• 3 Ways Government Regulation Is Creating a Hospital Bed Shortage

    From (David P.)@21:1/5 to All on Mon Sep 6 14:19:43 2021
    3 Ways Government Regulation Is Creating a Hospital Bed Shortage
    by Hannah Cox, 8/31/21, Foundation For Economic Education

    Hospital beds are again filling up across the country as
    America copes with another variant of the COVID-19 virus.
    3/4 of intensive care unit (ICU) beds are occupied at the
    moment, & 28% of those are by COVID patients.

    Furthermore, almost half of all states report their
    hospitals’ ICU beds have exceeded 75% capacity. And hospitals
    across the US report 75% of their general inpatient beds are
    also filled, with 13.4% of those being COVID-19 patients.

    This is a big problem. Not only does that mean people with
    the coronavirus may be unable to access needed & timely
    care, it also means that individuals seeking assistance
    for other pressing medical issues may be severely delayed.

    But, when outlets merely report that hospitals are at or
    approaching capacity, it neglects a key part of the equation.
    75% of beds being full sounds scary, but people need to ask:
    75% of what number of beds in the first place? 75% of 200
    beds in a given region is a lot of patients; 75% of 4 beds
    is a different story.

    In reality, it doesn’t take much for most hospitals to
    reach “capacity,” because their supply of beds is already
    severely restricted even before an emergency takes place.
    And the reason for that traces right back to govt policies
    that make healthcare more expensive & harder to access for
    all. Let’s examine a few.

    Certificate of Need (CON) Laws
    Many Americans are unaware of the presence of Certificate
    of Need (CON) laws. These laws are appropriately named
    because they are a total con: an arrangement between the
    govt & large healthcare providers to limit competition &
    keep prices artificially high.

    This is a textbook case of cronyism, which John Stossel
    defines as “the economic system in which the marketplace
    is substantially shaped by a cozy relationship among govt,
    big biz, & big labor. Under crony capitalism, govt bestows
    a variety of privileges that are simply unattainable in the
    free market.” Cronyism is not to be confused with
    free-market capitalism.

    Implemented in the 70s, a total of 27 states still have
    CON laws in operation, & many of those states—like Alabama,

    Mississippi, & Arkansas—are the ones most strapped for
    hospital beds at the moment.

    That’s because these laws arbitrarily restrict the amount
    of beds in a state, as well as the number of hospitals &
    other medical equipment. They do this by mandating would-be
    providers go before a board & show evidence of their need
    to add additional beds, equipment, services, & locations.
    At the same time, their competitors get to come in & argue
    against them, & often win out—esp. when large hospital
    corporations (who are often in cahoots with regulators)
    are pitted against independent providers.

    All of this means consumers have fewer healthcare options
    & higher costs for services.

    The US only has 2.6 beds per 1,000 people, which is below
    the rate we see in countries like Italy, China, & South
    Korea. Acc. to reporting by Reason, “Since Mar 2020, states
    that use CON laws to regulate the supply of hospital beds
    have seen an average of 14.99 days/month where ICU capacity
    has exceeded 70%, acc. to Matthew Mitchell, a senior research
    fellow at the Mercatus Center who crunched Dept of Health &
    Human Services (HHS) data...Meanwhile, states that don't
    have CON laws governing the supply of hospital beds have
    seen an average of just 8.65 days/month with ICU capacity
    exceeding 70%, acc. to Mitchell.”

    Mitchell & his colleagues also found that states using CON
    laws to regulate healthcare have fewer hospitals, dialysis
    clinics, & surgical centers. And on top of all of that,
    even more studies show CON laws lead to lower quality of
    care, higher risks of complications after surgery, & even
    higher mortality rates for some conditions.

    All of this was true & problematic long before COVID, but
    the pandemic exacerbated the pre-existing condition.

    Mandatory Vaccinations for Healthcare Workers ==================================
    The govt’s contribution to the healthcare shortage doesn't
    end with CON laws, though. It has also implemented policies
    & pushed practices that have led to a shortage in healthcare

    As one nurse in Tennessee, who spoke to me on the condition
    of anonymity, put it, “To be honest, the biggest problem
    we’re having is nurses to staff the beds. We say we are
    maxed out, but it’s usually more that we don’t have the
    staff to take care of the people rather than the physical
    space to put them.”

    Why don’t hospitals have the nurses they need?
    Where to start.

    Nurses unquestionably have one of the hardest jobs in the
    country—physically & emotionally. They work incredibly long
    hours, have to move heavy patients, are often abused by
    patients in distress, & deal with all of the grossest aspects
    of the human body. The pandemic has only added to that, &
    many have expressed feelings of despair & burnout for months.

    They do all of this even while their salaries have been
    stagnating for some time.

    Now, on top of everything else, they are being forced to
    make a choice between getting vaccinated or leaving their
    jobs. And many have decided enough is enough. Bloomberg
    reports 1 in 8 nurses say they won't take the vaccine.

    As a result, 150 medical pros were fired in Houston over
    refusals to take the vaccine. Shortly thereafter, Houston
    suffered a massive nurse shortage. Similar stories are
    cropping up across the country. At the beginning of the
    pandemic, nurses were touted as the heroes of the pandemic.
    Now that they’ve worked to bring us thru the worst of it,
    they’re treated as disposable—an attitude that's expediting
    the exodus of many nurses. Reportedly 20-30% of frontline
    healthcare workers say they're considering leaving the

    It’s important to remember that the hospitals are largely
    forcing vaccines on their workers out of fear of liability
    & governmental pressure. But while they will insist these
    mandates are to keep customers safe, the science doesn’t
    actually match up. First, nurses have been exposed to COVID
    more than any other group, & many have built up natural
    immunity as a result. Secondly, data from the CDC shows
    vaccinated people can still get & transmit the virus, &
    that these people carry just as many particles of the virus
    in nasal passages & their throat as unvaccinated people.

    Occupational Licenses and Other Provider Restrictions ==========================================
    Did you think we were done? Hardly. We’ve barely scratched
    the surface of all the ways the govt has meddled in the
    healthcare market & blocked access to affordable care.

    Up until the pandemic, states kept a whole hoard of crony
    regs on the book meant to restrict supply, prevent compe-
    tition, & keep prices artificially high. While many states
    have eased the enforcement of these laws since the pandemic
    began, their presence in the first place has still created
    barriers to care & the inability for the healthcare market
    to increase supply to the levels needed to address a crisis.

    One of those regulation types is occupational licenses,
    which litter the healthcare sector more than virtually any
    other field. Often implemented under the mantle of public
    health & safety, all occupational licenses really do is
    ensure people have to pay the state to work. They often
    include expensive & time-consuming barriers to entry in a
    field, high fees, & the inability to take one’s skill set
    across state lines. On top of that, many arbitrarily
    exclude large numbers of the population from working in
    a certain field, or prevent people from fully offering the
    services they're trained in.

    For one example, nurse practitioners must complete years
    of schooling & training. By all metrics they are more than
    equipped to handle the vast majority of issues that come
    before a general practitioner. But in most states they are
    prohibited from seeing patients unless they work under a
    doctor. Why? Because this prevents them from competing with
    doctors & keeps prices & doctor salaries high. There’s a
    massive shortage of GP's in the country, which could be
    quickly eased by widening the scope of practice for nurse

    practitioners—which would also free up the doctors’ time
    for more pressing matters. But cronyism stands as a barrier.

    Another example of govt policies that create supply
    shortages in healthcare are “ethical clauses” within
    occupational licenses. In many states people with a record
    are prohibited from obtaining such a license, permanently
    blocking them from employment opportunities in numerous
    fields. This not only prevents millions of Americans from
    rising, it also means important jobs go unfilled. When you
    consider all of the petty laws on our books & how easy it
    is for someone to transgress one of them, you begin to
    recognize how silly & unjust these laws are.

    Lastly, in another example, doctors in Mississippi who
    wished to make house calls during the pandemic were blocked
    from doing so. Why? Because state regulators capped the
    number of licenses for home healthcare services in 1981
    under the argument that no more would ever be needed.

    Occupational licenses are a dirty scam the public keeps
    falling for. They aren’t in place to keep you safe (as if
    the govt even could). They are in place to keep your health-
    care prices high. And when a pandemic hits, that artificial
    restriction of supply also means you can’t access the care
    you need.

    Another corrupt govt reg that blocks supply is telehealth
    restrictions. These regs have impeded care for decades, &
    the govt has worked hard to ensure existing providers were
    blocked from the competition telehealth could provide.

    Though some of these restrictions were also eased at the
    beginning of the pandemic, the market can’t create the
    needed infrastructure to provide these services overnight,
    & so the industry has been operating from behind the 8-ball.

    In conclusion, COVID is a crisis, & it's one we should all
    be concerned about. But we should also be aware that this
    is a crisis largely of our own govt’s making.

    When we allow the govt to interfere with the market, as it
    has in healthcare for over a 100 years, it always leads to
    higher costs, less access, and lower quality: to the harm
    of the many and to the benefit of a privileged few. This
    isn’t capitalism, it’s cronyism—it’s important people know
    the difference.

    Hannah Cox is the Content Manager and Brand Ambassador
    for the Foundation for Economic Education.


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