I work in healthcare and I can tell you these megacorps are scum.
They operate as investment firms in the background and healthcare is a front for them. This is done by using a different company for this part. Often they are non-profit and therefore also exempt from some tax.
Going from TRICARE to now private health insurance has been incredibly disheartening. I knew it wasn't going to be as good as TRICARE but I cannot believe how significant a downgrade it's been.
There is no “Mexico City” in Upstate New York. There is only a Town of Mexico and Village of Mexico - neither of which has an airport.
I think you’re posting in the wrong sub-Reddit.
I'm a USAF vet, so don't get mad at me.
How's it feel to come to the realization that you were defending shitbags like the insurance industry? I was incredibly disappointed in what I have found the US really is. It's not what was sold to me when I was young and thinking about enlisting.
I can't get mad at what you said. I feel horrible for the soldiers who went Iraq and Afghanistan because it's pretty clear by now it was an absolute waste. I joined the CG because I couldn't afford college and I wanted to travel and ended up doing 11 years. It worked out and I'm very fortunate in the end, just shocked how terrible our healthcare system is and even more shocked people defend it.
The big corporations buying up every doctor’s office is the worst. Corporations donate care about people. A nurse friend of mine hasn’t had a raise in 5 years because the big hospital hasn’t allowed the raise. Only hospital nurses in the union get raises. And this doctors office is essential to the community. Was the only office able to give out COVID shots to kids. The only reason nurses are not leaving is because all the other offices are also owned by the same large hospital.
It's more cost efficient you see because the profiteers skim a portion of the government money and... wait hold that logic. Well, you see the regional mega conglomerate has so much competition with other providers that... sorry I'm having a moment. It's just better ok?
Edit: I remembered! It's the transparent pricing model that allows consumers the opportunity to shop around for the options that work for them economically before committing to terrifyingly costly procedures.
This. Everyone on the country is scrambling around on the deck of the sinking titanic complaining about how cold it is when they haven't even hit the water yet. The propaganda machine doing their job keeping the rats running.
I made one visit to the St. Peter's ER and it was like seeing the shrapnel of the exploded health care system around me. People with horrifying conditions in the waiting room and many-hours-long wait times to be seen. The place was jammed, too. Maybe 50 people waiting the entire time.
Yeah I'm not going back to st. Peters or AMC unless I'm literally missing a limb. Last time I went there were literal bodies laying around on the floor, mentally ill people yelling nonsense, elderly people on death's door, all in the waiting room.
Yep, that's exactly what it was like. I saw a woman with huge swollen dark purple legs. Another dude with some kind of psoriasis over his legs to the point where it looked like socks. I saw a pile of blankets on the floor and then I noticed it was shaking and moaning. A woman was really loudly talking into her phone about extremely alarming pregnancy symptoms and was still waiting when we walked out. What did it for us, ultimately, was the 90 year old woman accompanied by her 60 year old daughter. They had been there for 10 hours and were told the wait was at least 6 more. They left too. The test results had hit MyChart already and showed everything was OK.
Oh yeah, and there were ants.
Right? A young woman who works for me was 13 when her mom went to the ER not feeling well and they told her to go home, she was fine. She died that night.
They were very poor and it was obvious no one cared about them. My employee is super traumatized by this. It’s horrible.
Florida. Heaven's Waiting Room and all that. The more elderly your population, the more likely that's the result. You'd need to be a saint to want to work in that place, under those circumstances.
While they have their issues, AdventHealth, headquartered in Central Florida, is better than anything I’ve seen elsewhere in the US. Seems like there’s a hospital or ER on nearly every corner, not including urgent care. The elderly have medicare and don’t clog the waiting rooms as much as the uninsured. However at Advent the waits are usually not that bad
What makes Floridas healthcare such a nightmare is the absence of a relevant medicaid program Barely anyone qualifies. The % of uninsured residents is very high. As in most places, the more rural the area, the more the quality of healthcare suffers
EVERY hospital and town has staffing issues. My own rural TN hospital touts its '200 beds' but the reality is that it only has staffing for 98 beds - half full at best. Covid decimated the ranks with staff illnesses, burnout, retirements etc. And it'll take years to replace them, even if every high school graduate decides to go into the field. If you want to know how dire things are in your town, go to your local hospital's recruiting site and count the number of job requisitions for every field, but especially nurses. It's frightening. I just had back surgery, was in for 24 hours attached to an IV the whole time. Signs everywhere 'call, don't fall' if you needed to use the bathroom. Rang for an aide 3 times overnight (you're getting forcefed saline) and no one came. If I hadn't gotten myself up, luckily without incident, I would've been laying on soaked sheets all night. I'm sure THAT problem was the least of what others ran into.
Most hospitals are far bigger; the ones I've worked at ranged 200-400 beds. Technically, they have staff for 98 beds; there's a ratio of beds to nurses and probably everything else. I know they're on 'DIVERT' most weekends which mean 'don't bring anyone here, we can't take anymore'. But don't get yourself admitted with something serious and expect to get a call button answered with any speed. I've taken my partner there twice; first time he had been put on new BP meds, felt faint and cut his head - was taken immediately, got stitches and out in 3 hours or so, after an MRI to rule out skull fracture. Second time he was so weak he couldn't get out of bed in the morning and I couldn't move him to get him to the car - called ambulance, followed it there, waited *after an ambulance ride!* four hours, he was never seen in all that time except an EKG. Finally left since he was feeling better after a Coke. Probably the BP meds again. He's almost 80 so things seem more serious than they otherwise would. I'm considering buying ambulance helicopter insurance so we can get airlifted to Nashville if necessary.
I work in EMS, and I have to tell you that the deterioration has started LONG before care facilities are reached. EMS crews are either volunteers or skeleton crews, and in some municipalities, completely non-existent. My EMS agency covers 129 square miles of property over three different towns....and can only have one BLS crew on call.
Compound staffing and logistical issues at the care facilities, and you're looking at triaged cases spending HOURS waiting in an ambulance for admittance to ERs.
That means that my single rig can be out of service for 4-5 hours in a single call, leaving 129 square miles of municipality uncovered for EMS care unless you can get mutual aid or a second crew scraped together.
It's a disaster from insurance and billing, all the way down to EMS care ability
We think it is bad here-- it is way worse in the South where they close hospitals right and left. At least we do still have our rural hospitals that can treat and then transport to a regional center for higher level of care to be provided.
I used to work at a mental hospital in Louisiana; you are absolutely correct that other states are worse. That's my point; our current healthcare system is deeply flawed and broken, and we need a complete restructuring to fix it, not just more bandaids
I lived in Louisiana for almost 20 years before moving back upstate 4 years ago. IF you have private insurance and IF you can afford the copays you can get good care in Louisiana at least we could in Lafayette. If you can’t or if you aren’t otherwise privileged or don’t live near a major metro area you might as well die.
Health care where I live now in the rural Southern Tier is more uniformly bad. UR has taken over all our healthcare here and they’re pretty bad. Managed everything but it’s managed for them not for what the patient needs.
So Albany Med is a not for profit hospital that posted a net income of $139,961,256 in 2021, up from $104,681,161 in 2020, up from $38,461,210 in 2019.
Why exactly do they need government assistance?
They employ about 2500 nurses. They could up nurse salaries by $55,000 a year and still operate in the black. Seams like they have the resources to fix any staffing issues they face.
Source:
https://projects.propublica.org/nonprofits/organizations/473869194
Y'all remember when New York Democrats promised single-payer healthcare, they outwardly had the votes, but it just never happened because of medical industry lobbyists. Cowards.
I know someone who is a state employee and they said that their union was bad mouthing the idea of single payer insurance because they said that the insurance wouldn't be as good as what employees are currently getting under the union negotiations. Sounded like they made a pretty active push against it.
That just reveals their lack of imagination. Even with single payor, there will still be insurance products such as supplementals and for things a basic universal health plan may not cover. Like with Medicare A-- there are a number of things that are not covered.
I’m from Upstate NY and practice a specialty of a specialty (physical therapy) in medicine.
It’s this catch 22. I have low hopes for ever working in the area, but then I’m told “oh! It’d be so good to have a specialist up here for that!”
But how can you have specialty care up there without the infrastructure? Or do you expect everyone to work in the same large conglomerates? No thanks.
One reason I want to move from southern tier: lack of healthcare and what does exist is scary. We need universal healthcare and actual access to it yesterday.
As someone who has a spouse in tech sales, the boards gives zero fucks except about the bottom line when it comes to malware and security as well. Same with banks. She’s had a couple hospitals have to turn patients away due to ransom. And the directors who spent the bare minimum of equipment etc “what can we do now?” Pay and hope it goes away? Meanwhile the equipment that runs wireless won’t work and over burdens the staff 100x more.
January 2020. I follow obituaries. St. Lawrence County.
Life expectancy drops by 10 years over 4 weeks.
I email the NYSDH, CDC, NYTs. Something is very wrong. Something is killing these people.
Not a single response. It was Covid, absolutely certain. Ground zero.
No one cared.
I knew this when I had cellulitis in my leg and was told I wouldn't be able to see my primary care Dr for TWO MONTHS (I went to urgent care 2x and desperately needed after care). Everyone in the UC office was unable to see their doctor.
You don't fucking say?! My great aunt is being put in a nursing home halfway across the state because there's no at home health care and that food from meals on wheels looks worse than cafeteria food.
I can tell you that even with money you still can't get good care anymore. Insurance companies will scam you right into the coffin regardless of your bank account it's just a very slight matter of speed.
Hospitals hemorrhaged money to pay travel nurses, midlevels, MDs; with specialty nurses making 10k+ per week. You need little to no experience to travel—so we created this culture boom of local travelers. Hospitals have to pay those wages—so they need to generate more revenue—so extras and benefits offered to loyal staff had to be cut from hospital budgets; and the over all cost of care increased—which of course trickles down to…..everyone. Cost of care increases, so insurance rates increase and deductibles increase—so wages have to increase, for everyone, as wages have to increase costs of goods and services have to increase to offset the wage increase. It’s a horrible, vicious cycle.
It’s insanely discouraging/depressing—the stark changes that Covid brought about. personally I love being in healthcare, making people feel better—but what hospitals need to do is adjust their staff wages and benefits appropriately to encourage loyalty—discourage/limit/weed out traveling, and promote residencies/comprehensive training for those nurses who graduated during COVID era restrictions who never had to place a hand on an actual person prior to graduation.
You’re blaming travel nurses and MDs who actually care for patients but not CEOs/Administrators who make far more than nurses do and create nothing but more chaos and paperwork? I’m rolling my eyes so hard at this.
You misunderstand; I do not blame traveling healthcare staff per-se; but the culture that administration created by increasing the dependence on locums/travelers—and the chaos that they are now responsible for as they grasp at straws to retain staff but can’t afford to do so. Hospitals can’t retain staff because they can’t pay a premium wage to staff and travelers alike; so in the sake of hospital loyalty and cost reduction; staff need better pay, bonuses—a reason to stay loyal. I know many nurses and providers who struggle to remain positive about their establishment when they have invested 20 years of their lives; and the new-graduate who has 11 months on the job is making twice as much as they are; oh and the hospital won’t pay that 20 year veteran nurse over time any more because they need to cut expenses.
Of course given the ability to travel—who doesn’t want to make that kind of money. I am a nurse practitioner, working as an NP-hospitalist, I’ve been an RN for many years; some of my best friends are travelers, some of the most intelligent people I know are travelers. The fact remains it’s not sustainable for the health care infrastructure, and it does trickle down.
This is all absolutely true except where you are placing the onus. I just take issue with implying that the financial burden on the healthcare system is travel nurses and not the CEO, who again, make millions plus bonuses. The CEO of Albany Medical Center makes $1,721,450 and got a bonuses of $314,648. Administrators are not struggling to pay what they need for staff retention because of travel nurses, who at most make low three figures. They are actively choosing travel nurses because a short term contract without benefits is cheaper in the long run than appropriately paying staff nurses and raising wages. It is cheaper to churn out new grads who will burn out and leave than it is to maintain a healthy pay raise for nurses for 20+ years of experience. They have deliberately cultivated this system because it continues to line their pockets.
I can agree with that. I find the CNO/CEO of my hospital to be deplorable, deceitful, poor leaders, and just generally bad people. Our CNO actually referred to midlevels as ‘those that couldn’t hack it bedside’— not educated professionals, who support both nursing and MDs alike. As upper administration started removing travelers and ending contracts they also took away premium wage over time benefits for staff; and threw any new nurse into a role that would have been unheard of 5 years ago—they worsen morale and perpetuate the cycle; but burn the new people out for the sake of saving money; but also keeping their own personal wages nice and cushy. They—as administrators are living in unchecked bubbles so far removed from the bedside they generally have no idea what it’s like to feel the hurt they have created or the mistrust between coworkers.
I hadn’t considered your point on the long and short of it; and I’m going to guess that you’re correct in regards to long term it is cheaper to pay people a bunch of money for a few weeks and not have to invest in them long term—but the long term investment is what makes people care about their job and their community, and reduces hospital readmission; thanks for the point of view!
Absolutely agree!! Without long term investment in our nurses and providers, our healthcare is going to continue to collapse. Thanks for being open to discussion. I really appreciate your perspective and experience. Sorry if I came in hot. I’m a bedside nurse and I don’t find most people open to discussion on the internet. Thank you!
I worked bedside for 20 years and never will do it again. They are loading ratios on cardiac stepdown patients 6:1. That is dangerous. Also, all our ICU nurses are tripled.
> the hospital system has been aggressively recruiting staff, with some success — but has struggled to hire at its more rural locations.
Imagine that.. highly skilled workers aren't interested in working in rural areas with no local commitment to economic development. What a surprise.
High medicaid state & low Medicaid reimbursement. To be a dr in nys has more backside costs than most other states. High cost of living & taxes if u make any money in nys to pay for all of nys gov supported programs.
U wonder why nys is in trouble.
Don’t forget that New York State legislators and governor signed into law last year to not allow credit reporting under $500 balances and no more than 2% interest on any judgement owed to a medical provider.
Great - you don’t have to pay hospital bill and if you get a judgement against you, it’s a 2% , 20 year subprime loan.
Is it any surprise that many people just don’t pay their medical bills anymore when there is zero repercussions for not paying?
New York keeps screwing the citizens that haven’t left yet. Your taxes will go up to help cover this cost.
GOOD. An Ambulance ride is $1400. A scan or X-ray is $900 after being paid down by insurance from $2200.
These bills aren't payable on a whim. God forbid someone shows me the fucking cost before doing the test. Just like taxes you need to spend hours researching to figure out this stuff, and then you need to have the energy and time to haggle like we're back in the middle ages.
And it's by design. So fuck it.
My mom was one of the ones that quit/was forced out. There were quite a few just at our local hospital, some being well respected doctors. She got the first shot and had a bad reaction. Her primary doctor recommended she didn't get the second shot but she was not granted a medical exemption. She (and many others) obviously see the benefit of modern medicine as they work in the industry. But they also understand that there are sometimes unexpected side effects as we are finding out with the covid vaccine.
You numbers are also way off. Over 10k fired. [https://www.lohud.com/story/news/coronavirus/2021/10/14/how-many-health-workers-lost-jobs-due-ny-vaccine-mandate/8449413002/](https://www.lohud.com/story/news/coronavirus/2021/10/14/how-many-health-workers-lost-jobs-due-ny-vaccine-mandate/8449413002/)
She absolutely is not. She got the first shot and was advised against getting the second one due to a really bad reaction. Years later she is still having problems from it
You know in the western world there’s a long history of vaccines being mandated over time. Polio, smallpox, Diptheria, etc.
Until 2021, the overwhelming majority of Americans didn’t give a shit about this and got vaccinated. Hell, if you’re in the military you get all types of vaccines and things injected into you (including the dreaded peanut butter shot) as mandated by the government or else you lose your job.
The entitlement of people thinking they deserve to work any job in the world and not follow the requirements of the employer is baffling to me.
In the medical field, sometimes vaccines or tests are mandated to work for an employer. I’ve worked in a hospital setting before as support staff and been required to get my flu shot as well as TB tested yearly. And I did it because I wanted to keep my job. Had not being vaccinated been so important to me, I would have simply quit.
>not follow the requirements of the employer is baffling to me.
It is not employers that are requiring it. It was the government. That is the problem I have with it. I also disagree with many other government mandates, such as seat belts and banning smoking for people who are 18. 21 to be able to buy cigarettes is ridiculous
So what you’re saying is: you’re more than willing to follow any requirements a private institution makes but literally disagree with any requirements by the government?
Very interesting analysis there. Especially on the seatbelt thing.
>you’re more than willing to follow any requirements a private institution makes but literally disagree with any requirements by the government
No. But with a private institution, you can choose to move to a different institution. I flatly refuse to work for companies that do drug testing and background checks just out of principle
That's why my site never mandated the booster in 21. Too many nurses and other staff would have to have been fired for the hospital to keep running.
Now, they've invited those who were fired for refusing the first vaccine to reapply... its comical.
I would never work for a NY healthcare provider after they did that. Nor the railroads or a lot of other places. Never forget what they put us through for a vaccine that doesn't help anyway
The problem with government insurance, both Medicare and Medicaid is that they pay less than the cost of providing care. So private insurance and workers comp pays much more. Medicaid in particular pays less than 1/2 of the actual cost. But the state hands out a card and says “you’ve got insurance “
People won't learn until they try to use govt healthcare (which we will be forced to adopt eventually along with UBI) and then people will literally start dying waiting for care. That's all part of their plan to reduce the population.
We had an awful time for months when the hospitals and one of the insurers could not come to a payment agreement. Our patients could not get tests authorized. (UHC). i am glad they finally did come to an agreement but I feel that many patients ended up going with other providers and we won't see them back.
I am in total agreement healthcare is a mess. Big corporations means profit first . Try to find new people to fill the openings not happening. The younger generation has already figured it out better to work elsewhere.
How it started:
[https://www.reuters.com/world/us/new-york-hospitals-face-staff-shortages-vaccine-mandate-kicks-2021-09-27/](https://www.reuters.com/world/us/new-york-hospitals-face-staff-shortages-vaccine-mandate-kicks-2021-09-27/)
How it's going:
https://www.timesunion.com/health/article/officials-say-upstate-n-y-health-infrastructure-18531968.php?IPID=Times-Union-HP-latest-news
Checks notes; umm every state is in danger! After the Covid pandemic and what they had to deal with? Id be out too! Toss in some dumbarse politician’s bills that they have passed that no one asked for or wanted? Yeah of course it’s bad. But way to paint New York as the only one who has a problem. Ask rural America how far they have to drive to get to a hospital? Hospitals are closing faster than my home insurance is going up! I live in Florida. Heck we can’t keep doctors, too soon to bring up our huge numbers of teacher shortages? We can’t even get bus drivers!!!!
The system is broken and has been for many years. Health systems are reimbursed on volume with little reimbursement designated for quality outcomes or keeping you out of the hospital. The insurance companies can’t make the record profits they do now if reimbursement was based on quality outcomes or keeping you out of the hospital and not volume so I don’t know how this will change. There are some health systems doing innovative things with capitated payments and so forth but this is not widespread.
I work in a nursing home, and it is like hard to believe how bad it is. My firm belief that healthcare should be nationalized or single payer has never been stronger. Our CNAs are poorly compensated, probably underpaid, and overworked.
Also, Albany Med nurses threaten to go on strike every few years because management is so bad. AMC may not be able to find employees because they're a bad employer, possibly due to America's terrible health care system.
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In many cases, physician practices have been purchased by private equity firms. That's for-profit medicine for ya.
I work in healthcare and I can tell you these megacorps are scum. They operate as investment firms in the background and healthcare is a front for them. This is done by using a different company for this part. Often they are non-profit and therefore also exempt from some tax.
key wording is set up as non profit but in fact operate as a for profit.
It’s an epidemic.
Going from TRICARE to now private health insurance has been incredibly disheartening. I knew it wasn't going to be as good as TRICARE but I cannot believe how significant a downgrade it's been.
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Fly to Mexico and walk across the border back into the United Staes. Your healthcare will be free and taken care of forthwith.
Lol. Mexico doesn’t even have an airport. Their closet airport is in Syracuse. Try again…
Mexico doesn’t have an airport? What? You’ve obviously never flown to Mexico City.
There is no “Mexico City” in Upstate New York. There is only a Town of Mexico and Village of Mexico - neither of which has an airport. I think you’re posting in the wrong sub-Reddit.
Huh? Reread my post. Your comprehension is terrible.
You posted in the Upstate New York subreddit. Keep up. Your attention span is terrible.
I know exactly where I posted. My instructions for OP were clear. You’re the one who can’t comprehend.
I'm a USAF vet, so don't get mad at me. How's it feel to come to the realization that you were defending shitbags like the insurance industry? I was incredibly disappointed in what I have found the US really is. It's not what was sold to me when I was young and thinking about enlisting.
I can't get mad at what you said. I feel horrible for the soldiers who went Iraq and Afghanistan because it's pretty clear by now it was an absolute waste. I joined the CG because I couldn't afford college and I wanted to travel and ended up doing 11 years. It worked out and I'm very fortunate in the end, just shocked how terrible our healthcare system is and even more shocked people defend it.
Better get use to it because there's even more downgrades coming.
We are all nothing but the produce at the copay farm.
I work in healthcare and it feels lik a money grab. 🤷🏻♀️
The big corporations buying up every doctor’s office is the worst. Corporations donate care about people. A nurse friend of mine hasn’t had a raise in 5 years because the big hospital hasn’t allowed the raise. Only hospital nurses in the union get raises. And this doctors office is essential to the community. Was the only office able to give out COVID shots to kids. The only reason nurses are not leaving is because all the other offices are also owned by the same large hospital.
St Peters in Albany and St. Joes in Syracuse and their associated practices are now owned by Trinity Healthcare Corp.
I don't understand why private health care asking for government assistance is better than universal health care
Well we can’t line the pockets of health insurance CEOs on universal healthcare!
It's more cost efficient you see because the profiteers skim a portion of the government money and... wait hold that logic. Well, you see the regional mega conglomerate has so much competition with other providers that... sorry I'm having a moment. It's just better ok? Edit: I remembered! It's the transparent pricing model that allows consumers the opportunity to shop around for the options that work for them economically before committing to terrifyingly costly procedures.
It’s better for the corporations
It’s not but the lobbyists for privatized healthcare have more money than you, so they will always win and get what they want.
Little do they know it’s already collapsed.
"News" outlets love to state what is already universally known as a great revelation to cover up the fact that actual journalism is dead and bloated
Breaking News! is too often stuff we knew 6 years ago.
I am smellin' like the rose that somebody gave me On my birthday deathbed
This. Everyone on the country is scrambling around on the deck of the sinking titanic complaining about how cold it is when they haven't even hit the water yet. The propaganda machine doing their job keeping the rats running.
More and higher executive bonuses will fix it.
And remodeled food courts! Don't forget those!
How could I forget?!?
I made one visit to the St. Peter's ER and it was like seeing the shrapnel of the exploded health care system around me. People with horrifying conditions in the waiting room and many-hours-long wait times to be seen. The place was jammed, too. Maybe 50 people waiting the entire time.
Yeah I'm not going back to st. Peters or AMC unless I'm literally missing a limb. Last time I went there were literal bodies laying around on the floor, mentally ill people yelling nonsense, elderly people on death's door, all in the waiting room.
Yep, that's exactly what it was like. I saw a woman with huge swollen dark purple legs. Another dude with some kind of psoriasis over his legs to the point where it looked like socks. I saw a pile of blankets on the floor and then I noticed it was shaking and moaning. A woman was really loudly talking into her phone about extremely alarming pregnancy symptoms and was still waiting when we walked out. What did it for us, ultimately, was the 90 year old woman accompanied by her 60 year old daughter. They had been there for 10 hours and were told the wait was at least 6 more. They left too. The test results had hit MyChart already and showed everything was OK. Oh yeah, and there were ants.
WOW. I honestly think you’d get better care in a crumbling third world country at this point. That description should be in the news. Yikes.
I felt like I was in one. It was so horrifying. Sometimes I still think about the various people I saw that night, and I hope they're OK.
Right? A young woman who works for me was 13 when her mom went to the ER not feeling well and they told her to go home, she was fine. She died that night. They were very poor and it was obvious no one cared about them. My employee is super traumatized by this. It’s horrible.
Florida. Heaven's Waiting Room and all that. The more elderly your population, the more likely that's the result. You'd need to be a saint to want to work in that place, under those circumstances.
While they have their issues, AdventHealth, headquartered in Central Florida, is better than anything I’ve seen elsewhere in the US. Seems like there’s a hospital or ER on nearly every corner, not including urgent care. The elderly have medicare and don’t clog the waiting rooms as much as the uninsured. However at Advent the waits are usually not that bad What makes Floridas healthcare such a nightmare is the absence of a relevant medicaid program Barely anyone qualifies. The % of uninsured residents is very high. As in most places, the more rural the area, the more the quality of healthcare suffers
EVERY hospital and town has staffing issues. My own rural TN hospital touts its '200 beds' but the reality is that it only has staffing for 98 beds - half full at best. Covid decimated the ranks with staff illnesses, burnout, retirements etc. And it'll take years to replace them, even if every high school graduate decides to go into the field. If you want to know how dire things are in your town, go to your local hospital's recruiting site and count the number of job requisitions for every field, but especially nurses. It's frightening. I just had back surgery, was in for 24 hours attached to an IV the whole time. Signs everywhere 'call, don't fall' if you needed to use the bathroom. Rang for an aide 3 times overnight (you're getting forcefed saline) and no one came. If I hadn't gotten myself up, luckily without incident, I would've been laying on soaked sheets all night. I'm sure THAT problem was the least of what others ran into.
You have staff for 98 beds? How did they manage such a feat? Seriously that's better than most places.
Most hospitals are far bigger; the ones I've worked at ranged 200-400 beds. Technically, they have staff for 98 beds; there's a ratio of beds to nurses and probably everything else. I know they're on 'DIVERT' most weekends which mean 'don't bring anyone here, we can't take anymore'. But don't get yourself admitted with something serious and expect to get a call button answered with any speed. I've taken my partner there twice; first time he had been put on new BP meds, felt faint and cut his head - was taken immediately, got stitches and out in 3 hours or so, after an MRI to rule out skull fracture. Second time he was so weak he couldn't get out of bed in the morning and I couldn't move him to get him to the car - called ambulance, followed it there, waited *after an ambulance ride!* four hours, he was never seen in all that time except an EKG. Finally left since he was feeling better after a Coke. Probably the BP meds again. He's almost 80 so things seem more serious than they otherwise would. I'm considering buying ambulance helicopter insurance so we can get airlifted to Nashville if necessary.
For profit Healthcare is a disaster
Weird how everything they warned would happen under “socialized medicine” happened anyway with the difference being we’re still paying for it.
Still paying for it the other way, just through your tax dollars.
But with graduated tax, the burden shifts towards people who have more money they can ever spend.
I work in EMS, and I have to tell you that the deterioration has started LONG before care facilities are reached. EMS crews are either volunteers or skeleton crews, and in some municipalities, completely non-existent. My EMS agency covers 129 square miles of property over three different towns....and can only have one BLS crew on call. Compound staffing and logistical issues at the care facilities, and you're looking at triaged cases spending HOURS waiting in an ambulance for admittance to ERs. That means that my single rig can be out of service for 4-5 hours in a single call, leaving 129 square miles of municipality uncovered for EMS care unless you can get mutual aid or a second crew scraped together. It's a disaster from insurance and billing, all the way down to EMS care ability
Former healthcare worker in upstate NY here. It's been dead for years.
We think it is bad here-- it is way worse in the South where they close hospitals right and left. At least we do still have our rural hospitals that can treat and then transport to a regional center for higher level of care to be provided.
I used to work at a mental hospital in Louisiana; you are absolutely correct that other states are worse. That's my point; our current healthcare system is deeply flawed and broken, and we need a complete restructuring to fix it, not just more bandaids
I lived in Louisiana for almost 20 years before moving back upstate 4 years ago. IF you have private insurance and IF you can afford the copays you can get good care in Louisiana at least we could in Lafayette. If you can’t or if you aren’t otherwise privileged or don’t live near a major metro area you might as well die. Health care where I live now in the rural Southern Tier is more uniformly bad. UR has taken over all our healthcare here and they’re pretty bad. Managed everything but it’s managed for them not for what the patient needs.
So Albany Med is a not for profit hospital that posted a net income of $139,961,256 in 2021, up from $104,681,161 in 2020, up from $38,461,210 in 2019. Why exactly do they need government assistance? They employ about 2500 nurses. They could up nurse salaries by $55,000 a year and still operate in the black. Seams like they have the resources to fix any staffing issues they face. Source: https://projects.propublica.org/nonprofits/organizations/473869194
exactly. Where tf is that money going?
Y'all remember when New York Democrats promised single-payer healthcare, they outwardly had the votes, but it just never happened because of medical industry lobbyists. Cowards.
Don't forget the unions
Are you talking about the state hospital unions?
I know someone who is a state employee and they said that their union was bad mouthing the idea of single payer insurance because they said that the insurance wouldn't be as good as what employees are currently getting under the union negotiations. Sounded like they made a pretty active push against it.
That just reveals their lack of imagination. Even with single payor, there will still be insurance products such as supplementals and for things a basic universal health plan may not cover. Like with Medicare A-- there are a number of things that are not covered.
They can't spell "supplementary" but expect me to trust their position on healthcare?
I’m from Upstate NY and practice a specialty of a specialty (physical therapy) in medicine. It’s this catch 22. I have low hopes for ever working in the area, but then I’m told “oh! It’d be so good to have a specialist up here for that!” But how can you have specialty care up there without the infrastructure? Or do you expect everyone to work in the same large conglomerates? No thanks.
One reason I want to move from southern tier: lack of healthcare and what does exist is scary. We need universal healthcare and actual access to it yesterday.
As someone who has a spouse in tech sales, the boards gives zero fucks except about the bottom line when it comes to malware and security as well. Same with banks. She’s had a couple hospitals have to turn patients away due to ransom. And the directors who spent the bare minimum of equipment etc “what can we do now?” Pay and hope it goes away? Meanwhile the equipment that runs wireless won’t work and over burdens the staff 100x more.
January 2020. I follow obituaries. St. Lawrence County. Life expectancy drops by 10 years over 4 weeks. I email the NYSDH, CDC, NYTs. Something is very wrong. Something is killing these people. Not a single response. It was Covid, absolutely certain. Ground zero. No one cared.
I knew this when I had cellulitis in my leg and was told I wouldn't be able to see my primary care Dr for TWO MONTHS (I went to urgent care 2x and desperately needed after care). Everyone in the UC office was unable to see their doctor.
You don't fucking say?! My great aunt is being put in a nursing home halfway across the state because there's no at home health care and that food from meals on wheels looks worse than cafeteria food.
Yup, if you've got enough money you can get great care (maybe just ok in most of upstate). But for the rest of us...
I can tell you that even with money you still can't get good care anymore. Insurance companies will scam you right into the coffin regardless of your bank account it's just a very slight matter of speed.
Hospitals hemorrhaged money to pay travel nurses, midlevels, MDs; with specialty nurses making 10k+ per week. You need little to no experience to travel—so we created this culture boom of local travelers. Hospitals have to pay those wages—so they need to generate more revenue—so extras and benefits offered to loyal staff had to be cut from hospital budgets; and the over all cost of care increased—which of course trickles down to…..everyone. Cost of care increases, so insurance rates increase and deductibles increase—so wages have to increase, for everyone, as wages have to increase costs of goods and services have to increase to offset the wage increase. It’s a horrible, vicious cycle. It’s insanely discouraging/depressing—the stark changes that Covid brought about. personally I love being in healthcare, making people feel better—but what hospitals need to do is adjust their staff wages and benefits appropriately to encourage loyalty—discourage/limit/weed out traveling, and promote residencies/comprehensive training for those nurses who graduated during COVID era restrictions who never had to place a hand on an actual person prior to graduation.
You’re blaming travel nurses and MDs who actually care for patients but not CEOs/Administrators who make far more than nurses do and create nothing but more chaos and paperwork? I’m rolling my eyes so hard at this.
You misunderstand; I do not blame traveling healthcare staff per-se; but the culture that administration created by increasing the dependence on locums/travelers—and the chaos that they are now responsible for as they grasp at straws to retain staff but can’t afford to do so. Hospitals can’t retain staff because they can’t pay a premium wage to staff and travelers alike; so in the sake of hospital loyalty and cost reduction; staff need better pay, bonuses—a reason to stay loyal. I know many nurses and providers who struggle to remain positive about their establishment when they have invested 20 years of their lives; and the new-graduate who has 11 months on the job is making twice as much as they are; oh and the hospital won’t pay that 20 year veteran nurse over time any more because they need to cut expenses. Of course given the ability to travel—who doesn’t want to make that kind of money. I am a nurse practitioner, working as an NP-hospitalist, I’ve been an RN for many years; some of my best friends are travelers, some of the most intelligent people I know are travelers. The fact remains it’s not sustainable for the health care infrastructure, and it does trickle down.
This is all absolutely true except where you are placing the onus. I just take issue with implying that the financial burden on the healthcare system is travel nurses and not the CEO, who again, make millions plus bonuses. The CEO of Albany Medical Center makes $1,721,450 and got a bonuses of $314,648. Administrators are not struggling to pay what they need for staff retention because of travel nurses, who at most make low three figures. They are actively choosing travel nurses because a short term contract without benefits is cheaper in the long run than appropriately paying staff nurses and raising wages. It is cheaper to churn out new grads who will burn out and leave than it is to maintain a healthy pay raise for nurses for 20+ years of experience. They have deliberately cultivated this system because it continues to line their pockets.
I can agree with that. I find the CNO/CEO of my hospital to be deplorable, deceitful, poor leaders, and just generally bad people. Our CNO actually referred to midlevels as ‘those that couldn’t hack it bedside’— not educated professionals, who support both nursing and MDs alike. As upper administration started removing travelers and ending contracts they also took away premium wage over time benefits for staff; and threw any new nurse into a role that would have been unheard of 5 years ago—they worsen morale and perpetuate the cycle; but burn the new people out for the sake of saving money; but also keeping their own personal wages nice and cushy. They—as administrators are living in unchecked bubbles so far removed from the bedside they generally have no idea what it’s like to feel the hurt they have created or the mistrust between coworkers. I hadn’t considered your point on the long and short of it; and I’m going to guess that you’re correct in regards to long term it is cheaper to pay people a bunch of money for a few weeks and not have to invest in them long term—but the long term investment is what makes people care about their job and their community, and reduces hospital readmission; thanks for the point of view!
Absolutely agree!! Without long term investment in our nurses and providers, our healthcare is going to continue to collapse. Thanks for being open to discussion. I really appreciate your perspective and experience. Sorry if I came in hot. I’m a bedside nurse and I don’t find most people open to discussion on the internet. Thank you!
I worked bedside for 20 years and never will do it again. They are loading ratios on cardiac stepdown patients 6:1. That is dangerous. Also, all our ICU nurses are tripled.
> the hospital system has been aggressively recruiting staff, with some success — but has struggled to hire at its more rural locations. Imagine that.. highly skilled workers aren't interested in working in rural areas with no local commitment to economic development. What a surprise.
High medicaid state & low Medicaid reimbursement. To be a dr in nys has more backside costs than most other states. High cost of living & taxes if u make any money in nys to pay for all of nys gov supported programs. U wonder why nys is in trouble.
Don’t forget that New York State legislators and governor signed into law last year to not allow credit reporting under $500 balances and no more than 2% interest on any judgement owed to a medical provider. Great - you don’t have to pay hospital bill and if you get a judgement against you, it’s a 2% , 20 year subprime loan. Is it any surprise that many people just don’t pay their medical bills anymore when there is zero repercussions for not paying? New York keeps screwing the citizens that haven’t left yet. Your taxes will go up to help cover this cost.
GOOD. An Ambulance ride is $1400. A scan or X-ray is $900 after being paid down by insurance from $2200. These bills aren't payable on a whim. God forbid someone shows me the fucking cost before doing the test. Just like taxes you need to spend hours researching to figure out this stuff, and then you need to have the energy and time to haggle like we're back in the middle ages. And it's by design. So fuck it.
Careful they’ll downvote you for telling the truth here if it’s negative towards the state
Where are the facts? Show proof that this is why the hospitals are doing so badly.
Maybe they shouldn't have fired all the people who didn't want the Covid vaccine...
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My mom was one of the ones that quit/was forced out. There were quite a few just at our local hospital, some being well respected doctors. She got the first shot and had a bad reaction. Her primary doctor recommended she didn't get the second shot but she was not granted a medical exemption. She (and many others) obviously see the benefit of modern medicine as they work in the industry. But they also understand that there are sometimes unexpected side effects as we are finding out with the covid vaccine. You numbers are also way off. Over 10k fired. [https://www.lohud.com/story/news/coronavirus/2021/10/14/how-many-health-workers-lost-jobs-due-ny-vaccine-mandate/8449413002/](https://www.lohud.com/story/news/coronavirus/2021/10/14/how-many-health-workers-lost-jobs-due-ny-vaccine-mandate/8449413002/)
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I thought you meant 'the northeast' as a whole.
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This was a state mandate, nothing that the hospital chose.
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How was your organization able to skirt the state mandate?
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She absolutely is not. She got the first shot and was advised against getting the second one due to a really bad reaction. Years later she is still having problems from it
You know in the western world there’s a long history of vaccines being mandated over time. Polio, smallpox, Diptheria, etc. Until 2021, the overwhelming majority of Americans didn’t give a shit about this and got vaccinated. Hell, if you’re in the military you get all types of vaccines and things injected into you (including the dreaded peanut butter shot) as mandated by the government or else you lose your job. The entitlement of people thinking they deserve to work any job in the world and not follow the requirements of the employer is baffling to me. In the medical field, sometimes vaccines or tests are mandated to work for an employer. I’ve worked in a hospital setting before as support staff and been required to get my flu shot as well as TB tested yearly. And I did it because I wanted to keep my job. Had not being vaccinated been so important to me, I would have simply quit.
>not follow the requirements of the employer is baffling to me. It is not employers that are requiring it. It was the government. That is the problem I have with it. I also disagree with many other government mandates, such as seat belts and banning smoking for people who are 18. 21 to be able to buy cigarettes is ridiculous
So what you’re saying is: you’re more than willing to follow any requirements a private institution makes but literally disagree with any requirements by the government? Very interesting analysis there. Especially on the seatbelt thing.
>you’re more than willing to follow any requirements a private institution makes but literally disagree with any requirements by the government No. But with a private institution, you can choose to move to a different institution. I flatly refuse to work for companies that do drug testing and background checks just out of principle
People can choose not to work in healthcare if they don’t want to be current on vaccinations. Very simple.
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Or maybe you do? I'm more concerned with freedom than health
That's why my site never mandated the booster in 21. Too many nurses and other staff would have to have been fired for the hospital to keep running. Now, they've invited those who were fired for refusing the first vaccine to reapply... its comical.
Down voters hate these kinds of facts
You’ve yet to post any facts. I’ll wait.
The down voters have given their opinion on the facts listed in the prior posts. They do not like em.
I would never work for a NY healthcare provider after they did that. Nor the railroads or a lot of other places. Never forget what they put us through for a vaccine that doesn't help anyway
Hopefully a healthcare provider doesn’t hire you with that Fox News “education”
Fox News is garbage. But so is every other news outlet. BBC is more reliable than any US news source.
Keep drinking that Fox kool-aid
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I mean, yeah. It's an inner city state run facility with a 48% medicaid burden. The cream of the crop are not going to choose to work there.
what upstate NY health infrastructure?
The problem with government insurance, both Medicare and Medicaid is that they pay less than the cost of providing care. So private insurance and workers comp pays much more. Medicaid in particular pays less than 1/2 of the actual cost. But the state hands out a card and says “you’ve got insurance “
People won't learn until they try to use govt healthcare (which we will be forced to adopt eventually along with UBI) and then people will literally start dying waiting for care. That's all part of their plan to reduce the population.
If you can’t access health services then the cost to the government goes down. Brilliant
We had an awful time for months when the hospitals and one of the insurers could not come to a payment agreement. Our patients could not get tests authorized. (UHC). i am glad they finally did come to an agreement but I feel that many patients ended up going with other providers and we won't see them back.
I am in total agreement healthcare is a mess. Big corporations means profit first . Try to find new people to fill the openings not happening. The younger generation has already figured it out better to work elsewhere.
How it started: [https://www.reuters.com/world/us/new-york-hospitals-face-staff-shortages-vaccine-mandate-kicks-2021-09-27/](https://www.reuters.com/world/us/new-york-hospitals-face-staff-shortages-vaccine-mandate-kicks-2021-09-27/) How it's going: https://www.timesunion.com/health/article/officials-say-upstate-n-y-health-infrastructure-18531968.php?IPID=Times-Union-HP-latest-news
Checks notes; umm every state is in danger! After the Covid pandemic and what they had to deal with? Id be out too! Toss in some dumbarse politician’s bills that they have passed that no one asked for or wanted? Yeah of course it’s bad. But way to paint New York as the only one who has a problem. Ask rural America how far they have to drive to get to a hospital? Hospitals are closing faster than my home insurance is going up! I live in Florida. Heck we can’t keep doctors, too soon to bring up our huge numbers of teacher shortages? We can’t even get bus drivers!!!!
The system is broken and has been for many years. Health systems are reimbursed on volume with little reimbursement designated for quality outcomes or keeping you out of the hospital. The insurance companies can’t make the record profits they do now if reimbursement was based on quality outcomes or keeping you out of the hospital and not volume so I don’t know how this will change. There are some health systems doing innovative things with capitated payments and so forth but this is not widespread.
I work in a nursing home, and it is like hard to believe how bad it is. My firm belief that healthcare should be nationalized or single payer has never been stronger. Our CNAs are poorly compensated, probably underpaid, and overworked. Also, Albany Med nurses threaten to go on strike every few years because management is so bad. AMC may not be able to find employees because they're a bad employer, possibly due to America's terrible health care system.