The Real Reason For Hospital Shortages In The United States

The Revolutionary Act ^ | 04/02/2020

[Chickensoup]

Up until the mid 80s the american health care system had excess capacity. It was a Civil Defense issue.

It really didnt matter if there were extra beds.

The hosptials were then required to earn certain amounts of dollars poer bed and that ended capacity. The MBAs took over and healthcare suffered greatly.

[Alberta's Child]

The biggest factor in the declining number of hospital beds has been the dramatic advances in surgical procedures that make lengthy hospital stays less common even for major surgeries. More and more of these surgeries are being done at outpatient facilities, and patients who used to spend weeks in the hospital are now home and starting rehab in a matter of hours or days.

[Chickensoup]

but there was no reason not to keep the beds and the plant.

And the dramatic changes in surgical proceudres did change the length of stays, but still the recovery times were relatively unchanged, expecpt that the patients were expected to recover at home. This was intiatally presented as an option with home health providing support. but that quickly dwindled. Now family cares for people or they are uncared for in many settings.

[familyop]

Does that include the single baby mamas and kids on Medicaid?

[The Great RJ]

I worked with CON laws from the late1970s through the mid 1990s and was an expert in obtaining certificates of need. The origin of CON laws was some little understood federal legislation PL. 93-641. This law created regional health planning organizations call HSAs and mandated states adopt CON laws with the direct involvement of the HSAs. HSAs were specifically charged with reducing “unneeded” hospital beds to no more than 4 beds per thousand population. The “unneeded” hospital beds were fallaciously seen as adding to health care costs. To this end states enacted as part of their CON laws strict quotas on new hospital beds or even imposed in some cases decade long moratoria on the construction of new hospital beds. While the HSAs were ended in the mid 1980s, most states retained their CON laws and the 4 bed per thousand goal persisted for nearly another decade. As a result of these CON restrictions that often applied not only to hospitals but also nursing home beds, there has been an artificial shortage of health care beds for years.

[octex]

Everyone doesn’t need a hospital to take care of minor medical needs. There are walk-up “Doc In A Box” facilities scattered around and I’ve used one two times in the past 15 years.

I’m 77 and haven’t gone to a hospital for treatment of any kind since I was born.

The Dr. that authored the article sounds like a snob of the old school of medical care, like Dr. Fauci.

[gattaca]

bmp

[mewzilla]

Given nosocomical infections, the last place you want to be if you absolutely don’t have to is a hospital.

Seems to me being able to ramp up fast is a far better way to do it than having rarely needed excess capacity that still has to be cleaned and sanitized. And loses money.

[rollo tomasi]

In the mid-70’s, administration costs were over 5%. By the late 1980’s they were under 4% so riddle me that especially the fact that hospital systems that began sprouting out in the early 1900’s had those pesky bean counters.

Also, explain why administrative costs have skyrocketed beginning in the 1990’s. Reacting in the face of HIPAA, OSHA, and other regulatory requirements take a great deal of those wicked MBA types to mitigate plus the demand to sustain economic growth.

[Jim Noble]

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

Very astute.

Once the policy change to.a fixed pool of money was made (from employers and taxpayers), the hospital industry realized that employing a tribe of accountants to make sure they got their share and then some would be a good strategy.

Of course, this has, over 30 years, made hospitals and hospital "systems" the kings, and the deciders of what gets done, when, where, and how.

Mix this with fixed, centrally administered prices that use 1968 as a benchmark, and all of a sudden you have no bread in Ukraine.

There are no pediatricians under 50, but we can't train people fast enough to do boob jobs.

[Albion Wilde]

layers of deadwood

But... but... we NEED those diversity and inclusion and social justice offices, and all the inspectors in them! For the children...

[ConservativeMind]

Great post!

[Kickass Conservative]

Which is why we need to secure our Borders to keep out Third World Diseases.