Thursday, October 24, 2024

American hospitals are on life support

And there's not enough IVs to save them.

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Today's Agenda

Drip, Drip, Drip

It's kinda wild that there's a critical IV shortage in the US right now and there's nary a peep about it. On the one hand, if you're a perfectly healthy person who doesn't work in the medical field, there's no reason you'd know that nurses are rationing saline bags and telling their 60/40 blood pressure patients to drink Pedialyte instead. On the other hand, IVs are basic equipment for a hospital! Fluids are crucial for so many situations — surgeries, car accidents, epidurals — and you'd think news of a shortage would be in everyone's feeds. But I've seen very little about it online, save for these grim comments from exhausted health professionals on TikTok:

"They gave us Liquid IV and Gatorade to give to patients instead of IV fluids."

"The charge on my floor today said 'please just encourage the patients to drink water' like babe, they just had brain surgery."

"I work in dialysis and I am STRESSED."

"**cries in ER.**"

"We have signs all over our med room saying 'is this IV fluid medically necessary?' like no I'm just running them for fun."

"I had to make my patient chug three Gatorades yesterday. In the ICU."

"It's funny bc if we don't make jokes we will actually scream."

Nurses are dispensing Gatorade for two reasons: Mother Nature and medical monopolies. When Hurricane Helene hit North Carolina, it struck Baxter International Inc., a supplier that makes 60% of IVs in the US. Although the Biden administration has invoked wartime powers to get Baxter's facility back up and running (it could take months), that'll just put a Band-Aid on the problem. Saline solution and sterile water have been scarce for years because bags of fluid take up a lot of space, are difficult to manufacture and — shocker! — have low profit margins.

It's just one example of how hospitals are struggling to stay afloat. Sarah Green Carmichael says "cutbacks and closures have expanded America's medical deserts — places without nearby health care facilities, or where long waiting times or high costs mean local people can't get timely care. … The declining number of hospitals coincides with some depressing declines in health care metrics. In 1980, the US had similar life expectancy rates to its peer countries; but over the last 40 years, we've fallen behind."

Money isn't the problem: "The US health care system absorbs shocking sums of money from patients and taxpayers," Sarah writes. Americans spend more on health care than anyone else, yet more than one-third of us live in areas without adequate medical care. The math isn't mathing, especially in rural areas.

Private equity ownership à la Steward Health — you know, the failed hospital chain with the CEO who splurged on a $40-million, six-bedroom yacht? — is clearly not the answer. Instead, Sarah points to Maryland as a model: The state has an essential hospital list that "requires public and private insurers to reimburse at the same rates" and "pays hospitals based on the population of their service area. Similar reforms could be adopted at the federal level to ensure more Americans have a place to turn for care," she writes. Read the whole thing. And don't be this guy!

Priceless Art

I'm fascinated by people who find extravagant art at thrift stores. Are they just lucky, or do they actually have a knack for finding things that end up at Sotheby's? If it's the latter, I need to know their secret:

Art is an intimate thing. If I enjoy an artist's work enough to want to bring it home and stare at it in the privacy of my apartment, I'll buy it! If, years down the line, the work is somehow worth more than I paid for it, that'd be exciting and I could retire early. But I'm not buying art to sell it; I'm buying it to savor it. I often think about how Dirt co-founder Daisy Alioto saw this painting in a coffee shop six years ago and bought it because she thought it externalized everything she believed about the relationship between art and science. Turns out, it was painted by Martin Schreiber in 1981. Fast-forward to 2023 and it's worth between $6,000 and $9,000. "Moral of the story? Taste is our most valuable asset," she wrote on X.

Even when taste doesn't yield monetary gains, it can still have narrative value. Howard Chua-Eoan wondered if he was on the cusp of his own windfall after he saw a complete set of Ode à Ma Mère by Louise Bourgeois at this year's Frieze Masters, the annual arts fair in Regent's Park. One image in the set — "a tall spider, either languid or exhausted, in some sort of conversation with a tiny member of her species" — was nearly identical to the print sitting in Howard's bedroom, which he purchased at a charity gala almost three decades ago:

"The Frieze series was priced at £62,000 ($80,000); I paid a few hundred dollars for mine," he writes. "Momentarily, I felt like an Antiques Roadshow participant at the moment an expert passes judgment on a dusty keepsake. But, very quickly, my expectations deflated. My spider is a test print. Though bearing an autograph, it's an out-of-context artifact separated from its eight other eight-legged kin."

Still, Howard isn't too upset about it: "My art story is priceless, provided you don't care about money." In an era of Baja Blast oil paintingshippo fart masterpieces and duct taped bananas, nobody knows who's going to be the next Vincent van Gogh. So, please, don't drop off your boring old art at Goodwill. Send it to me instead!

Bad Calls

The New York Liberty celebrated their first-ever WNBA championship today with a ticker-tape parade. I didn't attend, but the photos alone were a joy to look at. Players were holding trophies and babies and smoking cigars and the whole thing just looked incredibly wholesome. Also, we got a new mayor?

Pictured left-right: Sabrina Ionescu, Breanna Stewart and Jonquel Jones Photo credit: Sarah Stier/Getty Images and Angela Weiss/AFP

Yet behind all the happy faces is a controversy about the victory itself. "Throughout the thrilling five-game series between New York and the Minnesota Lynx, officials made bad and inconsistent calls," Adam Minter writes. "It was so bad that following Sunday's game, Lynx coach Cheryl Reeve seethed that the series 'was stolen from us.'" The saga compelled Adam to go down a bit of a rabbit hole to learn more about how games are officiated.

When speaking with the NBA's head of development and training for referee operations, Adam learned that there's no difference in how WNBA and NBA referees are taught, and that they use technology to learn from each other's mistakes. "That's great, but the WNBA is still coming up short," he writes. "Meaningful change could come from the NBA ensuring that the WNBA has the same officiating resources as the men's league."

Bonus Basketball Reading: WNBA stars Breanna Stewart and Napheesa Collier launched a new league. It could rival their own employer. — Adam Minter

Telltale Charts

David Fickling says there are 58 trillion metric tons of carbon stowed away in the world, but storage is a bit precarious: "By heating the planet, we risk changing the delicate conditions that ensure those trillions of tons stay locked up in soils, plants, and seawater. Tip the balance too far, and we might provide the catalyst for these immense natural reserves to start disgorging themselves, like a bottle of soda fizzing up when it's opened." He calls this a "methane bomb," and scientists warn it could detonate sooner than we think.

Not helping matters? The thick gray goo construction workers spread on the sidewalks. "Concrete is the second-most consumed material on the planet after water," Lara Williams writes. "About 8% of global emissions comes from cement production — the binding agent within concrete is the source of most of its emissions — which is more than twice aviation's contributions." The solution? A new type of concrete called "calcined clay," which has up to 40% lower carbon emissions.

Further Reading

Nebraska Republicans just pulled the most anti-voter stunt yet. — Patricia Lopez

Clashes over the war in Gaza threaten to pull Pittsburgh apart. — Frank Barry

I guess this means Tesla is an EV company again. — Liam Denning

Boeing needs to settle its strike — now. — Thomas Black

Markets say that Trump will make inflation worse. — Jonathan Levin

China would be better off surrendering to Europe on EVs. — Minxin Pei

Barclays and Deutsche Bank are lagging their US peers. — Paul J. Davies

ICYMI

The secret crisis affecting college RAs.

Elon Musk is X's biggest anti-immigrant conspiracist.

Beyoncé will appear with Kamala Harris in Houston.

E. Coli has fast food chains going onion-less.

Kickers

The Row sale is where rent money goes to die.

Rat-proof bins were too good to be true.

A bronze turd got dumped on Capitol Hill.

Life advice from Stevie Nicks: "Get off the internet."

Notes: Please send priceless art and feedback to Jessica Karl at jkarl9@bloomberg.net.

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