Cal88 said:
TandemBear said:
Cal88 said:
In all fairness, it is normal for ICU and ER units to be working at full capacity at the peak of a flu season, and a bit beyond that in a bad flu season. If that weren't the case, ER capacity would have been reduced.
You have to measure this covid-19 peak against normal seasonal peaks to get a grasp of its relative scale. I will try to get some of that data.
I guess it comes down to priorities. We COULD have spent more tax money on ERs and ICUs that would never hit capacity, OR give additional tax cuts. I guess we chose the latter.
Stop running hospitals like businesses. We don't run schools, fire or police departments, libraries or parks like businesses, so let's do the same with hospitals. We can decide as a country that hospitals have more worth than just "lean and mean" organizations vying to maximize profits/revenues for those benefiting.
There was a discussion about nuclear energy on this board a few years ago, where Calumnus used the French model, the world's best by most measures (nearly 3/4 of electricity generated without any major incidents for the last half century), and provided it as a model to emulate for the US.
I've answered that nuclear energy is great for France, but is a dangerous proposition in the cultural and regulatory US environment. You cannot run an industry like this as a business, and that's what it will eventually tend to become with the lack of oversight and revolving door regulatory culture (see brownouts in CA, from Enron in the 90s to PG&E today).
Note that the cultural and regulatory norms have significantly degraded in France as well the past decade or two. You have the same kind of degradation in the British healthcare system, they have been ahead of the neoliberalization curve in Europe every since the Thatcher and Blair tenures. Note also that this rampant neoliberalization is being done across bipartisan lines. You have for instance Cuomo, who is being praised today, responsible for slashing the NY state health budget and for leaving his state woefully unprepared for this crisis:
Quote:
"Andrew Cuomo has repeatedly stated, over and over again, that New York has excess capacity of hospital beds, that it's too expensive and not needed and we need to reduce spending. He said this over and over again throughout his entire tenure," said Sean Petty, a pediatric nurse at a public hospital in the Bronx and a high-ranking member of the state's politically active nurses' union. "If this budget goes through in April, next year's health and hospitals budget is going to be devastating."
What's striking to Petty and other health care experts is how Cuomo has not backed off his plan to cut Medicaid, despite the horrific Covid-19 outbreak. Earlier this year, Cuomo empaneled what is called a Medicaid Redesign Team to slash Medicaid spending in New York after a $6 billion budget shortfall, driven largely by rising Medicaid costs, became evident in late 2019.
https://www.thenation.com/article/politics/covid-ny-hospital-medicaid/
In the US the discrepancy between what we spend on the military (the so-called "defense budget") and what needs to be spent to safeguard the health and safety of our population has become staggering, that gap is now being exposed.
Let me start by saying: I hope to not shut down any opinion or idea (except that we should carry 20% occupancy in healthcare). I just want to show context and where
I think the "real" threat is hiding.
In 2020 the Federal Healthcare budget is just over
1,100 billion dollars. That is just federal spending. Not included in another $500 billion in non direct costs in the form of exchange subsidies, and tax incentives (not counted because I am not counting those against the defense budget).
In 2020 the Federal Defense budget is just over
$730 billion dollars.
Additionally we would have spent another $2 Trillion on healthcare privately, in a normal non-COVID year.
In other words, ALL military spending would only increase healthcare spending 25%. It should be noted that our Federal Spending alone outstrips all developed nation spending per capita.
I think the biggest problem is that our enormous healthcare budget, in a time of crisis, cant even produce testing or masks. What should be exposed is that in a time of need, we have almost zero capacity to produce anything remotely useful.
To the military comparison: We produce tanks here. We force foreign companies like Beretta, H&K, Sig, etc to make our small arms in factories we own in the US. We make bullets and bombs and helicopters and aircraft here. We make ships here. We know that when crisis comes, broken supply chain will be what separates us from success.
We make masks in China. We make Tylenol in China. Everything we make here requires parts from China.
Listen, And this is no joke: Reform tort law around medicine. It has absolutely crippled our system. It is making it so people think they need insurance to get care. Where was this drive for insurance previously? It didnt exist because people didnt go broke from their kid breaking her arm.
And how does this effect the COVID crisis directly?
We dont make PPE because manufacturers left us. In 2006 N95 mask producers begged the federal government to reform the law that let people sue them when they used the masks incorrectly. We didnt. They left the country and stopped selling masks here.
News today?
First N95 shipment since February (130k masks made by 3M overseas) arrived yesterday. A MONTH with no deliveries during a pandemic? Thats what the failure of addressing the ACTUAL problem in healthcare has produced.
1. Fix our ******* supply chain. Health is critical infrastructure. It should be designed around supply chains we control.
2. Reform laws that drive costs up and supply down.
Those two, alone, while not sexy, will fix both our crisis response and our ongoing need to insure everyone against ever rising insane costs. You guys may remember a time when breaking your arm didnt cost you the arm and a leg. Now its the end of you if you dont have insurance. Tort. Reform.
