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ERs are hiring fewer doctors to save money

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Re: ERs are hiring fewer doctors to save money

#71

Post by mikeyouse »

nostromo wrote: post #67
mikeyouse wrote: post #48

Earlier quoted context omitted.

I appreciate that R&D funding requires investment, but that doesn't have much to do with hospital reimbursement rates -- especially when the alternative of a more European-style healthcare system comes along with a German company inventing one of the two Covid vaccines ( https://en.wikipedia.org/wiki/BioNTech )..

European drugs are often funded by their profits from America.

Just a completely evidence-free claim that's repeated ad nauseam. The big European pharmas (along with the big US ones) are repurchasing shares on the order of tens of billions of dollars per year. If they're so reliant on excess profits to fund R&D, maybe they should have held onto those funds?

Re: ERs are hiring fewer doctors to save money

#72

Post by PenguinCoder »

dsfyu404ed wrote: post #44
azinman2 wrote: post #23

Earlier quoted context omitted.

We need to outlaw for profit anything with healthcare. The incentives are misaligned with society’s needs.

The overwhelming majority of hospitals are nonprofit. The overwhelming majority of prisons are run by the state. The overwhelming majority of higher education is nonprofit. The Catcholic church circa 1500 was nominally nonprofit. PE probably does turn everything to shit but acting like not having shareholders or owners who are looking to wring every cent out so they can get the fattest check will solve the problem se…

Non profit is a tax designation and that's it. Non profits, especially healthcare, still pay their execs and c suite multiple times *more* than physicians and staff, and cut corners and costs in many areas. Non profit status doesn't mean shit.

Re: ERs are hiring fewer doctors to save money

#73

Post by wahnfrieden »

l33t233372 wrote: post #34
wahnfrieden wrote: post #25

Earlier quoted context omitted.

Why only healthcare specifically?

We’ve seen that having a profit motive is, to a point, generally good in many areas of commercial life. Healthcare is not one of these areas.

I'm asking why the difference? Why is it good for society sometimes, and sometimes terribly wrong, in your view?

Re: ERs are hiring fewer doctors to save money

#74

Post by danesparza »

dsfyu404ed wrote: post #44
azinman2 wrote: post #23

Earlier quoted context omitted.

We need to outlaw for profit anything with healthcare. The incentives are misaligned with society’s needs.

The overwhelming majority of hospitals are nonprofit. The overwhelming majority of prisons are run by the state. The overwhelming majority of higher education is nonprofit. The Catcholic church circa 1500 was nominally nonprofit. PE probably does turn everything to shit but acting like not having shareholders or owners who are looking to wring every cent out so they can get the fattest check will solve the problem se…

Having a non-majority of something doesn't make it "not true" or "not matter".

Why in the world would you include a statistic about the Catholic church in this conversation? Are you insinuating something? You can do better.

You really need to put more context around your last comment. It's confusing at best.

Re: ERs are hiring fewer doctors to save money

#75

Post by ghufran_syed »

mikeyouse wrote: post #68
ghufran_syed wrote: post #54

Earlier quoted context omitted.

Right - and the risk is much greater seeing “unfiltered” emergency patients, compared to a patient who has had a full assessment in the ED, had surgical issues ruled out, etc and was then admitted to the internal medicine service.

What risk? Malpractice coverage is provided by the hospital, or more typically, the private equity group that owns the ER physician practice. Last I looked, independent ER docs pay something like $15k more per year than IM docs for solo coverage... there's still quite a ways to go to make up that other quarter million dollars. I don't think the average person realizes that Blackstone is one of the largest employers o…

because besides money, maybe some human doctors find it emotionally difficult to tell someone their family member died because we made the wrong diagnosis, or took too long to make the correct diagnosis?

By analogy, if you have home insurance, you don’t mind if your house burns down? Seems unlikely…

Re: ERs are hiring fewer doctors to save money

#76

Post by armchairhacker »

oneepic wrote: post #53
armchairhacker wrote: post #33

Check out https://www.reddit.com/r/nursing/ to get a glimpse of the modern US healthcare system (Canada and EU are similar). I don't really know what else to call it than "shitshow". In an effort to cut costs hospitals severely overwork their doctors and nurses. It's endemic, anyone who knows anything about healthcare understands that people work >12hour shifts where they are always busy and you can see the constant…

+1. Without citing sources, I will also say I think hospital admins, directors, execs, etc. are constantly looking for ways to cut costs, while the top execs take home millions in pay. Even in nonprofits that haven't been touched by private equity. They don't value the providers, nurses, doctors, or PAs.

The thing is, I think a big part of solving the crisis is cutting costs and improving efficiency, and also advertising and lobbying to get more income. Because healthcare is intrinsically expensive. So I get why admins are important.

That being said, even with no experience or understanding of admin myself, I can still see that they are doing a really bad job. Because they are "taking home millions in pay"; because there are simple things like increasing nurses' pay (when the alternative is hiring traveling nurses for even more!) and actually listening to their feedback; because even to the unknowing public there should be some support, yet I've never heard anything good about admin except when they don't take excess pay and implement the obvious.

Re: ERs are hiring fewer doctors to save money

#77

Post by M95D »

VWWHFSfQ wrote: post #66
mucholove wrote: post #63

Earlier quoted context omitted.

Private is not the same thing as for profit. A non-profit is a private entity. They are not part of the public sector. In fact, much healthcare was delivered like so pre-WW2. Still today, Kaiser and Cleveland Clinic are non-profit.

I'm happy with my private, for-profit healthcare. But I'm also glad to support public healthcare services with taxes. It's not just one or the other, we can have both of them.

Probably because you are generally healthy...

Re: ERs are hiring fewer doctors to save money

#78

Post by seanmcdirmid »

mikeyouse wrote: post #68
ghufran_syed wrote: post #54

Earlier quoted context omitted.

Right - and the risk is much greater seeing “unfiltered” emergency patients, compared to a patient who has had a full assessment in the ED, had surgical issues ruled out, etc and was then admitted to the internal medicine service.

What risk? Malpractice coverage is provided by the hospital, or more typically, the private equity group that owns the ER physician practice. Last I looked, independent ER docs pay something like $15k more per year than IM docs for solo coverage... there's still quite a ways to go to make up that other quarter million dollars. I don't think the average person realizes that Blackstone is one of the largest employers o…

> What risk? Malpractice coverage is provided by the hospital, or more typically, the private equity group that owns the ER physician practice.

Stress isn't alleviated just by insurance. Sometimes people care about doing their job right and "winning". ER docs are just put on the spot constantly.

> I don't think the average person realizes that Blackstone is one of the largest employers of ER docs...

It doesn't really matter, unless you want to claim that they employ more ER docs than the other systems put together, which I doubt they are even close to that. If Blackstone had a lock up on ER services, you would think they would not pay their ER docs as much to stick around since they would have fewer places else to go.

Re: ERs are hiring fewer doctors to save money

#79

Post by soco »

mucholove wrote: post #63
VWWHFSfQ wrote: post #42

Earlier quoted context omitted.

A lot of people are perfectly happy with private healthcare. I happen to be one of them. But I'm also not opposed to my tax money funding the county hospital either. We can have both.

Private is not the same thing as for profit. A non-profit is a private entity. They are not part of the public sector. In fact, much healthcare was delivered like so pre-WW2. Still today, Kaiser and Cleveland Clinic are non-profit.

I will mention again for the fun of it, that private healthcare for profit works very fine in other places, like Switzerland for which I can vouch. There might be a lesson somewhere, maybe?

Re: ERs are hiring fewer doctors to save money

#80

Post by nostromo »

mikeyouse wrote: post #71
nostromo wrote: post #67

Earlier quoted context omitted.

European drugs are often funded by their profits from America.

Just a completely evidence-free claim that's repeated ad nauseam. The big European pharmas (along with the big US ones) are repurchasing shares on the order of tens of billions of dollars per year. If they're so reliant on excess profits to fund R&D, maybe they should have held onto those funds?

Go look at Pfizer revenue from US vs Europe. Europe has more people, but less than half the revenue in a typical year.

Americans are indeed subsidizing new drugs for the entire world.

Presenting Pfizer as if it's primarily serving the German market is silly. Pfizer by revenue is primarily in the US market.

https://www.statista.com/statistics/267877/revenues-of-pfize...

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