinations. The price is going up because the cost/benefit for insurance companies is to still pay for the vaccine. They’d much prefer the vaccine be dirt cheap.",
">\n\n\nInsurance companies benefit the most from healthy patients who pay their premiums\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year. \nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up. And two they can take over more and more of medicare.",
">\n\n\nIf everyone on their plans got 50% healthier and used 50% less care or if insurance companies got 50% better prices than total healthcare costs would go down 50% do we agree?\n\nNo? That’s impossible to know and such an oversimplification of reality I can’t possibly agree. I could agree that “if we eliminated 50% of cancer costs would go down” but I’m not going to agree to a broad definition of “healthier” or “less care” or that care and price are a linear relationship. Most young people use very little care. 50% improvement on them saves $0. They aren’t going anyways. \n\nAnd by law that means their 20% cut would also go down by 50%. They would even have to refund their customers half of their monthly premium or so at the end of the year.\n\nTypically no, but it can happen (and I’m confident has on occasion). My understanding is they are allowed 20% profits. If their costs are massive, they may not make any profit. They may only make 10% profit. If costs decrease in a vacuum, they would make more profit on the same revenue. But once again, you are done some weird logic where 50% of X and 50% of Y are the same number because they are both 50%. \n\nFact is there are only 2 ways insurance companies can keep making more money year after year. One, total costs can go up.\n\nThis continues to be absurdly wrong. Total costs going up can’t possibly result in more profit. This is on the same level as those who think earning more money and jumping income brackets means they pay more in taxes for a net loss. It’s just not remotely how any of this works.\nI honestly don’t think you know how percentages work.",
">\n\n\nThat’s impossible to know and such an oversimplification of reality\n\nIt's basic math. They routinely take close to 20% in admin costs the limit allowed. If all of a sudden the government said hey, everyone has to charge Medicare rates and Canada drug prices, insurance companies would see their 20% cut go down significantly. You can argue their \"profit\" levels are different but keep in mind admin costs include everything from CEO bonuses to advertising to building new offices. They don't want their 20% cut to go down. And yes if the government started setting prices like most every other country does, their 20% take would absolutely go down.",
">\n\nIt’s not at all basic math, and the fact you think it is is wildly concerning. \nAssuming all other variables stay equal, if costs go up, there is zero way their profitability goes up. Whatever financial math you are trying to do is not correct.\nEdit: it’s possible you might be under the idea that the government reimburses costs for Medicare and Medicaid. If so, that is not accurate. The government does not reimburse costs.",
">\n\nAnd this is BEFORE republican states realize they can effectively re-shape (and destroy) the medical systems by adding morality clauses to medical licensing that prohibits anyone who has participated in \"unethical treatments\" such as those related to abortion or trans affirming care from ever receiving a license.",
">\n\nDon't give them any ideas!",
">\n\nThe USA is the richest nation not only in the world, but in the history of the world.\nAmericans dying by the tens of thousands every year purely due to a lack of (or insufficient) coverage.\nYear after year, American ProfitCare is one of the most profitable industries in the world. \nShame on us. Shame on us all.",
">\n\nAnd the gqp house is poised to strip medicare and social security as well as stop the IRS from collecting income tax. This is what happens when the loonies are in charge.",
">\n\nThose loonies are in charge because a bunch of other loonies voted for them.\nI think that root cause is too often overlooked.\nWe're getting the results we vote for. We're getting the results we deserve.",
">\n\nI’m getting the results I never voted for.",
">\n\nI agree with many of the points in this article but isn't it true that most large hospital/medical systems are still making huge profits?",
">\n\nSome are in my experience. They are making money by unsafe staffing. Literally sacrificing people for profits. Unsafe staffing leads to poor patient outcomes. It is well known.",
">\n\nI would argue that this is happening to many US systems. Stability is important to a system, but job system has gone from one of stability (where jobs offered tons of benefits to stay and learn their systems) to one of transience. The same thing is happening with our teachers. The days are gone where teachers stay in one job or even in the profession for extended periods of time.",
">\n\nFor being named Time magazine, they’re definitely late in their reporting. Shit has been bad homie, check on your healthcare workers, it’s been collapsing for years.",
">\n\nWait another 10 years when the boomers need to go to hospital it will be a catastrophe.",
">\n\nBoomers are already 70+, it’s already happening",
">\n\nYeah, in 10 years it'll be gen x rocking up.",
">\n\nThey're already there, too. They're part of the Love Canel/Three Mile Island/leaded gasoline/acid rain/hole in the ozone generation (look at Documerica Project photos of 1970s pollution), exposure to now banned chemicals, asbestos in their schools, plus they went through the discovery of Lyme disease and other chronic illness along with the wear and tear of physical labor.",
">\n\nWe saw the collapse of our healthcare system during COVID. There is only one solution: Medicare for All. Everyone would have quality healthcare no matter what. It would also cost less.",
">\n\nA lot of the hospitals in NYC settled with the nurses, it just seems like Mount Sinai and Memododes (sp?) have particularly heinous administrators.",
">\n\n“Coming collapse” … lol listen. This things been fucked for like 2 years.",
">\n\nLonger. Especially in rural communities where hospitals have been closing years before covid.",
">\n\n\nAdding to this breakdown for many were the city and state vaccine mandates. Many believed that they had worked hard with limited resources and experience against COVID-19 and now the appreciation is losing your job over your own ability to make health care decisions. \n\nLost me here.",
">\n\nThere were some folks who worked in healthcare who refused to get the vaccine and thus, were unsuited to continue working. They feel deserving of special status because of their service.",
">\n\nSorry, I understand that. What I meant was that the article lost my faith in objective reporting at that point. I don't feel that nurses have special expertise in communicable diseases and immunology, and I felt the vaccine requirements were totally justified.",
">\n\nI hope more nurses strike around the country.",
">\n\nWill it take a total collapse for our politicians to fix it? They aren’t doing anything otherwise. Let it collapse then.",
">\n\nThis iceberg has been headed our way for some time now. I'm sure I'll see the usual blame game of people who don't want to work or some perceived blame for why we don't pay nurses more. \nUnfortunately, the fixes are not quick or easy. The average age of a RN is 52 years old. Average wage according to BLS is $82k. Growth rate 9%. More than 1/5 of nurses polled plan to retire in the next 5 years. Enrollment has increased in nursing school, but still at half the growth rate. Run the numbers. That's half the number of nurses we will need.",
">\n\nWait...\nYou mean not making higher education affordable and accessible is actually going to come with real social and economic consequences???\n[/s]",
">\n\nIt felt like the article was rushed and ended early.",
">\n\nAnd not well written. There were at least a few misspelled words. All which detract from its credibility.",
">\n\nI’m glad this article is trying to illuminate the crisis. But they really missed the mark on causes.\nStaff nurses are fleeing providers or the entire healthcare industry because of unacceptable working conditions. Administrators are heavy handedly imposing mandatory overtime and unsafe patient ratios while simultaneously refusing to pay reasonable salaries. These staffing shortages are entirely self inflicted.",
">\n\nComing? It's going to get worse?",
">\n\nI've been watching things get worse since the 90s. It's not letting up anytime soon.",
">\n\nWe have a health care system? It's more like an insurance company system - matching bank accounts to company profits.",
">\n\nExactly as Republicans planned.",
">\n\nComing?",
">\n\nThat level of dramatic hyperbole is why no one on the right trusts journalists anymore. \nA nursing strike is not “collapse of the healthcare system”. \nAnd even the complete failure of medicare wouldn’t be the “collapse of the healthcare system”. It would just be the collapse of a payer. \nThe healthcare industry isn’t going anywhere. There does need to be be some controls put in place in the US where it’s like 5% of GDP, but even if every single insurer goes out of business and doctors and nurses go on strike at every US hospital, there won’t be a “collapse”",
">\n\nhealth care is 18.5% of the GDP. the only control that will work is single payer system and make health care workers government employees. and while we're at it maybe get rid of the fucking AMA. they get to set the number of medical student in the US and for 100 years it's been their policy that the US should have 5% less doctors than they need to keep the pay higher. maybe if we treated health care like other professions we'd have a lot more doctors and nurses.",
">\n\nMy understanding is that the AMA used to do that 20+ years ago. The number of resident positions is set by Congress and their salaries are funded by the Centers for Medicare and Medicaid. Current leadership at the AMA is trying to remove the residency law (Balanced Budget Amendment) it helped introduce in 1997. The current blocker is Republicans in Congress want to cut funding to Medicare and Medicaid, not expand it.",
">\n\nthanks for the clarification. i wasn't aware of the funding for resident programs. i guess in theory that should make expanding the seats in med schools doable, it just seems like a fucked up way to run 20% of our economy.",
">\n\nThe coming collapse of the U.S. economy is what we should be worried about. Health care is a tiny fraction of the overall economy.",
">\n\nTiny fraction? US healthcare is one of the largest parts of the overall economy",
">\n\nAs a nurse \nYes",
">\n\nYep!"
] |
But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.
The conditions included creating a certain number of jobs which would be retained over an agreed number of years. | [] |
>
How much has it brought into the area in the last 17 years? It might have proved value for money. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years."
] |
>
This was 17 years ago? Fucking hell - this is a bit if a stretch for a headline. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money."
] |
>
Government and big business work together to fleece the public yet again. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline."
] |
>
That’s OK, Scots don’t hold grudges.
/s | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again."
] |
>
Hahaha | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s"
] |
>
This is the best tl;dr I could make, original reduced by 90%. (I'm a bot)
AMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.
The Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.
Amazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.
Extended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5 | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha"
] |
>
They. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5"
] |
>
Scots fault for not putting stipulations into the contract if they're upset with it. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5",
">\n\nThey. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling."
] |
>
They did and Amazon satisfied them? | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5",
">\n\nThey. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling.",
">\n\nScots fault for not putting stipulations into the contract if they're upset with it."
] |
>
We're going down like B.H.S. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5",
">\n\nThey. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling.",
">\n\nScots fault for not putting stipulations into the contract if they're upset with it.",
">\n\nThey did and Amazon satisfied them?"
] |
>
Lol so basically they got mugged off. Classic Amazon. | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5",
">\n\nThey. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling.",
">\n\nScots fault for not putting stipulations into the contract if they're upset with it.",
">\n\nThey did and Amazon satisfied them?",
">\n\nWe're going down like B.H.S."
] |
>
well 17 years of it running | [
"But Scottish Enterprise sources say there will be no attempt to recover the money as the conditions attached to funding had been met and are now expired.\nThe conditions included creating a certain number of jobs which would be retained over an agreed number of years.",
">\n\nHow much has it brought into the area in the last 17 years? It might have proved value for money.",
">\n\nThis was 17 years ago? Fucking hell - this is a bit if a stretch for a headline.",
">\n\nGovernment and big business work together to fleece the public yet again.",
">\n\nThat’s OK, Scots don’t hold grudges.\n/s",
">\n\nHahaha",
">\n\nThis is the best tl;dr I could make, original reduced by 90%. (I'm a bot)\n\n\nAMAZON which is planning to close its distribution centre in Inverclyde with the loss of several hundred jobs is under pressure to refund the 2.137m of taxpayers' money it received to establish and expand it, the Herald can reveal.\nThe Herald can reveal that the Amazon plan received three tranches of taxpayers' money between 2005 and 2011 to develop the centre.\nAmazon UK Services, which received the money, saw its operating profit soar by 58.5% in 2021 to £229.2m. The planned closure comes as Amazon prepares to open new delivery warehouses in Peddimore in the West Midlands and Stockton-on-Tees, County Durham, which will employ 2,500 people.\n\n\nExtended Summary | FAQ | Feedback | Top keywords: AMAZON^#1 new^#2 job^#3 Scottish^#4 centre^#5",
">\n\nThey. Don't. Care. About. You. We are money slaves to them, we exist to be worked till exhaustion, so we can afford to buy what they're selling.",
">\n\nScots fault for not putting stipulations into the contract if they're upset with it.",
">\n\nThey did and Amazon satisfied them?",
">\n\nWe're going down like B.H.S.",
">\n\nLol so basically they got mugged off. Classic Amazon."
] |
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