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Comment by bluGill | Hacker News Reader

Just be careful. While hospitals need to do better, a large part of what I want from a hospital is to be over prepared. Just in time is good, for a lot of things, but there needs to be a large buffer of things in inventory at a hospital just in case there is a large disaster. (this is hard - blood expires and people don't like to hear about their donation being wasted even though wasted blood means no doctor had to decide which person didn't get blood for lack of supply)

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It's not even about inventory of individual items (like blood or enough scalpels) it's that they need to have every expensive machine. They need x-ray machines and MRI machines and proton beam cancer treatment and that stuff adds up very quickly. That's why a trip to the ER for stitches can cost five figures in the US, because a large amount of that bill is covering the hospital's cost to be ready not just for the stitches but also car crashes or mass shooting events or whatever

Then why does the expensive treatment cost 7 figures? Estimating hospital costs is hard, but a quick glance at many buildings/offices would tell you that they are by no means struggling.

We overpay for healthcare because we must pay, and it has institutional and natural bottlenecks which restrict availability and choice.

Because they are going to allocate as much as they can to that service that is actually using those advanced facilities. The stiches patient in the ER is carrying some load for the cardiac surgery suite just not as much as the person who actually has quadruple bypass. Plus that is just part of it. They're also covering uncompensated costs across the whole system

Even if you only have stitches you want the ER to have those machines just in case the doctor looks at your injury and says "wait, this isn't the standard routine thing everybody has we need to get you into the expensive machines". Probably this will never happen - the doctor will always look and see the standard routine things that everybody has and you don't need the rest.

This is why urgent care exists and is why if you don't have something that you think is life threatening, that's almost always better. If you need more than they can provide, they can and very much will forward you on to an ER

If you need stitches then the ER is the correct place to be.

Most of the minor lacerations which require stitches to heal cleanly can be handled perfectly well in urgent care. There's usually no need for ER level care.

Elective surgeries have fallen in price because many no longer occur in hospitals. In the USA, ERs have to treat everyone regardless of their ability to pay. That's why you see a lot of urgent care.

We've socialized healthcare, just in the worst possible (but politically easiest) way.

X-ray machines aren't all that expensive.

MRI machines generally run close to capacity because of how expensive they are. There is very little slack.

Cancer treatment already costs a fortune.

there's more expensive equipment than just an x-ray machine and MRI machines, those were just examples. The building itself is expensive. Having the labor there ready to respond and service patients is expensive. Overall there is a ton of overhead with very expensive inputs that even if you come in and end up just getting a tylenol, you're going to pay for part of it

A quick Google search shows me that I could afford to buy a used lower-end MRI machine... (not that I would) They don't seem that expensive (though there's a factor of 10 difference between the cheapest lower-resolution used machines and the high end)

The ease of availability of same-day MRI services in London suggests to me there's quite a bit of slack here at least.

EDIT: Though one solution to preparedness for temporary capacity issues without as much over-provisioning everywhere: Mobile suites. My local hospital currently has a mobile MRI suite parked outside to clear their backlog.

The machines cost the same in Poland and yet the personnel costs are still over 80% of the expenses.

The costs of “hospital overpreparedness” should still be clearly understood (and should probably be funded by taxpayers and not by people who need elective procedures).

To make it more concrete: the lack of hospital capacity is one of the major reasons why COVID lockdowns lasted for so long after vaccines were available. Hospital capacity numbers were what politicians and bureaucrats were watching to determine when and how to ease lockdowns. If we had more excess hospital capacity, the lockdowns would have ended sooner.

When hospitals routinely operate at 120% and a major crisis doubles what we ask of them, people don't get the treatment they need.

I'm sure most of us have stories of friends or relations who needed hospital care during COVID and received less care than they normally would have received outside of the crisis.

When hospitals routinely operate at 120% and a major crisis doubles what we ask of them, people don't get the treatment they need.

A lot of people don't realize how stretched hospitals are these days.

The newspapers in Britain regularly run headlines about people waiting for hours, days, or even so long that they die on a gurney in the hallways.

It's better, but still problematic in the U.S., though for different reasons.

Here, a lot of people wait the hallways for hours and hours because there are simply not enough doctors, nurses, and support staff available. People look at a shiny hospital building from the outside and think it's brimming with doctors and patients. Often, it's not.

There can be many unoccupied rooms in a hospital simply because there aren't enough people available to meet the standard of care required to occupy a room. That leaves patients to wait in the hallways until the next shift change, and maybe there will be enough staff available to move a patient into a room.

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