Do we wonder why public health problems and inequality and misinformation are so rampant?
so NPR-news reported "Rural Psychological Units, Facing Regulation Pressures, Choose To Close"
Federal regulations require inpatient psychological facilities to make changes aimed at patient safety. Small units, such as a facility in Wyoming, can't justify the renovation costs and are closing.
… If you don't pay attention to details - you assume... what?
That "government regulation is at fault"?
But that is not really true...
That's everyone’s favorite meme - the left might assume Trump's administration is botching things and the right is certain that it's "gummint overreach" that destroys free market innovation (and stuff)
A real problem is that rural and native communities are getting screwed — and private companies want the government (us taxpayers) to pay extra to "address" those companies “needs” (for profit)
But delve into the story — and you see how the reporters just accepted “common wisdom” and commercial talking points… the reporters either don’t understand or don’t question the details
(especially if it’s about “complicated” medical and business… stuff)
You see the reporters relied on spokespeople talking about local clinics based on _regional clinics_ (SageWest Health)... repeating information they got from their Parent Company (LifePoint Inc - a Tennessee Corporation) based on their "consultants" (National Association for Behavioral Healthcare - a trade group) who are citing reports from their "industry research group"
(and I went and read the actual “research” — it consists of “surveys” of and from people who do not have accurate measures when they are reporting them)
* * * this is a whole separate problem that reporters NEVER address — see all those “crime statistics” when local police departments make it a point of pride to disparage “bureaucratic paperwork” and the individual perceptions reported are inherenetly prone to bias. Or “industry reports” where companies estimate their “cost of compliance” (does anyone seriously think an industry consultant is going to tell them they are the problem?)
In this healthcare story — basically everyone being interviewed has a very serious profit motive
But reporters let others frame the narrative as if "we are just trying to do what's best to help patients... but the gosh darn government is getting in the way"
(and that includes their fake neutral framing "oh, the government is means well... but they just can't handle details")
This is all so much bullshit
(Please feel free to go read all the articles at the end to form your own views)
I understand how large companies do managerial accounting ("cost accounting" is more tightly constrained about how you do the actual numbers — FASB and GAAP)... but managerial accounting is how you communicate interpret and assign the “labels” of what costs are and how they are “allocated” (and although there are "recommendations" they are industry driven standards)
(just like SEC's "financial risk measures" during all prior crises were and are industry driven)
(just like the FAA's aircraft safety certifications are industry driven)
there seems to be a pattern?
in any case - if you go past NPR-news' superficial reporting and read the articles from the Wyoming papers and industry trade groups — you find that rural clinics are not "cost effective"
period.
So large healthcare companies buy up smaller chains under the pretext of "providing scale efficiency" (which there are not) and then want to close those clinics - but often run into PR or state regulations
So they blame federal rules
(and note that even in these news reports - they are very careful in shifting from saying one thing (e.g. "ligature regulation" or "B-card") as a single example and then generalize to many situations that do not have the same criteria - and further they cite "enforcement is too ambiguous" (which often means there are not enough regulators, they are not trained, or the industry self-regulates and they do a poor job)
So a very real problem is that these under-served communities are not being provided adequate healthcare - a "free market" ain't gonna do it
Note- The postal service was not created to "make a profit" it was intended (by Benjamin Franklin) to provide a connection between _every_ American for the purpose of a stronger union.
(That's why FedEx and UPS can make a profit — they can drop all those "unprofitable last miles")
The purpose of government is to strengthen our union - and a "for profit" model is a really bad idea
But the other problem is how insidious "common knowledge" assumptions and narratives can cause you to get the wrong impression just because blame is easy and those stories are exactly that — narratives designed to lead your thoughts
I'm interested what other people think about this?
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Rethinking Rural Health Solutions To Save Patients And Communities
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Federal Regulations Shutdown An Inpatient Pysch Bed Unit, Now What?
Assessing the Regulatory Burden on Inpatient Psychiatric Facilities