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OustedStrongman t1_iycmnqk wrote

the chart conflicts with the text of the article. it shows Maine at 72% use while the text says 109%.

also the chart indicates that we have 85 pediatric beds statewide. seems low on a per Capita basis but I have no point of reference for what is considered appropriate.

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markydsade t1_iyctvem wrote

People don’t realize how few hospital beds are available day to day. The trick in normal times is to have 80-90% usage. It’s very expensive to have 24-7 staff so you’ll never have hundreds of empty beds standing by. The pandemic destroyed this model as it didn’t take much to overwhelm the system. This was the reason for lockdowns-just an attempt to keep hospitals from being even more overwhelmed.

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DMvsPC t1_iyenjqh wrote

Not even that, Mercy for example is canceling nurse shifts leaving at times only two on the floor so they don't have to pay them for the day.

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markydsade t1_iyfcxsm wrote

As a nurse for over 40 I’ve been driven crazy by the lean staffing practices of hospitals. One person calls out and everything gets worse for the remaining nurses. This gets them exhausted and then more likely to get sick. Rinse and repeat.

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Dire88 t1_iyd80ql wrote

85 beds does not mean 85 beds available.

Staffing shortages, which have hit Maine hard, reduce bed availability. So you can be over capacity without using your total beds.

The bulk of chronic pediatric cases, such as genetic conditions or cancers, will end up in specialized hospitals which for Maine generals means Boston.

The bulk of local beds will be for acute cases such as surgical recovery, trauma recovery, and acute illnesses. Usually these don't take too much space. But we're in a perfect world for healthcare failures and a bad flu season on top of COVID resurgence.

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bubba1819 t1_iycqpjk wrote

I see what you’re saying from the article. Maybe, the chart data was updated since Nov 24? The text says that the 109% was as of the 24th so maybe some children were moved to beds out of state or something. I do agree that the number of pediatric beds seems low but I also have no reference point.

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Rredheadbedhead t1_iycunlz wrote

I used to work in pediatric emergency preparedness. The important thing to know when you’re talking “beds” in this sense is that it’s not about physical furniture, it’s about staffing and equipment. 1 bed = x skilled staff (nurses and docs) + y equipment (pediatric capable ventilators etc- many adult vents can’t be used for pediatric patients) and other considerations. Many large hospitals will only have a handful of pediatric critical care beds.

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SobeysBags t1_iyddlx8 wrote

I always wondered why they don't use the term "medically staffed beds" to avoid this confusion. So many people think "beds" just means furniture and they will be magically staffed by nurses and doctors.

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bubba1819 t1_iydjuud wrote

With the shortage of medical staff and everything it makes sense then why the numbers appear low

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arms_room_rat t1_iycs12z wrote

"Healthcare" companies have vlbeen reducing the number of pediatric beds because they don't make as much money as adult beds, which has been a trend for years that the pandemic exacerbated because of the need for adult ICU beds. Just another symptom of money driving Healthcare rather than community need.

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mainedpc t1_iycuaxh wrote

Much, if not most, of the money in pediatric healthcare is from the government, Medicaid (Mainecare). The hospitals and clinics are very responsive to whatever their source of money wants.

The problems in healthcare are a lot more complicated than your post would suggest.

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arms_room_rat t1_iycuk8t wrote

Obviously if reimbursement were higher for kids then hospitals would be incentivized to have more pediatric beds - nothing in my post suggests otherwise.

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mainedpc t1_iyd4kjo wrote

Then if we need more beds, the government could pay for keeping beds available. Of course, "beds" need nurses and CNAs which are in short supply and expensive to maintain compared to a wing of empty beds.

Why do you expect hospitals to do this without getting paid?

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arms_room_rat t1_iydv81o wrote

I don't, I literally just said reimbursement is too low and in my previous post as well. Wow, there really seems to be a reading comprehension issue going on in here today.

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Standsaboxer t1_iycwiym wrote

Write your representative. Cigna isn’t the problem here for pediatric beds.

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arms_room_rat t1_iycwsgu wrote

Cigna is an insurance company, if they (and other payors) paid more for reimbursement then there would be more pediatric beds. But we also probably shouldn't have a system where whether or not children die without access is based on profit.

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Standsaboxer t1_iycx7xt wrote

As OP said, most of the money comes for pediatric care comes from the government, which has abysmal reimbursement rates.

Also I’ve worked in healthcare in this state for 16 years. I have never seen a child die due to profit margins.

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arms_room_rat t1_iycxiqf wrote

...which is why I said and other payors...mainecare is a payor. And I'm talking about lack of access, not lack of profit margins. You are really dense.

Eta: lol now you are going to send me dm's telling me to go fuck myself? Wow what a mature individual. I really hope you don't actually work anywhere near patients.

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jazzcanary t1_iydb0vp wrote

Your original comment accused insurance companies were at fault for lack of pedriatric beds. You were corrected repeatedly that the government is the problem as a payor, not profits. Now you're adding on to what you said, and calling people dense. You are wrong, and it's frustrating to others.

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arms_room_rat t1_iydjjrm wrote

All I said is that "Healthcare" companies are reducing the number of beds for kids because the reimbursement is poor, reimbursement comes from insurance (which, yes, includes medicaid/medicare). So please point out what I'm "wrong" about. In my opinion we should be allocating resources (money and services) based on community need not on profit, that involves an entire overhaul of our extremely broken "Healthcare" system.

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jazzcanary t1_iydvkou wrote

That is not what you said. No reasonable person hears "healthcare companies" and thinks "Mainecare", and "Mainecare" isn't associated with an entity answerable to stockholders and profit. In terms of making beds available, the current design and the needs of the community are not always aligning, and so how do you make that design more flexible.

In the real world of problem-solving, you can't just say shit and whine; you have to work with people.

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arms_room_rat t1_iydx3rs wrote

Oh my God. Go back and read my post again, and maybe again. Healthcare companies rely on third party payors, which are private and government insurers, to get paid. Healthcare companies also determine what services they offer. Reimbursement is LOWER than adults for pediatric beds because PAYORS (like MAINECARE but also other entities) do not pay as much. Mainecare is NOT a healthcare company. Healthcare companies have reduced the number of pediatric beds because they are putting profit motive above community need.

An obvious and short term fix is to increase reimbursement rates through the government funded payors, however unless you eliminate the profit motive from Healthcare it is only temporary as the cycle of rising costs will repeat.

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jazzcanary t1_iye0i80 wrote

Healthcare facilities, which you are calling healthcare companies, make no money on empty beds or staffing for them. Paying higher reimbursements doesn't create more child patients. Maine has problems like this everywhere due to small populations. Taxpayers won't fund it. It's not Cigna et. al.

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Electrical-Bed8577 t1_iyeesjm wrote

"Empty beds", have been used in the past by Healthcare companies/corporations (more than one "facility") as a ploy for government funding or favors, from local as well federal entities. The whole thing needs an overhaul. From the companies laying off permanent nurses then hiring traveling nurses to defray the cost of ever diminishing reimbursement ("insurance", gov), to healthcare institutions being traded on Wall Street like kids game cards. The more they are able to pit us against each other, the more time they have to keep getting away with it.

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arms_room_rat t1_iye1axt wrote

Omg the beds aren't empty they are overflowing, which is the ENTIRE point of the post! What are you even saying right now? Healthcare facilities are owned by healthcare companies...what is the point even saying that lol? Lol this whole exchange has been kafka-esque - up is down apparently?

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arms_room_rat t1_iydjoe0 wrote

Also, my comments are "frustrating" so it's ok to DM someone to tell them to go fuck themselves? Wow, what a special snowflake.

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jazzcanary t1_iydt4xz wrote

I did not say it was okay, and I didn't DM you. On the other hand, you're expecting a lot of complete strangers. Why do you insult people? It makes no sense.

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Dull_Dog t1_iycy7j5 wrote

Is this demand due to RSV?

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arms_room_rat t1_iycz9lf wrote

It's a combination of higher than normal RSV rates and a reduction in the number of pediatric beds.

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DidDunMegasploded t1_iyd1rxl wrote

A triple whammy of RSV, COVID, and the flu.

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ThisOriginalSource t1_iyddzmk wrote

Yea, this is the case. Our pediatrician said that a lot of the hospitalizations are due to a combo of RSV and flu or Covid. The two illnesses combined are just too much for the immune system.

Stay safe out there Mainers.

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hike_me t1_iyd2z2n wrote

About a month ago there was a thread on the New Hampshire subreddit about a child with RSV that had to be taken to Maine Med because there were no pediatric beds available in NH.

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Curiousbluheron t1_iydonn3 wrote

Maine Med routinely gets kids from eastern New Hampshire (North Conway, Rochester, and Dover catchment areas)

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IamSauerKraut t1_iyctn68 wrote

If your kid is really sick or has a chronic condition, Maine hospitals have been sending you and yours to Mass Gen or Children's in Boston for years and years.

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Curiousbluheron t1_iydo8vz wrote

As someone who works in the pediatric care system in Maine, I can tell you that only a small portion of sick kids in Maine need to be transferred to Boston. The Barbara Bush Children’s Hospital in Portland has a PICU, congenital open heart surgery program, a NICU kidney transplant service, and a comprehensive children’s cancer program. There is a relatively short list of conditions for which transfer to Boston or other centers is needed, including bone cancers, stem cell transplants, or liver or lung transplants.

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joeydokes t1_iyelafu wrote

And, like on my recent RSV post, so goes the never ending debate on protection versus exposure (to build up one's immunity) and more “Immunity debt” defenders vis-a-vis protecting the community writ large AOT possibly/maybe building up greater bodily resistance to germs.

Fortunately, most all of us are vax'd and have the common sense to wear a mask when indoors public space. And WRT masks:

[K]N95 masks protect you from ingesting a nuclei , serge masks, at least, are a barrier that stops the (larger, infected) envelope from becoming airborne.

Please be a considerate soul and wear either when indoors in public spaces; "think of the children" if doing so is a bitter pill to swallow :)

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joeydokes t1_iyerraf wrote

"why should I wear a surge mask if I don't have a fever and I'm not infected?"

"Why should I wear an n95 mask if I'm okay with being infected and letting my immune system fight it?"

Honestly, I don't have a good answer.

all I know is I was at a (funeral) reception yesterday and there were over 60 people in a tiny little room and the only one with a mask on was me. I give up.

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tobascodagama t1_iye9vpj wrote

Re-instituting mandatory masking would reduce the incidence of all three viruses that are contributing to this surge, but nobody in power is even floating the idea. An absolutely disgraceful dereliction of duty.

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DidDunMegasploded t1_iyee74d wrote

Do you really think people would be okay with mandatory masking if it were implemented again?

You tell someone they need to do something they don't want to do, they'll be oppositional but probably still do it. You tell someone they need to do the same thing again, they're gonna get even more upset and even more oppositional. Big guys upstairs don't want to risk that, especially fresh out of midterms.

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tobascodagama t1_iyehwg5 wrote

Remember when the argument for dropping the mandates was "if we give people a break, they'll be more inclined to comply if we need to do them again later"?

Our leaders should not be in the business of trying to psychoanalyse the population like this. They should be noticing a problem and implementing the solution that we already know would work.

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tyler92203 t1_iyemg92 wrote

If you think that would work you’re delusional. Implementing mandatory masking would have 33% compliance at best, and if you think that makes a positive difference you just haven’t talked to anyone in the state.

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Electrical-Bed8577 t1_iyehthf wrote

That is a dual edged sword. We need people, especially kids, to develop immunity. That means exposure and with that, hopefully limited illness. Most masks I see out in the world aren't very protective, so consistently wearing one (Mandatory Masking) in crowd events like concerts, classroom, retail, in or by food service, especially farmers markets, where there are activity aerosols, makes sense. For decades, children were brought to other ill children, for immunity boosting. Flu was reduced during Covid masking. Masks come off, people crowd up, limited immunity, boom, you're down. It's a process.

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steelymouthtrout t1_iycvvx6 wrote

Maine isn't exactly going to have a plethora of pediatric beds when it has a mostly elderly population demographic base.

Just because work from home people moved in with kids doesn't mean that the state was ready to serve those kids medically. As someone else pointed out a lot of pediatric patients get sent right to Boston. As they should.

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[deleted] t1_iych081 wrote

[deleted]

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FleekAdjacent t1_iyckm1n wrote

“Immunity debt” is something invented by media and politicians to explain why kids getting their immune systems battered by COVID for years isn’t the problem.

The idea kids spent years in a disease free bubble with undeveloped immune systems doesn’t jibe with the reality we were all here to see. Hell, plenty of kids had their parents drag them to restaurants by mid-2020.

The immunity debt narrative is a strategy to retroactively blame the current situation on doing anything to limit the impact of COVID, or protect people in general.

It’s super MAGA thinking designed to make people feel like they were right to not want to make an effort in the first place.

It’s pseudoscience to excuse selfishness.

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MaineviaIllinois t1_iyciqlb wrote

So your solution was to not mask and distance and have a couple hundred thousand more deaths to potentially save approximately 5,000 lives in the future- assuming of course that this years flu would not have resulted in any deaths had we not masked?

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Blatts t1_iycjmlq wrote

I imagine that the Venn diagram of military hazmat and pandemic response is two circles.

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