Hospitals build out capacity based on projections of need. So they look at the population of their catchment area, other hospitals, demographics of the locals, and calculate that they’ll need about X icu beds / maternity rooms etc etc and then build in a small overcapacity for surges.
If they routinely overbuilt then cost would go up even more. I think this approach is reasonable for any business,* whether private or public hospital.
The Covid surge isn’t something you can plan for, nor could you really build ICU capacity quickly enough for.
Also there’s a systems issue: the ICU pressure shouldn’t even exist to the degree it does as we have a “defense in depth”: vaccination. But for some reason people aren’t using that defense, which simply makes things worse for the rest of us.
* not getting into the cost issues in general, just addressing your specific comment.
I generally agree but just to clarify I didn’t say overbuild—just more than our current capacity which seems to be admittedly inadequate for the current crisis. We have no flexibility.
Look at how many fewer deaths there are in countries with universal healthcare. Maybe when we don’t have to pay useless middlemen like insurers then we can spend the money to hire more healthcare workers. I think it’s just our for-profit healthcare is always going to provide the bare minimum for the highest cost—-and is woefully unprepared for this pandemic.
>I think this approach is reasonable for any business
It's reasonable for business, but not reasonable for society (because healthcare should be more risk adverse than a business). That's why the hospital system for op of this thread, which is German, isn't a business, and why they get to complain about how it's deployed
I have benefitted from the German health care system myself and I stand by my statement.
Governments are not immune against financial considerations any more than the private sector is. For example the transportation ministry/department has a figure at which a life is valued and won’t build a road improvement if the cost/mile exceeds that.
If they routinely overbuilt then cost would go up even more. I think this approach is reasonable for any business,* whether private or public hospital.
The Covid surge isn’t something you can plan for, nor could you really build ICU capacity quickly enough for.
Also there’s a systems issue: the ICU pressure shouldn’t even exist to the degree it does as we have a “defense in depth”: vaccination. But for some reason people aren’t using that defense, which simply makes things worse for the rest of us.
* not getting into the cost issues in general, just addressing your specific comment.