Italian hospitals on the verge of collapse

I have worked a little bit with facilities in the italian health system in my career. As with any health system you build out to handle a certain idea of peak utilization which is much higher than average utilization. My experience in Italy was the there was a very modest difference between average and peak. It is extremely expensive to maintain a lot of unused capacity for modern health facilities. Bottlenecks around imaging, and ICU in particular. As with any health system you do the best you can with the resources that are available. Unfortunately, it is a very long lead time to add additional peak capacity.

I don't like the usage of "collapse". It's a weasel word. What they actually mean is that some meaningful amount of patients won't be able to receive a proper standard of care. That is a -- possibly avoidable -- tragedy.

The sad truth about COVID-19 is that the American health care system, and possibly global Western medicine, was terrified of the understaffing and poor management at hospitals.

The whole bit about "flatten the curve" and "don't overcrowd the hospitals" wasn't about crowding at all, but because there weren't enough physicians and support staff to handle increasing patient numbers.

Health care has been a booming growth industry, and COVID-19 gave it a literal shot in the arm. Facilities are popping up like mushrooms, especially those that serve the "seriously mentally ill" and there's a whole continuum of facilities to do that, from acute inpatient to discreetly unlabeled outpatient clinics.

Health care is expanding and encompassing more and more, while at the same time it is tightly integrating to provide "one-stop shopping" of comprehensive services under a single umbrella. My insurance carrier owns a chain of pharmacies, leaving nothing to chance: the more ultra-processed food and booze they can sell, the more people come in the front door of their PCPs and addiction treatments. The more lousy condoms and "95%" contraception they can sell, the more OB/GYN business for unplanned pregnancies.

However it seems that there's a perfect storm of rational people being disillusioned by this sort of "health care" that they don't really feel like working in the field, plus gatekeeping and artificial limits on medical graduates. The physicians I've interacted with are burned out and turning extremely cynical. "Verge of collapse" is quite a charitable assessment.

I never get how a healthcare system could "collapse". What could happen, and in fact what is happening in societies with stretched health care systems, is that people get triaged and wait, possibly until they die off.

I strongly suspect that strong, albeit invisible, hands of Honorable Gentlemen are at work in Italy. The further south, the more Honorable Society.

The Covid-19 pandemic in particular was a good opportunity for healthy profits.