The problem is – and this may be very bizarre in a society as capitalistic as the US – healthcare should not be beholden to making a profit.
Rehabilitating people is clearly "valuable" to the economy in that without people to participate in the economic system, a debt-based economy collapses; I'd argue that healthcare is much more valuable to capitalism than is reflected on a balance sheet of paper costs/revenues/profits, and yet a system such as ours has absolutely no way in its current form to price that in (sure, in an academic defense you could wave hands that "positive externalities" such as these should be priced in to the model, but it's clear with the racket the medical industry has found itself in that will never happen practically).
The main issue profit-seeking conflicts with is that whole rehabilitating/healing/saving people is an intrinsically good thing to do, and that letting people who have full lives to live die or suffer is an intrinsically bad thing to do.
What's not sustainable is that healthcare has to survive within the confines of a system that is many times in complete opposition to it. Other otherwise-capitalist countries have at least tried to insulate their healthcare industry from market forces, meanwhile the US has just wrapped it in another layer of capitalism with its insurance market.
Capacity is generally limited by staffing, not space or actual beds. When hospitals report how many "beds" they have available, they're generally not talking about the furniture.
Might ship in more nurses, and until they do, the beds that can't be staffed don't count towards capacity.
> 50% occupancy
Having the capacity to staff those beds is not the same as the beds being occupied. Beds are occupied by patients, not nurses.
I happen to work at a healthcare company that reports number of beds and did receive FEMA sourced labor during the pandemic in some of our rural hospitals that were short staffed and literally do not have the physical labor pool to tap into.
I think you’re discussing how you like to interpret the metrics of beds and occupancy but it’s not how it’s actually discussed in the industry.
' October 22, 2020, the FDA approved remdesivir (Veklury) for the treatment of COVID-19 for adults and certain pediatric patients requiring hospitalization '
That stuff is lethal. https://www.fiercebiotech.com/biotech/gilead-mulls-repositio...
https://www.drugdiscoverytrends.com/50-of-2021s-best-selling...
' Veklury (remdesivir) Gilead Sciences $5,565,000,000.00 COVID-19 requiring hospitalization '
And it is administered via IV, so add maybe $1000 for the IV procedure.
It doesn't even work for helping recovery. Literally poison with no medical use anywhere for anything. Another drug company and hospital emergency payday.
LTAC companies, in capitalism, would simply not accept patients if they thought they were too sick to make money on. Accepting parients put them out of business. The government wants hospitals to admit as many patients as they can in a health crisis. So , I feel this was more of a case where they acted quick and broad and didn’t actual think much about whether the drug was valid. If doctors want to prescribe it, it shouldn’t bankrupt the hospital where they work. The clinical value is up to the medical professions to figure out.
They aren't supposed to.
It doesn't match up to the reality of the US's "system"
[0]: https://www.beckershospitalreview.com/rankings-and-ratings/1....
On an individual basis, nurses are overworked because they choose to be and their employers allow for it. The standard work week is 3 12 hour shifts, which is much less than most professionals work. Like a retail or warehouse worker, they are expected to clock out as soon as possible and leave when the shift ends. Those of us with salary jobs knows how difficult that can be in our arrangements and how much "free" work we end up performing. They get paid premiums for everything; night, weekend, etc. And since they're hourly, they typically LIKE the overtime and signup for it as much as possible. They also might work FT at one hospital and pull extra shifts at another hospital on a PRN basis. These things are very common. Just like in a retail environment, people typically LIKE to work holidays so long as it's voluntary because it's 1.5x pay (or more?).
> Rather than hiring permanent people or upping salary, Hospitals have instead elected to just use travel nurses and an extreme premium so as to avoid any salary increases.
This makes no sense. Capacity is the problem, paying more for the same capacity does not solve the problem. Hospitals try very hard to avoid overtime and the travel nurses due to the cost. It's also a very elastic model to balance and a lot of flex (non Full Time) folks are needed to fill the gaps and manage cost somewhat.
> The fix is one that Hospital admins don't want. Pay your nurses more and hire more than the minimum to cover shifts so a nurse being out sick doesn't result in another working a 80 hour week.
That is the current system. The problem is usually time. If someone calls in sick, they do it an hour before their shift starts. They usually can solve for this. Either they call from their roster or a supervisor level person with an active RN license steps into the clinical side that day. Staffing at 2x just in case everyone calls in makes no sense. Staffing at 5x just in case a pandemic hits makes no sense.
Hospitals barely make money as it is, I don't see how this is a sustainable solution. Paying more does not create capacity in this industry.
It's also important to note that "nurse" is a very generic term. For example, ICU nurses is a very distinct type of nurse that has been dealing with COVID first hand (caring for vent patients). They are the ones you hear about making $150-200/hour in COVID times. It is difficult to become an ICU nurse. It hasn't been possible for a surgical nurse to pivot to ICU nurse in these times so the labor pool has been rather fixed, or shrinking due to natural churn and inability to onboard new folks. It would be akin to suggesting why does some [insert super specific domain expertise] developer make $1M/year at FAANG when they could hire a PHP coder for $15/hour on a freelance website. There is no immediate/cheap substitute for the experience and knowledge that the expensive developer has, so they cost more. This is happening in nursing where some are thriving while many actually got furloughed early on in the pandemic.
My personal opinion on the matter, is one only has to look at the demographics of an average nurse. It's become quite "old" and like other industries, the boomer's retiring is causing a labor issue. The handful of nurses that made 5-10 years of salary since Q1.2020 are now ready to retire early as well. I don't blame them.