Here Comes The Fucking

In the last 15 years, more than 190 rural hospitals have shut down, partly because of the plague of Private Equity, but generally because of the ongoing attack of "conservatives" looking to cut funding for a healthcare system they insist can be shoehorned into a standard business model.

There are some things that just don't work according to Harvard Business School principles, and the metrics of a bean-counter's 12-column ledger.

You can walk into a busy shoe store waving $500, saying, "This belongs to whoever finds me a pair of brown wingtips in the next 5 minutes", and the clerks will swarm all over your ass to get you what you want.

Do the same in a busy ER, and the charge nurse is going to look daggers into your heart while she tells you to shut up and sit down - you'll just have to wait while they take care of the flail chest injury, and the gunshot wound, and the comatose diabetic, and the teenaged footballer who's thrashing around the exam room because of an obvious brain bleed due to concussion - your broken arm just isn't at the top of the triage list.

Some things have to be driven by need, and not demand.

In medicine - especially in emergency medicine - whoever needs it most gets it first.

Jesus, it's like some of these genius Masters of the Universe never saw an episode of M*A*S*H, or just can't fathom a world where not everything has to conform to Freddie Hayak's vision of totally unfettered free market capitalism.

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