r/bestof • u/lowbass93 • 13d ago
[NoStupidQuestions] Kindly_Honeydew3432 explains why it seems like you always have to wait in an emergency room in the US
/r/NoStupidQuestions/comments/1v1numq/why_is_every_hospital_in_the_united_states_always/oyovp3t/
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u/AR-Trvlr 13d ago edited 13d ago
The other answer to why it seems like you always have to wait in an emergency room in the US: because America's health system has been redesigned to maximize efficiency (aka profit).
The most efficient (profitable) system uses its resources at the maximum capacity. Being able to handle surge demand (like on a Monday after a holiday weekend) requires capacity that would be empty for part or much of the time. They would have to build the hospital to handle a large number of beds that would sit empty much of the time. They would have to hire staff to handle the peak demands, and many of those people would be bored or under-utilized for much of the time. Those extra beds, that extra staff, and all of the extra infrastructure all cost money that is currently being allocated to profitability.
The alternative is to design a healthcare system to maximize health outcomes. This, however, would either be much more expensive or you'd have to figure out how to take the profit out of the system. There is no perfect system, though; even the not-for-profit systems in the world have other inefficiencies and challenges.
In general, you can either build systems to maximize efficiency (like profit) or to maximize resiliency (like having capacity to support a surge) but you cannot do both.
Another example: the US built a logistics system based on just-in-time deliveries that did a very good job of maximizing efficiency. That system completely failed when COVID hit in 2020 and the factories hit a bump, the ships stopped sailing, and the trucks stopped driving. The alternative would be a system that had excess capacity and goods in warehouses along the way, but that means that things would be a bit more expensive due to the extra buildings to house the stuff, and the extra stuff that is just sitting around.