40
votes
After Appalachian hospitals merged into a monopoly, their emergency departments slowed to a crawl
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- Authors
- Brett Kelman, Samantha Liss
- Published
- Mar 25 2024
- Word count
- 1686 words
We all need food, shelter, water, and healthcare. These should always have been public goods. They never should have become profit centers.
Have private equity firms demonstrably done more harm than good to the world? It would be lovely to prove that and then turn the gears of government to force that to change.
It is difficult for me not to see this with dismay: part of a greater "enshittification" of society and the continued strip mining of humanity by the wealthiest.
I'll add that, IMO, incarceration and education should also never be profit-driven industries as they are also human necessities.
Replace 'incarceration' with 'criminal justice' and I'll get behind that.
Just working to chip away at the very-deeply en-grained belief that incarceration is an intrinsic part of criminal justice. And that's one of those barriers standing in the way of restorative justice.
Would you like to know more?
Has restorative justice been applied in environments where the gap in education and social standing/status are as wide as they can be in the United States?
I suspect our society is too fragmented, that we have othered ourselves into too many pieces, to be capable of negotiating this at scale.
For instance, how would this play out in a situation where a hypothetical home owner has their home burgled, the burglars are people earning below poverty wages, they stole several thousand dollars of both replaceable and irreplaceable items, these items are lost due to the black and gray markets. The home owners experience the trauma of violation. Perhaps dead pets are lost as a door/window is left open for a significant period of time.
No bodily harm is done yet real harm is done.
Are these burglars likely to feel empathy for the people they robbed? Are the people who were robbed, who lost family heirlooms and even members of their family (pets) likely to feel empathy for the burglars? How do you get to a participatory conflict resolution here, even when you include the community in the negotiation?
It seems more likely that the burglars would have, at best, apathy for their victims.
I would genuinely like to see a better way but I have difficulty believing it is this.
By way of alternative, is "incarceration" so terrible if, as in Nordic countries, it isn't punitive but genuinely rehabilitative?
So much crime seems to be a failure of an adequate education and acculturation. People coming from disadvantaged beginnings are kept disadvantaged by a system rigged to keep the wealthy where they are at the cost of everyone else. Again, an enshittification. Education alone doesn't fix this. Restoring dignity to those with less privilege seems critical. Also, providing a meaningful social safety net (see my original comment above).
You're almost certainly correct, but as is said: All long journeys begin with a single step.
I'm betting 80% of the population hasn't even heard the term 'restorative justice,' let alone given it any serious thought as an alternative.
Agreed
It depends on what would have happened otherwise, which is hard to say without knowing more. In some places, hospitals and clinics are closing.
It’s not clear to me why some rural hospitals find it harder than before to stay in business. Costs are going up?
Costs are static or increasing, while rural populations are decreasing, and you can only increase prices so much. Additionally, it is harder and harder to attract doctors and nurses long-term to these hospitals.
Rural areas also often have more regressive health policies which might lead to liability on the part of the physicians or hospitals. An uncertain environment regarding what new laws might be enacted can make continuing to run a hospital a more questionable endeavor. If it's already running near the break-even line and next year you might be able to be sued for something that was previously part of your normal practice, you might shutter things before the lawsuits start flying.
background article
Your exorbitant medical bill brought by a hospital merger