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Hospital exec says employees are walking off the job

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Re: Hospital exec says employees are walking off the job

#251

Post by varelse »

iammisc wrote: post #225
varelse wrote: post #212

Earlier quoted context omitted.

And private insurance has a long history of denying claims. How is this any different? https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-...

Because the denied claims are the responsibility of the individual, not the government.

A company's responsibility is solely to its shareholders, not to its customers. If those two goals align, win/win. Denying expensive claims increases profitability right up to the point they lose enough customers to offset those gains. Am I missing something fundamental about capitalism here?

I'm not saying that's particularly ethical behavior and they wouldn't get my business if I could help it, but if they choose to behave otherwise, they risk delivering suboptimal shareholder value, no?

Re: Hospital exec says employees are walking off the job

#252

Post by iammisc »

varelse wrote: post #228
iammisc wrote: post #220

Earlier quoted context omitted.

> But that could change or are you asserting it won't How can you interpret what I wrote to say that a new virus or variant certainly won't cause a higher fatality rate? Anything can happen at any time. For all we know, a new virus could become prevalent. Typically though, we base public policy based on things that have already happened and the likelihood of future things. There is little reason to believe COVID will…

So you assert viruses cannot evolve to be deadlier but at the same time insist they always evolve to become less deadly. But the only evolutionary imperative is more virus particles. If becoming less deadly is the best path, the virus becomes less deadly. But if increased fatality comes along with making more virus particles, it will get deadlier. But don't take it from me: "But there’s no obvious evolutionary advant…

> >COVID does not seem to be bouncing between animal hosts

You make antibodies to all kinds of things. You likely have antibodies to cat viruses that have no chance of infecting you.

Again, stop the fear mongering.

> they always evolve to become less deadly.

As with any 'rule', there are exceptions, but that is the general idea yes. There is little need to worry about future variants.

Re: Hospital exec says employees are walking off the job

#253

Post by iammisc »

myko wrote: post #241
iammisc wrote: post #220

Earlier quoted context omitted.

> But that could change or are you asserting it won't How can you interpret what I wrote to say that a new virus or variant certainly won't cause a higher fatality rate? Anything can happen at any time. For all we know, a new virus could become prevalent. Typically though, we base public policy based on things that have already happened and the likelihood of future things. There is little reason to believe COVID will…

> There is little reason to believe COVID will evolve into something more deadly. In general viruses rarely make this evolutionary step. This is false, and has already happened with COVID-19's delta variant. "in addition to being more contagious, the delta variant likely increases the risk of severe disease and hospitalization, compared with the original strain." - https://www.npr.org/2021/07/29/1022580439/a-cdc-inte…

> It also says that in addition to being more contagious, the delta variant likely increases the risk of severe disease and hospitalization, compared with the original strain.

Hold on, hospitalization and severe disease and death are completely different things. This is a disingenuous use of this article.

I mean, mono is severe (tired for months potentially), but not deadly. A burst appendix requires hospitalization and is a severe medical emergency, but is not deadly in the developed world. We can go on...

Re: Hospital exec says employees are walking off the job

#254

Post by iammisc »

varelse wrote: post #251
iammisc wrote: post #225

Earlier quoted context omitted.

Because the denied claims are the responsibility of the individual, not the government.

A company's responsibility is solely to its shareholders, not to its customers. If those two goals align, win/win. Denying expensive claims increases profitability right up to the point they lose enough customers to offset those gains. Am I missing something fundamental about capitalism here? I'm not saying that's particularly ethical behavior and they wouldn't get my business if I could help it, but if they choose t…

> Denying expensive claims increases profitability right up to the point they lose enough customers to offset those gains. Am I missing something fundamental about capitalism here?

Yes... the ultimate responsible party is the patient, not the insurance company. It makes no sense to deny Americans the right to use the hospital because the hospitals are private entities contracting with their patients, not a government service.

Insurance is an ancillary concern and of concern only to two private parties, not the government.

Re: Hospital exec says employees are walking off the job

#255

Post by EForEndeavour »

armchairhacker wrote: post #246
roel_v wrote: post #194

Earlier quoted context omitted.

"Apparently going on shifts working 72+ hours non-stop is the norm." C'mon, that's 3 straight days , i.e. skipping 2 nights . How can that be 'the norm' anywhere? Extraordinary claims requires extraordinary evidence - or in this case, just any evidence.

Ok, it’s probably not the norm, but i’ve heard from multiple people saying they needed to stay awake for 80+ hours. Maybe because it was college and they were also taking classes? I can reliably say that they’re still very overworked. 12+ hour shifts is the norm, and sometimes even 24 hours.

> i’ve heard from multiple people saying they needed to stay awake for 80+ hours

This vague allusion doesn't do much to convince me of the 72-hour claim. While we're doing anecdotes of extreme sleep deprivation, check out this personal account and AMA of someone who claims to have stayed up for 81 hours straight. What makes me doubt your "multiple people" is that after missing only two full nights of sleep (so ~48 hours), people start hearing and seeing hallucinations, and can't reliably hold conversation, much less deliver healthcare: https://old.reddit.com/r/AMA/comments/6sab7t/i_stayed_awake_...

Re: Hospital exec says employees are walking off the job

#256

Post by mumblemumble »

skt5 wrote: post #240
mumblemumble wrote: post #80

Earlier quoted context omitted.

The disgruntled nurses I know don't want more money anywhere near as much as they want things like lunch and bathroom breaks. Money can't buy happiness, but not being able to take care of your basic bodily needs can absolutely buy unhappiness.

> Money can't buy happiness Usually when someone says this to me, I respond with "then you're spending your money poorly". What I mean to say is that more money buys more flexibility and options, which should lead to more opportunities to leave unhappy situations or at least add more happy situations. Note that this is a generalization so there are plenty of edge cases to counter this.

There's also this distressing hump in the money/happiness curve. More money leads to a greater sense of well being up to a point where you meet your basic sufficiency needs, and then, beyond that, the correlation goes inverse.

My guess is that there is a very strong diminishing returns effect to the utility of money, and that, at some point, other effects start to dominate. Perhaps what's happening with health care workers is a case study for what's going on there.

Re: Hospital exec says employees are walking off the job

#257

Post by switch007 »

greedo wrote: post #250
switch007 wrote: post #249

Earlier quoted context omitted.

What’s that got to do with my post? The flu season places extra pressure on the hospitals - I’m not comparing the two viruses. Don’t get so triggered.

Not triggered at all, except by the continued conflation of COVID with influenza. You specifically mentioned: "Where was your haughty indignation during the last bad flu season?" Show me a flu season that has exerted the same amount of pressure on hospitals and healthcare workers.

How are you measuring it? What metric would you like to compare?

My comment does not conflate the two. You’re reaching. Every winter (flu season) exerts extra pressure. It doesn’t take much to push hospitals over the edge.

Re: Hospital exec says employees are walking off the job

#258

Post by newsclues »

Frondo wrote: post #214
pempem wrote: post #128

Earlier quoted context omitted.

I'm not sure what this comment is steeped in beyond a lack of reading on the topic.

He's referring to William Halstead, whose cocaine habit let him work long hours without sleep, and who was one of the instrumental figures in developing the modern medical residency system (with its brutally long hours): https://en.wikipedia.org/wiki/William_Stewart_Halsted

Yeah, it took me slightly too long that he was a founder of but not John Hopkins, so it was hard to drop the wiki link, thanks.

Great show called “the Knick” where I learned about this.

Re: Hospital exec says employees are walking off the job

#259

Post by bzbarsky »

greedo wrote: post #242
bzbarsky wrote: post #227

Earlier quoted context omitted.

> The top tax rate in the US, decades ago, was 90%. Which pretty much no one paid because there were so many exceptions to it. Starting with the fact that the top long-term capital gains tax rate was 25%, not 90%. A lot of those exceptions got eliminated as part of the process of reducing the top marginal rate to the levels we observe now. The current "top" Federal rate is 39.35% on earned income, 40.8% on interest,…

I haven't researched this at all, so perhaps these type of studies are out there, but I think it would be interesting to see how exemptions/credits and deductions were actually utilized over time. We have roughly 200B tax returns filed since the income tax was created (not counting corporate returns). It would be good to be able to visualize how tax collections changed over time etc.

There are absolutely studies out there.

https://www.cbo.gov/publication/57061 and similar for other years (this is data through 2018, but published this year, presumably after they are pretty sure that various delayed tax return filing has happened and whatnot).

This only goes back to 1979, though. If you find something with data older than that I would be interested.

Of interest in the document I linked to is "Exhibit 11. Average Federal Tax Rates, by Income Group, 1979 to 2018" and "Exhibit 12. Average Federal Tax Rates Among Households in the Top 1 Percent, 1979 to 2018", with the latter showing top 0.1% and top 0.01% average tax rates. https://www.cbo.gov/publication/57061#data has links to various xls and csv files, including the data tables those graphs are generated from. Note that per "Appendix C" of this document, the tax rates in these graphs include some sort of individualized attribution of corporate income tax incidence and that attribution could easily be quibbled with. The more detailed data tables include more breakdowns into what fraction of tax is attributed to this source, but I didn't find it more finer grained than "top 1%".

Re: Hospital exec says employees are walking off the job

#260

Post by newsclues »

pempem wrote: post #128
newsclues wrote: post #66

Earlier quoted context omitted.

Century old standard set by drug addicted doctor, continues to this day despite the evidence proving it foolish and dangerous. Funny tradition that refuses to die.

I'm not sure what this comment is steeped in beyond a lack of reading on the topic.

I don’t think I’ve failed to read up on this topic, if you look at the link from the other user, you may be shocked…
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