I haven't seen many "a truly free market would fix this" comments lately. Seen a whole lot of "we need more regulation" comments though.

I wonder if the race to the bottom is inherent in free market or if there's a truly free market solution to this issue with hospital staffing.

It's inherent when quarterly numbers trump long term stability. If managers are only incentivized to meet short term numbers, they make decisions that are detrimental to the future to meet present-day goals. Our financial markets reward this (though there's a question about why they do this that's open in my mind, as most of the money in the market is invested long-term!), so it trickles down into managerial metrics.

There's a huge bottleneck in training and education of the licensed professionals involved in nursing.

To have a 'truly free market', there wouldn't be government licensing (a similar role would likely be carried out by third party certification).

I don't think that eliminating licensing would improve anything, but the regulation of nurse training absolutely needs to be included in the discussion of the problem.

> if there's a truly free market solution to this issue with hospital staffing.

You are seeing it happen. People do not accept current labor prices for healthcare work, politicians come under political fire for not providing sufficient level of healthcare, politicians increase funding to healthcare to increase pay, possibly requiring increasing taxes if they cannot figure out how to punt them to future generations.

Or insufficient number of voters want to direct more resources to healthcare to those that cannot afford it out of their own pocket, and they get less or lower quality healthcare. Maybe society decides it is not worth the cost of supporting people past 90, or even 80.

There's plenty of people willing to work at the offered salaries, there is a structural problem in the licensing process preventing them from doing so.

Where is the structural problem?

Total time from high school to nurse can be as low as 16 months, plus however long to get government paperwork.

https://bestaccreditedcolleges.org/articles/how-long-does-it...

A case can be made for doctors who have limited residency spots effectively capping new yearly supply, but what possible argument could there be for nurses other than nurse pay is not high enough to attract more people to nursing?

People changing bedpans get paid $10 to $15 per hour in many states, who wants to do that unless they have zero other options?

The number of people accepted is too small.

Hundreds of people applying for dozens of slots. The trainers that are training are not well compensated.

How do you know the people not accepted would have made desirable nurses? Surely one would want some minimum standard for the people poking you with needles and administering your healthcare/medicines.

> The trainers that are training are not well compensated.

This is just another insufficient pay scenario.

I don't know it, but I sort of take it as a given that the marginal rejectees are going to be roughly as capable as the marginal acceptees. It's not really an aggressive assumption.

And it isn't just an insufficient pay scenario. Hospitals just pass on the high cost of nursing to patients instead of subsidizing training programs. Patients don't see the supply as part of the cost problem and don't demand that more money be devoted to education.

Yes, the feedback mechanisms get quite complicated because 80%+ of people cannot not afford the level of healthcare that they receive.

But the root of the problem remains the disparity in people’s expectations of the services they will receive with the amount those service providers are getting paid.

Health care is so regulated that the word free market doesn't make any sense.

A truely free market solution would be to train people specially to deal with COVID-19 cases and build a specialized hospital to deal with that. It would also bring the cost down.

Any kind of efficient resource allocation relies on accurate predictions. No matter what system you use, free market or otherwise, if reality is constantly defying prediction, or changes too quickly, allocation won't be great.