Why our hospitals are at or near capacity

Why our hospitals are at or near capacity

The temper of the multitude is fickle – Niccolò Machiavelli

Despite the vast number of years I’ve plied this planet, I’ll never get used to the bizarre blood sport known as the American mob mentality. Perhaps if my national compatriots were a bit more consistent it would be somewhat simpler to contend with it, but that never seems to be the case.

 

After the Vietnam War, returning soldiers were labelled as “baby killers,” but now we thank them for their service. After 9/11, law enforcement was heralded as heroes, but now we want to “defund” the police. After a spate mergers and takeovers drove medical expenses through the roof, hospitals were roundly excoriated for charging $936 for a couple of aspirin. But now they’re the heroes holding the COVID line.

That small reasonable minority knows the truth always sits somewhere in the middle, but we seem to be unwilling to make the effort to dispense with the obfuscating rhetoric because it’s much more fun to hold up a sign saying “Hooray for our side!” than it is to have to think.

With that in mind, and for those brave souls willing to continue reading, let’s take a closer look at the dynamic that’s led to so many hospitals hitting or coming close to their plague era capacity.

If you recall, in the early COVID days even I said we have to protect our healthcare system from any potential implosion, but that sentiment was borne of not fully understanding the disease and we had to start with where we were. But once we got beyond that first pandemic month, it became abundantly clear that the current hospital business model can’t begin to cope with any serious pandemic.

And that stark reality starts with the sad fact that the U.S. comes in almost dead last in the number of First World country per capital hospital beds. Here’s the data:

  • Japan             1 beds per thousand
  • S. Korea         12.3
  • Germany       10
  • Russia            7.1
  • Bulgaria         6.0
  • China              4.3
  • U. S.                2.8

This, of course, is the direct result of a for-profit hospital industry that, just like those perpetually overbooked airlines, considers an empty bed to be a vast liability.

And let’s be unequivocal! With the exception of public facilities like Cook County, there’s no such thing as a “non-profit” hospital. Northwestern Delnor will be the first to tell you they’re a “non-profit,” but high-level insiders repeatedly tell me they typically post a 200 percent annual “profit.”

Put more simply, the reason for the previous flurry of medical mergers and buyouts is, before the pandemic hit, urban hospitals were a license to print money.

Ah! But to make these potential plague matters so much worse, the real medical money isn’t in treating temporarily sick people, it’s in elective surgeries and repeat outpatient business like cancer care, heart disease support, and the plethora of problems associated with our expanding obesity epidemic.

But why listen to me! As Dr. Angel Leon, professor of medicine at Emory University in Atlanta, so eloquently put it:

The bottom line is that a finely tuned hospital – for profit or otherwise – must deliver well-reimbursed elective services, with predictable lengths of stay, and ready access for patients and referring physicians, while tightly controlling costs. It should generate big profit margins to the university, stockholders, or foundation. Cynically, the last thing these hospitals need is an influx of very sick patients to gum up the works.

That means, since – god forbid – they actually had to treat sick people, the American Hospital Association projects a $205 billion plague era loss through the end of this summer.

So, while it’s certainly an important consideration, we’re not actually being asked to protect nurses and doctors, we’re being asked to protect corporate medical profits. We’re being asked to save hospitals from themselves!

As the great D. L. Hughley would inevitably put it, “Ain’t that a bitch?”

Those administrators were counting on a pesky pandemic rearing its ugly about once every hundred years, but it’s only been 52 years since the last lethal one, and as Baby Boomers age and Americans insist on setting new obesity records, the next pandemic is already a foregone conclusion. And when you considering our propensity for physical self-destruction, it will likely be worse than this one.

You know I like to propose solutions, but there’s no simple answer to this corporate hospital paradigm, either. In my misspent youth, those highly regarded medical institutions were typically founded and run by religious orders or universities who truly cared about their communities and constituents. It’s not as if the government can pass legislation that’ll force them to return to those lofty ideals.

Perhaps in a future column we’ll cover some of the possible solutions to how our healthcare system might prepare for the next plague, but those remedies generally require a proactive and reasonably intelligent government and neither one of those oxymorons is about to happen anytime soon.

Please! It’s not that I’m calling our hospital administrators out as nefarious. I may not hold them in the highest regard, but just like it is with any other money-making proposition, they’re always driven by market forces rather than principles. It’s the very nature of the human beast.

So, considering this bleak scenario, why bother writing about it, right?

I was beset by those same reservations before I hit the keyboard, but there is a certain solace to pulling the corporate medical veil back – even if it’s just a little bit. Now you know who and what you’re really trying to protect when you’re forced to wear a mask, and it certainly ain’t you or any frontline hospital staff!

 

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