I heard today from a physician whose hospital is on the verge of collapse, and an ICU nurse at a different hospital who is likely struggling with COVID, but being instructed not to get tested so as not to miss work. Two fairly typical stories from the edge of the healthcare abyss, but entirely predictable and a long time in the making. “Hospitals are understaffed” is now common knowledge, not a news story. The question is why. There’s no way to answer that question in the absence of information about staffing and budget decisions, themselves connected to facts about medical billing and collecting. This article is a case in point.
Yes, hospitals are understaffed. But that’s a matter of economics, and economics is a matter of math. What’s the math here? How much money do hospitals have at their disposal to make new hires? What does their accounts receivable look like, generally? How much would it cost to hire more, and at what wages? Obvious questions in search of answers. To fail to report on the spreadsheet-level details of these things, almost two years into the pandemic, is to keep the public in a state of perpetual ignorance–or else in a state of slogan-driven outrage. But from reading the mainstream press, I sometimes wonder whether that’s what journalists want. Math, as Jack Black famously put it, is a wonderful thing. Why do we read so little of it when and where it counts?
Six months ago, before I lost my car to a flash flood in Hurricane Ida (yes, I was in the car when it happened), I was engaged in a concerted attempt to find a part-time hospital job to supplement my income. I was turned down wherever I applied, even in this labor-scarce environment, even with hospital experience, even at a hospital that had promised me a job and had scheduled me for work. Staffing, I was told, was perfectly “adequate.” I knew it wasn’t. Front line staff insisted to me that it wasn’t. But managers know better, I guess: better to skimp a bit on hiring than do better than “adequate.”
I sort of gave up on my job search after I lost my car–much harder to get anywhere now–but it’s not as though these understaffed hospitals are calling me back to ask me to work. On the contrary, HR regularly ignores my calls.
It’s hard to feel sorry for these hospitals once you come to see from the inside how they’re run. Of course, the way they’re run is so inscrutable and opaque that it practically invites ascriptions of bad motivations even if you haven’t seen them from the inside. In this, as in so many things, the pandemic has exposed the weaknesses and defects of a hubristic society addicted to self-congratulation, but incapable of getting the basics right. What we need is a journalism that shows us the mechanics, and counts the costs.
Neither the Left nor the Right are really focused on the right things here. The Right equates better working conditions with “socialism.” The Left equates fiscal realism with the reign of Ebenezer Scrooge. Reality seems to fall between the cracks of their fixations without ever satisfying them, and without ever going away. But winter is here with its grim, countable realities–realities we should have learned to handle back on Sesame Street, but, alas, didn’t.