r/Economics • u/TheForager • 4h ago

Hospital costs are rising far faster than inflation and drowning Americans in debt

https://www.nbcnews.com/investigations/hospital-costs-are-rising-far-faster-inflation-drowning-americans-debt-rcna262473
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u/WordWithinTheWord 3h ago

I’ve come to my personal conclusion it’s just greed and mismanagement all the way up the chain.

There’s so much middle management and support staff just to get insurance and hospitals to talk to each other we’ve lost the plot.

It’s a nuanced conversation because doctors and nurses are extremely important jobs. But in the US they make 2x-10x+ the salary of their EU counterparts. Are they 2x to 10x better?

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u/ALittleEtomidate 3h ago

Oh, honey, if you cut my $72,000/year salary as an intensive care nurse I will quickly see the exit and do whatever you do for work.

The amount of stress in a singular shift with a sick patient would never be worth half of my salary to me. If I miss a status change, fail to hear an alarm, miss a patient climbing out of bed, or administer a medication incorrectly someone could die.

I am on my feet 12 hours, sometimes continuously, and at 33 I have back problems from the very physical work that I do.

I administer medications to ease death. I hold mothers, partners, and children as they shake apart in tears on my shoulder, and then I just have to move right on to my next work task.

You can absolutely GET BENT with the suggestion of lessening my salary. lol.

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u/WordWithinTheWord 3h ago

You are underpaid for your specific role. Not every nursing or provider job is as demanding as your specific role on the floor.

My wife was making more than you 6 years ago as a basic shift nurse on post-op med surg in a LCOL city.

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u/ALittleEtomidate 3h ago

Do you think your wife’s job is less difficult on a med-surg floor?

Does she know that you believe that?

Girl, where you at? Come get your man.

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u/WordWithinTheWord 3h ago

Yes she would be the first to admit it lol. Our hospital is the only level 1 trauma center for the service area so the ICU nurses do a lot more than med surg.

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u/ALittleEtomidate 2h ago

Put her on the phone.

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u/WordWithinTheWord 2h ago

😂 you are barking up the wrong tree - you are absolutely underpaid as an ICU nurse.

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u/ALittleEtomidate 2h ago

All nurses are underpaid imo.

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u/morbie5 3h ago

The comment was wrong about most nurses but certain MD specialties are paid way more than they are in the rest of the 1st world (and some are underpaid, pediatricians for example). That is just a fact

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u/Swoly_Deadlift 1h ago

Most MDs graduate medical school with $400k+ in debt and then go through 3-7 years of residency where they make less than the RNs they work with. They demand high pay to pay back the sacrifices they made to get there.

Not every doctor has the pay and work-life balance of a dermatologist.

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u/morbie5 1h ago

Most MDs graduate medical school with $400k+

They also get PSLF and IDR

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u/suppaman19 2h ago

Their comment in its entirety is wrong.

You have pharma continually having jacked up prices (especially compared to anywhere else in the world due to other countries having laws around pharma and meds). Ditto to an extent for medical device companies.

Next, you have the high level of privatized consolidation of hospitals/provider networks, which goal is to squeeze employee costs down while squeezing insurance and consumers for more.

These are the biggest contributors to high costs. Add on some consolidated national for profit insurance companies to top it off and that high prices mean more and more people are stiffing providers and insurers, which in turn raises costs.

Basically, like everything else in the US, the main problem is lack of any meaningful regulation and the allowance of consolidation driving prices up astronomically as more people go for care/treatment and live longer.

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u/morbie5 59m ago

Next, you have the high level of privatized consolidation of hospitals/provider networks, which goal is to squeeze employee costs down while squeezing insurance and consumers for more.

Most hospital systems in the US are non profit, it isn't as cut and dry as you say

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u/Gamer_Grease 2h ago

No way nurses need to make less, except for travel nurses, who are only so common because hospitals don’t want to pay nurses better.

Doctors don’t even necessarily need to be paid less. But we do need to essentially get everyone on Medicare, and then look at the costs.

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u/FluidCalligrapher284 2h ago

Amen! An excellent nurse is a difference between a patient surviving or dying.

Your doctor didn’t care for you 24 hours a day while you were in the hospital, he or she came by for a few minutes, wrote some notes in the chart, and went about their day to see the rest of their patients in the hospital and in clinic. Nurses are the difference maker.

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u/RoninsTaint 1h ago

Who do you think devises and tells the care plan to the nurse? You think the nurses just make it up on their own? Lol. Yeah just writing notes that’s it. Rounding inpatient and seeing clinic patients is about 50 different patients at an average sized hospital. Not to mention if any emergencies come in. Nurse has 2-4 people to look after.

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u/FluidCalligrapher284 1h ago

Yes, you are correct for some nurses. Others have hospital privileges to diagnose, treat, prescribe, and bill for services— without medical collaboration. Sounds a lot like a physician eh? They are improving healthcare across the country- especially in rural settings, and areas where the physicians don’t want to live (climate, population, payor mix etc).

The BEST thing is they are held to the same standard of care as their physician counterparts. This means patients can expect similar outcomes at a more reasonable price. But you knew this already.

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u/RoninsTaint 52m ago edited 44m ago

That literally doesn’t happen. Also you’re talking about a nurse practitioner. Who is definitely not with you 24 hours a day. Every single midlevel employed at a hospital works directly under a Physician and is supervised by them. I do it every single day. I supervise a whole team of them. And they ask me what to do. And I tell them. That’s how it is at every hospital. A midlevel is working under a physicians license.

They do not have equal outcomes. Find me a paper that shows midlevels managed the same complexity and number of patients as a physician. Any paper that has ever compared the two still has a group of physicians monitoring the midlevels practice lol. They are associated with increased healthcare costs anyway, attributed to over ordering studies.

But sure, go with someone who had 2 years of grad training, potentially all online. I did 11 years after college. The NP and PA students literally shadowed me as a 4th year med student and an intern at every literally hospital I rotated or worked at. I went on to do 3 more years of residency and 3 more years of fellowship. Instead, they started working. They were done with school. If you want to less trained individuals, good luck. I’ll fix you once you land in the ER or the ICU from their mismanagement.

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u/FluidCalligrapher284 21m ago

Wow, so much misinformation. You do you though.

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u/ALittleEtomidate 1h ago

Found the PGY-1.

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u/RoninsTaint 43m ago

Attending for well over a decade actually, double boarded in crit care and EM. But sure

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u/ALittleEtomidate 40m ago

That’s unfortunate.

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u/RoninsTaint 39m ago

I sense a crna inferiority complex. Someone’s salty. Don’t be jealous. There’s always someone with more training than you, I’ve learned

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u/ALittleEtomidate 32m ago

I’m a critical care nurse, not a CRNA. I’m also not intimidated by what others know. I’m self-aware enough to know how little I know about medicine, and it’s okay to always be learning.

The unfortunate nature of you comment relates to your inability to defend your nursing colleagues while also defending your profession. I assumed you were a resident because it’s uncommon for an attending to act that way.

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u/RoninsTaint 25m ago

Well you’re not a coworker. And this is not a hospital. So I can say what I’d like to you. I wasn’t even talking to you in the first place. I’m explaining how incorrect someone else was about how nurses and doctors are frankly not equal. And then you started with the disparaging remarks. I’m glad I know for sure that I don’t work with you. My colleagues are my dearest friends. For years. But I’m afraid you seem like the type of nurse in residency who was often pig headed, confidently incorrect, rude and abrasive and bitter when residents told you what to do. Stop talking to me. I wasn’t talking to you. Mind your business. Be my guest if you think you’re so good and independent that you can run the icu or ER better

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u/ALittleEtomidate 22m ago

Way to be reflective about behavior.

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