[rticesterp]

It's also not as simple as adding 7 more beds so we have all we need on 99.999% of days. Sure you have 14 beds, but you also need more doctors, nurses, surgeons, OTs, etc. to support those beds. Those health care providers won't get the patient contact they need to maintain their skills as competent providers. I know as a part-time EMT if I don't go on a certain number of calls a month that I have a noticeable decline in my skills

[Jtsummers]

At some point you must choose your bottlenecks. Excess physical capacity doesn't have to be used all the time (that is, there's no "currency" for a bed, and other equipment can be rotated through use and maintenance cycles). If you choose to constrain yourself with the number of beds needed for your 99% situation, then you can't expand beyond that without great difficulty. If you have physical capacity for your 99% situation x 2 or even just one or two extra beds, then you don't have to maintain full-time staff for it. You could extend staff hours, or bring part-time staffers to full-time hours, or bring in (with supervision) students from a nearby medical or nursing school to handle what they can and offload the burden for that 1% situation.

[wisty]

A hospital can call a part-time EMT and ask them to work a few extra shifts due to some disaster. They can't ask them to bring a bed.