8 Comments
Jun 23, 2023Liked by Hamilton Nolan

I didn't fully appreciate the role of nurses until I was undergoing aggressive cancer treatment. When I had serious reactions to immunotherapy, 8-10 nurses were immediately there, some for the hours it took to stabilize me. I can't really imagine Joe's role in a psychiatric unit with the sheer unpredictability of that patient set. It's unconscionable that Joe and his colleagues are reduced to being a cost to be managed and that patients' well-being of subject to the willingness of hospitals/hospital management to ensure they're cared for so long as it doesn't cost much.

I worked with public insurers as HMOs were being pushed. It was all about throughput (utilization). The trade-off was level of care. And when doctors and nurses got backlogged the patient experience was like being caught in a traffic jam - you couldn't see what started it but boy was it bad.

Expand full comment
Jun 22, 2023Liked by Hamilton Nolan

I worked inpatient psych in Colorado through the pandemic. Recently moved. Joe described my experience to a T but the nurses in CO are not unionized so it’s just jumping place to place trying to get better pay or benefits or stay in one hospital and try to change the culture from within. The profit motive really has no place in healthcare. All that money health care insurance companies have should be spent on care. Just cut them out of the equation

Expand full comment

The frustrating thing about this and all of the changes that WILL inevitably happen (decreased fossil fuel use, socialized healthcare, increased housing stock - is that even though they are inevitable there are too many people making profits now for it to happen as soon as it could. Oil companies and health insurers know their model is unsustainable but can bank on lax regulation until the public reckoning comes. I've worked for privately owned ERs/urgent cares and it's always a shitty proposition to advise patients to have testing performed but have to make sure that said patients are able to pay all their costs upfront in order to perform said testing. Picture this - "we COULD run tests and perform imaging to check for specific diseases but if you can't afford it I can just treat based on my best guess."

That's the model we have and it's an absolute shitshow in underfunded/underinsured states - see Texas.

Expand full comment

In the Guardian article (https://www.theguardian.com/commentisfree/2023/jun/21/ameicans-union-demand-biden-endorsement) to which you linked, you wrote, "[T]he single biggest labor issue of Biden’s first term was the potential national rail strike, which he dealt with by crushing the workers’ right to strike and imposing a contract on them that they didn’t want."

I read that article as well as one from last December (https://www.theguardian.com/commentisfree/2022/dec/01/joe-biden-rail-strike-labor-unions) criticizing Biden over his suppression of that strike. I cited your writing in my own Substack blog, Political Economy Watch, earlier this week (https://jamesekeenan.substack.com/p/biden-2024-why-no-challengers-from).

A reader (https://jamesekeenan.substack.com/p/biden-2024-why-no-challengers-from/comment/17756302) then directed my attention to an article on the website of the International Brotherhood of Electrical Workers thanking both Biden and Bernie Sanders for their subsequent activities (https://www.ibew.org/media-center/Articles/23Daily/2306/230620_IBEWandPaid). How do you square that statement from the IBEW with your earlier criticism?

Expand full comment

"Joe: I was definitely in favor of it before. But if I wasn’t before, I don’t know how I would not be now. I don’t know how you look at this and say it’s okay. I don’t mean to aggrandize what I do for a job"

Sir...you have carte blanc to aggrandize ALL you want

Expand full comment

"I like that as a Richard Scarry-type idea"

I like Joe! I know EXACTLY what he is talking about

Expand full comment

Was in hospital few weeks ago and half of the nurses were crabby - I’m on Medicare so did not have to pay big $ but nurses were it

Crabby

Expand full comment