Posted on 04/02/2020 4:37:41 PM PDT by Liberty7732
by Julio Gonzalez, M.D., J.D.
An article published by the Kaiser Family Foundation on Wednesday showed the United States ranked eleventh in the world in per capita distribution of hospitals. That article pointed out that the United States had a “lower hospital density than almost all comparable countries.”
Predictably, there are a slew of other hospital-related resources in which the United States is lacking, including the number of hospital-employed nurses and the number of physicians. Although the Kaiser article does not detail the cause of these shortages, I do so in my new book, The Case for Free Market Healthcare.
The reason is actually quite simple and predictable: government intervention.
Although the details of the dynamics are too extensive to cover in this forum (I therefore urge you to explore them further in The Case for Free Market Healthcare), there are a few observations that can be gleaned regarding the degree of error with which we have approached healthcare delivery in our country.
First, government has been openly hostile to hospitals, particularly private hospitals, viewing them mostly as vehicles for greedy investors to make money off the sick and the poor. This hostile and destructive attitude led to the passage of the Health Planning Resources Development Act in 1974 that actually rewarded states for implementing “certificate of need” (CON) programs to restrict the abilities of entrepreneurs to build hospitals.
Within a few years, forty-nine states enacted CON laws, and their models for governmental interference have since been shown not to lower prices for inpatient services and not improve hospital financial investment in communities as had been touted by the bill’s advocates.
But the damage still persists. To this day, despite the certificate of need program’s total failure, only thirteen states have rescinded it demonstrating the difficulty of undoing misguided legislation after it has been passed.
Government also has and continues to manipulate the market in ways that have destroyed projects aimed at improving the availability of hospital emergency rooms. In 2018, the Medicare Payment Advisory Board advised Congress to cut reimbursements to freestanding emergency rooms operating within 6 miles of their parent hospitals by 30%. Why? Because, according to MedPAC, “such systems would encourage providers to treat lower intensity rooms rather than urgent care centers.” Which begs the question: what business is it of Medicare, an insurance company for seniors and the disabled, where the market decides that it is more efficient to treat urgent and emergent patients?
As a result of MedPAC’s misguided market manipulations, over 250 shovel-ready or unfinished projects were canned, robbing America of greater healthcare access — and a lot more beds to deal with today’s crisis.
To be sure, the federal government has also engaged in a wide variety of activities that favor hospitals over other models, but in each of unnatural interventions, the consequences are the same: government continues to impose delivery models upon the population and with it, its bias of how healthcare is provided to the consumer.
As a result, the market is not free to respond to consumer demands and cost-saving opportunities in an efficient manner. Thus, we are never given the opportunity to develop the right number of hospitals and the correct number of physicians, nurses, physical therapists. . .you get the point.
Now, we are faced with the challenges of a pandemic where many, including President Trump, have observed that we were not ready with a coordinated response mechanism. In point of fact, we weren’t even ready with a baseline set of operating resources with which to handle the larger numbers that would present themselves, and the blame lies squarely on government for attempting to impose upon us its ideas of what those numbers should be, instead of allowing the market to settle upon them by itself.
If it had allowed the market to freely operate, we would have more hospital capacity, more medical personnel and more supplies.
we’ll have less hospitals after this debacle....we’re bankrupting them....
They’ll call this a failure after it’s all over( if ever)and demand single payer.
The author spends a lot of time and energy needlessly. The simple reason for the “hospital shortage” in the U.S. is that it’s a waste of money and other resources to design any system or institution — with the possible exception of the military — to meet a maximum surge demand that may only occur once every 50 to 100 years.
The hospital I work at in southern NJ is not only in the process of expanding the ER it’s also building new additions to the existing hospital and building new treatment centers.
I can tell you that in the 1980’s with DRG’ s and Medicare and Medicaid changes, hospitals changed from being run by doctors and nurses to being run by MBA execs. Then layers and layers of seafood. My observations as a 40 year was-just-about-to-retire nurse.
I understand that in New York City, a large number of private or charitable hospitals closed in the last 40 years due to the competition from public hospitals. Of course, everywhere in the country, hospitals associated with Catholic religious orders or Protestant denominations have been absorbed by corporate entities.
Our hospitals are big, as in big big. I live near a medical epicenter. The clinics around it are also massive. Everything is big.
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
The real reason? Obamacare. The same reason why my area now has a shortage of 800 doctors. Several of our hospitals also shut down or went through receivership or shrunk services because the couldn’t make it economically after Obamacare.
“Managed Care” in the 1980s caused me to leave nursing. The sense of being able to provide the level of care patients needed along with compassion was ruined by the “bean counters.” Patients were being booted out with raging infections. I worked orthopedics some patients needed extensive and intense care and therapy for the long haul. Not with managed care... out you go.
At this rate, we’re gonna have less of everything...except government.
Layers of seafood? Lol. Sorry. I typed layers of deadwood, not seafood.
And illegal aliens.
Remember Bush43 saying "that's too bad" about the hospitals near the Southern border closing?
I think the hospital where both my siblings were born closed down because of illegal aliens, at least according to VOA a few years ago.
Here in South Jersey where I live,we have a brand new hospital and clinics and health “campuses” are being built all over.
Because a far smaller percentage of people are insured than over 40 years ago.
I disagree.
In 1980 the number of uninsured was 30m.
In 2018 it was 27.5m
The 1980 number was higher in numbers and percentage.
But there aren't any.
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