Two Years On

We’re two years on into the pandemic now, and predictably, the healthcare system we collectively rely on is fraying at more than the just edges now. It is threadbare, worn away by profit squeezing at every point of service. I know — I used to be a practicing physician — that the healthcare “system” we have in America is much less of a system than an industry of barely-connected parts and special interests, who all can lay claim to profiteering off the human body. Hospital systems, in particular, are in a crisis of their own making, now unable to attract or retain staff (nurses, aides, cooks, cleaners) when private industry is able to pay the truly princely sum of $15-an-hour*. They have turned to temporary staffing agencies to fill the gaps, at wildly inflated short-term wages, stoking resentment among employees who weathered years-long budgetary constraints and cuts, begged to “do more with less” for the “sake of the patient.” Every time a wealthy, private, hospital system bumped nurse staffing ratios and watered down the punch at the (truly mediocre) cafeteria, it was with the unspoken premise that we’re doing this because we need to; patients — vulnerable people- are relying on us.

So the bodies of the system, the workers who make up the loosely interconnected system as we know it, ground on. The 24 hour+ nights and days and holidays piled onto the already hideous tower of weekday hours stacked into a Colossus. The whole hospital system is a behemoth of martyrdom and self-neglect, egged on in part by the weight of history and pride, but most vigorously prodded by administrators and executives, middle managers, program directors, department heads, charge nurses, HR, etc. in the name of “culture.” The whole mess stands on feet of clay that are now beginning to crack. These administrators, who lived in a different state, both literally and figuratively for the pandemic, have chipped away at the boulderstone of goodwill for years, relying on the drumbeat of the unspoken incantation patients are relying on us ringing heavily in staff ears to squeeze another night, weekend, overtime from a system running very close to the limit on a good day. It’s now been close to two years of very bad days.

Now, what’s left of the boulderstone is shrinking, fast. The solidarity of humanity is splintering, and an ideological war has broken out, between the people who work in a hospital, and the people who don’t: ad hominem attacks against the victims of stubborn misinformation against vaccines who now represent the vulnerable (data is clear: if you’ve been vaccinated, this won’t be what calls your number,) are bubbling up. Two years on, the pressure of relentless days, nights, weekends and extras have now become completely intolerable. Lives, both in and out of the hospital have been on hold, and the two camps are angrier at each other. These are the wrong targets.

To everyone on the outside, get vaccinated: healthcare is relying on us.

To everyone on the inside, channel your rage for those who deserve it most: the people who sleepwalk, beholden to a faceless stack of paper in Delaware, who masquerade being in the trenches with you but who for years kept you on the bleeding edge of overwork and insanity, in the name of profits that have all but evaporated with the whole system on the brink.

*sarcasm, if you can’t tell.

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Main Street Economist

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Irreverent, clear-eyed observer of the strangest corners of the real economy.

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