The U.S. Healthcare System is About to Collapse

I don't think the general public understands the dire situation happening in the healthcare system right now. Some of these problems are new and some are cracks that are just now being exposed.

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1. We all know that hospitals are at capacity every time there is a COVID spike. It is no secret: we've seen crisis mode happen in Seattle, NYC, Jackson MS, etc etc. during bad spikes. Now it is becoming more widespread and less dependent on COVID spikes. Entire cities with full hospitals before this spike started, hospitals being so understaffed that they can't use all their beds, difficulty getting patients out of the hospital because rehab facilities can't take more patients. The problems go on. Now COVID is spiking again and these hospitals that are already near capacity are going to break. https://protect-public.hhs.gov/pages/hospital-utilization Just go click around your local location and see how bad it is. Make sure to focus on larger cities in your state where your trauma centers are; that tells the real picture. A lot of hospital systems have gone to a Hub and spoke model, which means the sickest patients get shipped to the bigger cities ON TOP OF them serving their own population. States with 1-2 large cities see the effects of this more.
2. We have a severe nursing shortage. So many hospitals cannot run at 100% bed capacity because they simply don't have the nurses. This is multifactorial but it can be summed up by saying that bedside nurses are underappreciated and underpaid. For the past 10-20 years it has been more profitable for people to earn their NP degree and leave bedside nursing. There have also been a lot of paths into nursing administration and education that didn't exist before which also takes from bedside nursing. The merit of having more NPs, educators, and administrators is a *hotly* debated issue and I won't dive into it here as it is outside the scope of this post. Regardless, it means there are less bedside nurses to run hospitals at full capacity.
3. Because of this nursing shortage, travel nursing has taken off. The *only* good thing about travel nursing is that nurses are getting their bag. They deserve the money after working frontline during COVID. The problem with this is that it's only temporary. Hospitals have decided it will cost them less money to pay outrageous rates for travel nursing in the short term than to just give raises across the board to retain their own employees. Seriously, they would rather pay travelers 5k a week (sometimes up to 10k during surge pricing!) + whatever they pay the travel agencies instead of giving a $5-10/hour raise across the board to retain their own nurses! They are expecting things to go back to normal and it just isn't. Not to mention travel nursing likely provides worse care as you are constantly cycling people into your hospital that has to learn your protocols and system + they have abbreviated training periods. Also who wants to train someone making 3x what they make?? It is madness.
4. Resident physicians are being more abused than ever. For this to make sense you need a little background. The amount of residency positions (which doctors have to complete before they can practice independently in this country) is paid for by Medicare, so congress more or less controls the number of available spots. The end of 2020 added 1k spots which was the first time they've expanded spots in 25 years. So the physician shortage is more or less manufactured, and their unwillingness to expand spots even moderately every 5-10 years put us in a horrible position. To add to this, residents are exempt from anti-trust laws which gives us little to no power over our situation. We HAVE to complete residency and we have little control over how it happens unless you are an absolute rock star medical student at a top school.
5. Residents are locked into residencies, making a set 50-60k a year with no bonuses or hazard pay during this time. COVID has not only interrupted education, but many programs (not all, there are some programs that really defend their residents) have used their residents as a COVID workforce to keep their hospitals running. When it was all hands on deck at the beginning of 2020, every specialty (including surgery, psychiatrists, etc.) were pulled to the hospital floors to care for COVID patients. I think most people were happy to help temporarily. Some programs have never stopped this and pull people off electives or from other specialties any time there is a spike. Residents make hospitals *a lot of money*, and some hospital systems can't even function without them. Case in point, the University of New Mexico neurosurgery program lost accreditation and had to hire a few doctors and 19 NP/PAs (several million in yearly salaries) to replace their ~10 residents. Now that they have COVID as an excuse, residents and fellows are being used wherever the hospital needs them and there's nothing residents can do as we have to finish residency, so you play by the rules.
6. Now that Omicron is super infectious, all these shortages are being amplified as people have to miss work for quarantine. Even before the CDC announced 5 day quarantine + 5 day masking, it was recommended that healthcare workers could return after 7 days. A large healthcare outbreak amongst workers could be the final straw for some hospitals. Other hospitals are already broken. Healthcare will never be the same after this pandemic. So many flaws have been exposed in our healthcare infrastructure but profit remains the most important thing. Just remember, insurance companies have had record profits during the pandemic. I am deeply concerned about the state of healthcare in this country and you should be too, as we ALL rely on a functioning healthcare system for our health needs.

Edit: sorry to all the PT, OT, pharmacy staff, EMS, healthcare IT, custodial staff, lab technicians, and every one else I didn’t include. I only spoke to what I knew but knew I couldn’t be comprehensive. There are some AWESOME comments explaining how every corner of healthcare is hurting right now. Keep up the good work everyone.

Edit 2: https://www.reddit.com/r/medicine/comments/rsy3un/i_think_the_next_46_weeks_might_just_be_the/?utm_source=share&utm_medium=ios_app&utm_name=iossmf this post inspired me

submitted by /u/DrWarEagle to r/antiwork
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