Weirdest subplot I’m tracking: failing hospital economics. This is something that can only happen in the US because they’re run for profit (or on individual nonprofit basis). Often owned by PE firms. Seems their high-margin “products” are a) elective procedures b) ER visits...
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For those who came in late: Because hospitals (esp ERs) are losing money due to Covid19 priority and fall in other causes of emergencies like traffic accidents, and delaying of elective surgeries, they’re in a short-term $ crisis. So cutting pay. Including for frontline staff.
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There’s a weird way some form of nationalized healthcare could happen. This will clearly (and justifiably) cause outrage. Frontline staff will not only demand (and should get) back pay, they should probably get hazard pay too. This will most likely come from bailout funds...
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The terms of this bailout are crucial. The PE firms that own these assets will likely try to score no-strings free money. Best case, they’ll probably get easy loan terms with requirement that it be used for back pay and not laying off/furloughing staff, either frontline or admin.
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But this is bad. The PE firms should NOT get to socialize the costs of their profiteering in better times with no consequences during public service periods. I think the government should get equity for bailout even if the owners lose control. Indirect partial nationalization.
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Not saying you necessarily want state run healthcare. But a transient public ownership phase might be the perfect condition under which to pass much needed reform laws and get a better healthcare for all type deal done, with infrastructural skin in the game.
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Caveat: I just learned about all this via reading public news coverage in the last week or so. I’m sure my naive layperson gloss on this is the tip of a very deep iceberg, and that there’s already an invisible war underway for control of the future of the hospital system.
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If I got anything badly wrong please correct me. If you have good deeper links on this, please share. I’m not linking anything I’ve read so far because... they’re not particularly good links/sources.
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Venkatesh Rao Retweeted Saccharomyces
Yep. I haven’t dug into this deeply. I suspect it’s not the ER doctors who choose this but facility owners. https://twitter.com/oddcopter/status/1246850161483091968?s=21 …https://twitter.com/oddcopter/status/1246850161483091968 …
Venkatesh Rao added,
Saccharomyces @oddcopterReplying to @vgrFor many emergency room doctors, the practice is evidently an intentional strategy: Stay outside insurer networks, and bill patients directly at extraordinary rates. https://www.bloomberg.com/opinion/articles/2019-03-13/surprise-medical-expenses-and-the-scandal-of-balance-billing …2 replies 0 retweets 11 likesShow this thread -
Venkatesh Rao Retweeted shawn z kumar
Good point, but will be hard to financially engineer since only fed can print the brrr money to do this, and they won’t want to do it on behalf of states esp under Trump who will fight for his PE buddies in the biz like Schwarzman to retain control. https://twitter.com/shawnkumar1000/status/1246850701839314944?s=21 …https://twitter.com/shawnkumar1000/status/1246850701839314944 …
Venkatesh Rao added,
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Venkatesh Rao Retweeted #BlackLivesMatter
Cory flagged this yesterday. https://twitter.com/doctorow/status/1246445485860118528?s=21 …https://twitter.com/doctorow/status/1246445485860118528 …
Venkatesh Rao added,
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Venkatesh Rao Retweeted Saccharomyces
Looks like at least some part of this is due to profiteeering ER docs https://twitter.com/oddcopter/status/1246853549977415685?s=21 …https://twitter.com/oddcopter/status/1246853549977415685 …
Venkatesh Rao added,
Saccharomyces @oddcopterReplying to @vgrIt's not one data point. I have researched it well. Spend some time researching it yourself. These docs bill whatever they wish. Many even fly from state to state doing shifts where there are no docs on staff. And no, it is not all ER docs. Luckily, legislation is stopping it.1 reply 1 retweet 10 likesShow this thread -
Note that already in CARES act, one of the battles was over coverage of uninsured Covid19 patients *at Medicare rates*. Iirc there was a fight over that for precisely this reason. If the “government put” had been priced the way the owners wanted, the $ would have been way higher
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Venkatesh Rao Retweeted stucchio
Twist. Not sure how to verify the actual pattern of cuts. This needs a good investigative journalist digging. https://twitter.com/stucchio/status/1246857095204311040?s=21 …https://twitter.com/stucchio/status/1246857095204311040 …
Venkatesh Rao added,
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End of conversation
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