re: Trigger Warning: UMC nurses in NO vote to unionize

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Hospitals can hire fewer low quality RN temps at equal or higher pay, then flex them off prn, quality be damned. "Costs" (money not lives) are saved, and Admin bonuses escalate.

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Which means, the expense side is market driven.

I don't know how you can continue to miss this. You're saying it yourself.

You don't WANT the market to drive the expense side. You just gave an example of the market driving the expense side as though it's evil and also somehow as though it's an example of health care expenses being fixed.

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Problematically, med reimbursement is not quality based.

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No, it's service based. Because doctors can control whether they provide a service or not. They can't control what the patient does before or after that. What you're saying is the same thing as wanting teachers paid based on test scores. It assumes everyone has the same raw material to work with. It can't be "quality" based.

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Until reimbursement is permanent-staff based, and RN ratio based

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Again, this is you arguing FOR fixed healthcare expenses instead of against them. Right now expenses are market driven and every argument you make is against that.

Understand, I'm not even saying you're wrong about what you propose. But you are wrong about how you're insisting on characterizing it.