Hey everybody, remember all those excellent explainer threads from last week about the problems with JIT manufacturing gutting the supply chain’s ability to weather hiccups? Now consider the health care insustry looks at “available hospital capacity” the same way…
Obviously, there’s no good way to just keep, like, half again as many hospitals idling most years IN CASE there’s a pandemic. But treating health care in aggregate as a profit focused enterprise ensures that surge capacity will always be squeezed put in favor of profit.
Why? “Insufficient hospital capacity to deal with unanticipated patient volume” is an externality — i.e., society’s problem, not the health care business’s. And for-profit businesses are basically machines for building around externalities.
Point of clarification: the quoted chart is NHS capacity, and it’s technically not a for-profit enterprise! However, its reduction in available surge capacity over time has come from pressures to be more like a business — squeeze out inefficiencies, etc.
The pattern is predictable: Early results are celebrated, workers in the trenches warn that it’s a bad idea, but the efficiencies and cost savings are treated as free money — why not squeeze MORE? — until a stressor arrives and the purpose of the “inefficiency” becomes clear.
Ideally, that would result in everyone learninf a painful but important lesson. But especially with public services, the failure often becomes a talking point for the people who pushed “efficiency” cuts in the first place & the “failure” is blamed on the service’s public nature…
Thus justifying a fresh round of “make it work like a business!” tweaks and squeezes. You can see the same pattern here in the US in the postal service.