Hacker News new | ask | show | jobs
by tptacek 2318 days ago
Depending on what you mean by "beds are capped and reduced", the opposite may be true: my understanding is that one of the major inefficiencies in US health care is that we have an unusually high vacancy rate in hospital beds. Addressing that problem is the central argument of Certificate Of Need laws.
1 comments
Spooky23 2318 days ago
Everyone fights hospital closures, so it's really hard to do. It's sort of like how everyone hates Congress, but loves their congressman. Certificate of Need addresses growth.

IIRC in New York, they closed something like 20 hospitals, with 10-12 in NYC. In my area (NY, but not NYC), there has lately there have been a bunch of hospital "mergers", where the lesser hospital gets converted into a sort of outpatient surgery site with urgent care, or an ER without longer term care.

link
tptacek 2318 days ago
I'm not even saying that CON laws are good; I have no idea. I'm just saying that the premise behind them appears to be accurate, and the argument that they are nationally responsible for lack of available hospital beds seems flawed (there are regions where there aren't enough vacant beds, but that doesn't seem to correspond to CON laws, and nationally the statistic is in the other direction).
link
cryptonector 2317 days ago
> just saying that the premise behind them appears to be accurate

There's only one way to find out.

Indeed, we're finding out as we speak, because all those new ERs and urgent care clinics and specialist clinics and birthing centers, they did not need CONs, so they got built. And they got built by people who risked capital to do it. And it seems to be working out. I know I'm not going to any hospital's ER if something happens to me, and neither is anyone in my family -- we know the score on pricing and billing.

So the free market has found a way around the protectionist regulation of hospital construction. Is that even a surprise to anyone?

link
tptacek 2317 days ago
It's not working out. It obviously isn't. We pay multiples of what other countries do, and one factor in that is the inefficiency of how our health facilities are deployed.
link