We can be ideological and let hospitals fail and doctors and nurses get laid off, or we can be pragmatic and focus on what creates the best outcome as we navigate the reality we are in.
This is much harder in universal healthcare systems that are cost centers and thus can't just decide to change to a newer better method. Furthermore, the universal healthcare system have to budget who gets what kind of medicine. So while all people gets treated the same way not all illnesses does.
Everything have pros and cons. The US system is much better in some ways and have shortfalls in others and vice versa.
But - other people in this study didn't get the drug. I don't know if they were given placebo or just something else instead. My point being - they didn't survive, my dad did. After the study was concluded, the drug is now paid for by the national health service and anyone who needs Glivec can get it.
So why isn't this a critique of the nationalized system? Well, because the way I see it - in a private health care system, no one in this group would survive, because no one in Poland could ever afford this treatment. At least some of the people were still given a chance because the system has enough flexibility to at least try new and experimental treatments.
The US has the best healthcare system in the world--if you're a millionaire.
I have a hard time rationalizing his recent experience with the assertion that you have to be a millionaire to receive top-flight care.
Meanwhile I am glad I live in a society with a nationalized health system where births cost nothing.
I just go with a PPO because that seems less crappy than the alternative. If anyone knows what metric leads to outcomes like my friend's (I'm not being facetious here), I would like to know.
Nitpick: Over half of US hospitals are nonprofits or government owned [1] though I believe hospitals are vastly outnumbered by private clinics and independent practices. Doesn't change your overall point - even the hospitals run by governments, the Catholic church, and other institutions have budgets and are watching their main incomes disappear without much hope for the near future.
Government owned is only meaningful with the Federal government, which has unlimited resources.
My wife is a nurse for Dignity Health (another "nonprofit" hospital here in California) and has been effectively laid off for the last couple months. It's great that the ER is empty, but in the mean time nurses are struggling and people aren't getting their cancer screenings. If this goes on long enough, our healthcare system will fall apart from atrophy, not from overuse.
Why is that? You don't think they lay people off in Canada or Japan when there's no patients? Even single-payer systems can have private hospitals. They are simply paid by the govt instead of (or really in addition to) by patients. They still need business and to balance the books.
Canada has a similar mix of all kinds of hospitals like the US, though it may be more slanted in some way.
Source: https://en.wikipedia.org/wiki/Kaiser_Permanente#Operations
Huh? It is exactly what I think of when I use the term non-profit in the context of a healthcare maintenance organization. I truly have no idea what you mean by your quoted statement.
Not only are no non-essential activities happening, many essential ones are also being pushed back and people are dying as a result. There are multiple stories of people not being able to go for dialysis because hospitals insist on a negative COViD test to admit you and authorities don't allow you to get tested if you are not showing COViD symptoms. It is a catch-22 that can be resolved only if you are well-connected or rich.
Also, in knock-on effects, immunization programs are severely impacted, and many infectious diseases are likely to make a huge comeback with the monsoon season since typical mitigating measures for those were put on hold. The non-COViD death toll will be massively above typical years.
People on the prudent/cautious camp are missing that lockdowns are really last-resort, expensive controls at the bottom of the pyramid, used when better controls fail.
We can't just netflix and chill for the next two years. But we can't just pretend nothing is wrong either!
This was apparently effective with cases limited to a few clusters at the moment & most of the lockdown restrictions removed by now.
Were the hospitals affected ? They did report funding shortfals right after the lockdown due to all the cancelled elective procedures, so the ministry of health simply gave them extra money to cover the lockdown loses. And at the moment most hospitals are back to normal workflow.
Also, the people involved in directly handling the infection got bonuses as a thank you for doing the needed but dangerous work.
(I would guess that Kaiser might be doing somewhat better since they're paid monthly but their finances aren't easy to find.)
Medicare pays on a set scale for performance. If you have a heart attack, they pay a fee for the surgery and x days of hospitalization and x days of rehab. If the hospital gets you home in x-3 days, they make money. If the hospital fucks up and you get an infection and stay for x+10 days, they eat it.
Medicaid is a PPO that pays on a per procedure basis. Their rates suck, but they don't care about quality for the most part. There's a billing optimization process to maximize revenue for poor old people. (Some things are better billed to Medicare, others to Medicaid)
Private insurance pays for whatever they cover at a rate of y+z% over the Medicare rate. The patient gets the bill for whatever else happens.
Uninsured get whatever treatment is legally necessary. They patch you up, take a loss, kick you out and do it again when you come back.
Not only are hospitals for profit, but their part of cartel-like health networks. For some jobs, its hard to jump because 80% of the work is affiliated with two companies regionally.
No it makes perfect sense, and it doesn't matter if it's 'nonprofit or for-profit' - the inefficient use of resources is just the same.
Hospitals are the most expensive places in the world to run, with very highly trained personnel, gear, etc.. In a socialized system, if they are not used, it's a massive inefficiency.
Now imagine a system where 10's of millions of people are in economic pain - but they still have to foot the bill for unused medical services via taxes.
It's just shifting around deck chairs with respect to where the pain will be borne.
Almost all states very early on had some level of 'lock-down', stay at home order, or what have you. This has limited movement of people, and as a side effect, or maybe even direct order from governors, closed down/ limited many business. Including hospitals.
Hospitals in America, believe it nor not, are for profit businesses. It is un-intuitive, but many of them are in serious financial trouble, despite the influx of Covid-19 patients. At a cursory level, I think most people would assume the hospital business is booming, but this assumption couldn't be more wrong.
At this point, nobody wants to go in for routine examinations or non-emergency procedures. For-profit hospitals (almost all of them are) as a business, depend on providing these non-emergency services/ surgeries/ procedures. Hospitals across the country are laying off health-care workers en-masse.
So it is not correct to imagine all hospitals are running at full capacity, and burning out their workers. In fact, many health care professionals are drawing unemployment at this point.
I know this is doesn't make sense at the surface level, but it is something we all need to consider when continuing to advocate for lock-down or stay at home strategies. Our economy depends on movement of people/ goods/ services. That includes hospitals. I wish there was more serious discussion about this, and how we keep things moving as much as possible, while also protecting one another from spreading the virus.
Lock-down alone is not an solution. If your areas hospitals are at risk of reaching capacity, for sure close it down. But almost nowhere in America outside of NY/NJ is there a risk of that right now. We've tried it for a while, but now we have more understanding. Now I want us to re-imagine how we can continue a life of movement, and also reduce risk of infection.