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

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A CEO in a metro region facility, with an active cardiac surgical program and a new ICU expansion, decided to save money by switching to "afterhours" telemetric ICU medicine. He employed enough intensivists to cover the new expansion, but would have to hire two or three more to cover overnight in-house call.

Instead, he avoided the new hires, and sent his intensivists home after 7pm. He switched ICU care to telemed after 7pm. FWIW, telemetric ICU medicine is great for low volume rural facilities. But it is woefully dangerous for a high volume location.

The cardiac surgeons, who were also hospital employed, raised concerns to the point they were called in, and had their jobs threatened. The CEO and his minions refused to accept their expert counsel, concerns, or suggestions. He blew off their input as stubbornness, resistance to change, and resistance to cost-savings.

It took several deaths, multiple near-misses, one surgeon's resignation, the whole affair surviving a politicized PI process, and word filtering to newshouses before the "cost-saving" ICU tele-med program was shutdown.

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That entire narrative is an example of hospital expenses (labor) being managed according to the market pressure to maximize profits. Profit motive is a market force.

You keep giving example after example of this over and over again while insisting that hospital expenses are not influenced by market forces.

It's fine, I guess, and I'm not going to continue to argue, but when you stubbornly continue to say, "A pear is not a fruit, it's a meat," over and over again while simultaneously giving all kinds of examples that illustrate that a pear is a fruit, it's hard to take anything else you say very seriously.

As to the substance of your opinion rather than your insistence on incorrectly characterizing part of it, American health care is a for-profit proposition, as your post above underscores.

That means that market pressures by definition do influence it. What you want—regardless of what you'll claim—what you really want and what you keep arguing for again and again is a system that is NOT influenced by market forces like profit motive.

The problem is that I don't think a union is going to solve your complaints. Because here's a surprise for you—the union isn't representing the patients either, nor does it ultimately care what happens to them. The union exists to represent the nurses and some of the things it will negotiate for might benefit the patients, but only by accident, and some of the things they might negotiate for might end up being just as bad for the patients as what we have now. I can't really think of a situation in which a union took control over an industry in which the customer didn't get at least partially screwed as a result of it, can you? Bottom line, the union is responding to the market force interests of the nurses—not the hospital, and not the patients.

I think you're going to have to move into a greater degree of fascism—which is what we have now in health care—or move into socialism. Either way, the government is going to have to regulate past the influence of market forces in these decisions and dictate the care decisions to give you what you want.

And the problem with that is that there are so many unintended consequences that arise when that degree of state control is implemented that it often ends up being worse than letting the market forces drive the decisions. Instead of hospital administrators making decisions that kill people out of a desire to maximize profits you end up with bureaucrats making decisions that kill people out of sheer stupidity and lack of caring.

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Also the decisions being made by non-clinicians that affect patient care.

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Give me an example of this that doesn’t involve patie

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Give me an example but don’t include the most prevalent and unsafe example.

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Profit motive is a market force.

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Tell it to Madoff's victims.

Tell it to occupants burned alive in Ford Pintos.

The thread is about unionization due, in no small part, to administrative stupidity. Given that equation, it appears you're attempting to justify the purchase of a million dollars of equipment, in exchange for three FTEs, several resultant deaths, and numerous avoidable complications. Retrospectively, there was not even evidence of cost-savings. Evidence instead pointed to the CEO attempting to self-promote as some sort of medical innovator.[/quote]

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You keep giving example after example of this over and over again while insisting that hospital expenses are not influenced by market forces.

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No. I've said that in an industry where quality is critical, and should be paramount, healthcare marketforces instead ARE NOT QUALITY DEPENDENT!

I've pointed out that facility reimbursement is predetermined dependent on facility-type and ownership, rather than facility-set charge or equipment cost. E.g., reimbursement has nothing to do with the equipment or utility in isolation. OTOH, each categorical-type facility is reimbursed identically for equipment usage, regardless of quality.

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what you really want and what you keep arguing for again and again is a system that is NOT influenced by market forces like profit motive.

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My goodness, you may not be an idiot IRL, but you're surely playing the part here.

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Union contracts may (should) put an end to that BS, and return facilities to a more traditional safer clinical model.

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You’ve not done a good job detailing exactly how you think unions will fix all of your(and their)grievances.

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The "customer" in this case is not getting "screwed." He's getting killed!

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Thatll happen when a third of your floor nurses decide to take a mental health day.

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Thatll happen when a third of your floor nurses decide to take a mental health day.

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Right. As I've said, you may well be right in the long term. But there is a clear and present danger. It is that situation which, if unaddressed willingly by Admins who are financially incented against it, will lead to unionization.

Again, my hope would be other hospital systems see the value in self-healing, rather than being forced by unions. But I suspect Admin stupidity will rule, and unions will prevail.

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Unions in no way shape or form care about safety.

They may not care about the cost of safety.

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They care about creating jobs, not safe environments.

Ironically unions will be a major factor in automation.

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Alot of hospital administration (in New Orleans) no way shape or form care about safety.

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Then they'll be out of work soon enough due to lawsuits.

If youre disgruntled, why dont you move somewhere else that pays better? Thats how workers grow, and advance in their career.

I have read in this thread theres a shortage, you should be able to write your ticket.

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Unions will reset that paradigm.

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You have admitted you don’t know that it will. This is your hope, despite zero evidence of a union in any industry ever improving the quality of employee. Unions are a de-incentivizer by design.