Would You Bid for a Job? 614
Roland Piquepaille writes "Several U.S. hospitals have found an innovative way to deal with nursing shortage. They post shift openings and the highest hourly rate they're willing to pay on their internal networks. Then, the nurses bid online for these extra shifts. The lowest bidders get the shifts and are notified by e-mail. This bidding process is almost certainly a good thing for the hospitals, but is it good for the nurses? Or safe for you? And what will happen if other industries also adopt auction systems? Imagine a company telling you, "Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash." What do you think of this bidding process? Read more before posting your comments."
Huge Scam, IMHO (Score:3, Insightful)
Why don't they have online queues for hospital waiting rooms? That's because they *want* you to bleed out in the Emergency room so that the hospital can help ensure they get better funding, or at least that's the way it is in Canada. They spend all kinds of money on eShift to get it running and all the nurses buy into it because they are either too tired to realize they're being screwed by the system, or they have no choice. *sigh*
This reminds me of some shady business practices in the petroleum industry. Once a project I was bidding on went to the competition because we refused to kickback a large diamond to the guy in charge of purchasing for this huge company. Yes, he wanted a diamond. Not sure why but I'm guessing he was going to tie a fob to it and use it for office-oriented bling-bling. Either that or he wanted to cut a safe open...
eShift == eShit
A bit confused? (Score:5, Insightful)
*Of course, this only isolates the lowest bidder, not the person/entity best suited for the job, a major flaw in this system that I see. Of course, all of the bidding nurses are employees already, and this shouldn't affect the quality of care.
Comment removed (Score:5, Informative)
Re:A bit confused? (Score:3, Informative)
Re:A bit confused? (Score:5, Insightful)
Yes, but its isn't how health care should necessarily work.
I'll give you one example. It friday night, 10 pm and you get a call to deal with someone vomiting up large quantities of blood in a more distant hospital in a major metro area.
Now the question - How much should that person pay based on free market principles?
For the record, I charged him the medicare rebate (Australian medicare) - no $ gap at all. But I was entitled to charge any amount I saw fit for my services. I suspect I could have charged $2000 or more as the price for my labour. And he could, of course, ring around for a better price if he wanted to do. Except he is vomiting up rather alot of blood at the time, and may have trouble securing the expertise required in the 30 or so minutes he would have left to live
I mean - I burst a hot water pipe last week - the plubmers considered that an emergency call - but I just turned off the hot water and waited for the pumber to show. That is sort of approximating a more free market situation.
Health care is not the same - people need to see an expert just to find out what is wrong. In other words, the supplier generates the demand! This knocks almost all the free market stuff out before you start.
That is why health care is so tightly regulated - because the deal society has struck that certain people get privlidges and paid well, but have obligations, including behaving ethically and having on call rosters.
Just my 2c worth.
Michael
Re:A bit confused? (Score:4, Funny)
Perfect, you're hired!
Re:Your example fails. (Score:3, Insightful)
Re:Your example fails. (Score:4, Insightful)
Wrong. An opportunistic hospital in many cases has a monopoly. Many emergencies can not wait 30 minutes to ge to the next county, let alone 1 hour to get to the market with competition. That assuming the market is truly competitive, not some major health block (like in Cincinatti, Ohio). Oh, yeah, and assuming your insurance company will let you go to someone they are not in bed with.
The only way you could actually get around this is if you had the medical expertise to diagnose and know the treatment required of the person you are taking to the ER. In which case, why are you not doing the care yourself (timlieness is the most important determinant in the outcome in an emergency).
The only way you can get competition in is to find an investor who has a multi-decade long outlook, can invest many hundreds of millions (if not several billion) dollars (US) to build, hire maintain, and defend (malpractice) their medical center. In the end in many communities, there would still only be one standing (not enough business). All businesses are based on profit. What do you think the new kid on the block will do with the amount of debt the hospital will have had to assume to get itself going. These things are far from cheap. You really do not want a "cheap" medical care facility. You think certain restaurants are bad, wait until you find out about all the stuff that can happen with really substandard medical care.
Innerweb
Re:Your example fails. (Score:3, Interesting)
Re:Your example fails. (Score:4, Insightful)
No, I don't mind you saying. I'm presenting my point of view (as someone who works in a mixed public/private healthcare system in Australia). You get to make your own mind up.
An opportunistic hospital that charged emergency patients an exorbitant amount would find that, aside from those very emergency patients, it had no business. If I had been charged like that during a time when I was helpless, I know I'd go well out of my way to avoid ever paying them for anything in the future. And thus, the "invisible hand" of the market would force them out of business, leaving only the hospitals who don't use such shady practices. See? Nothing beyond free market necessary.
I would like to think its that simple, and certainly things like the internet do equalise the relationship between health providers and consumers. However, I can assure you that health care requires more than a free market.
The original inventors of the obstetric forceps were the Chamberlen family, back around 1650. They kept the invention a secret for 50 years by using the instrument within a black box. No I'm not making this up: See this link [umanitoba.ca] During that 50 year period thousands of women died horrible deaths from prolonged labour and exhaustion. The family did well however.
This isn't so different from what we see today in patent laws, which most people on
But by free market principles, if a company invents a better process, great, more profit for them. In health care you want to publish this stuff to remove your monopoly. Status and respect aren't economically rational goals, but its better to be famous for publishing something in a medical journal (for your competitors to use freely) than get rich exploiting a secret.
I really believe that health care (particularly when it relates to emergencies, psyciatric illness and other areas when judgement is impaired) should not be driven by market forces, at least in any society that wants to call itself civilised.
Michael
Re:A bit confused? (Score:3, Insightful)
Where does he god given right to make 15 bucks an hour come from?
Re:A bit confused? (Score:3)
What do you do for a living?
Re:A bit confused? (Score:3, Insightful)
This would probably still have to obey minimum wage regulations, and if the staff can come to an agreement (perhaps via some form of organisation) they can simply avoid bidding lower than w
Re:Huge Scam, IMHO (Score:5, Insightful)
Okay... somebody doesn't know what triage is. When somebody shows up in the an emergency room, the first person they see is always the triage nurse. The process of triage is a simple concept that's hard to execute... putting people into one of three groups.
- Those who are in such extreme need they must be treated right away in order to save their life. These get treated first.
- Those who are in need of treatment, but aren't going to die or suffer much if their treatment is delayed a bit. Those are the people who have to wait until all of the people in the first category have been taken care of.
- Those who can't be treated. They're already beyond hope, and any effort spent on them would be wasted.
The waiting in the emergency room isn't due to lack of funding... it's a random thing based on whether a higher-priority case is in your way at the moment.
Re:Huge Scam, IMHO (Score:4, Interesting)
An EMT described essentially that, but I think he put it more eloquently:
"This is how they set up a triage. They make four areas. A green area, a yellow area, a red area, and a black area. In the green area goes people who are in need of treatment, but will basically survive if they aren't immediately tended to. In the yellow area they put people who are in need of treatment or they'll die. They put corpses in the black area."
Here's where we ask "So who goes in the red area?", obviously being set up.
"In the red area they put people who are badly injured but still alive. But they don't receive any treatment, because either they're untreatable, or the effort that they put into treating them could save several times as many people in the yellow area. People they put into the red area are abandoned to die."
Wrong! (Score:5, Informative)
Triage begins by pointing, and asking all people who can walk to go over to where we are pointing. This will correspond to the area we've decided to establish as the green triage area. Any patient who can follow directions and walk to a location we indicated is presumably relatively okay, and treatment of them can wait till last. Therefore, anybody who walks over there is automatically classified as green, or "walking wounded." This step is critical, as it saves a lot of assessment time, often clearing out 90% of potential patients, and allowing us to locate and evaluate the 10% of patients who need care urgently much faster.
Next, a triage crew goes around evaluating all remaining patients, classifying them as either black, red, or yellow.
This determination begins by checking if they have a pulse and are breathing. If they are not breathing, we will reposition the head once to open the airway, hoping that restarts their breathing. Here is the big difference in treatment between a triage (mass casualty, number of patients overwhelming the system) and a normal setting. Normally, if a patient is not breathing, we would attempt to resuscitate them using CPR, etc. However, in a triage situation, CPR is not viable, as devoting several EMT's to extended treatment of one individual who most likely will not survive will almost definitely result in the death of several other patients. So, in a triage situation, patients are declared dead and ignored who we would normally attempt to save. However, a key difference from what the parent claimed is that we would black tag these individuals, officially declaring them dead/unsalveagable.
Red is used exclusively for those patients who are most critical, such as altered mental status, difficulty breathing (but breathing), etc., that will die without immediate medical care. The odds of survival of a patient who is not breathing are too low to justify spending time treating them, because for every one that you could save, you'd most likely lose several additional red tagged individuals on average. If you remember, I mentioned we try repositioning the airway once for all individuals who aren't breathing before we black tag them as dead. Repositioning the airway takes neglible time, and if doing so restores their breathing, then they are red tagged, because their odds of survival are sufficient to justify spending time on them. Red tagged patients are the only patients treated until there are no more red tagged patients. We do have to make tough choices (following protocol... We don't make decisions about who lives or dies, we follow protocol of how to choose who to treat to save the most lives.). Nor do we conceal that we are doing so, we clearly label as dead (black tag) individuals who we have negligible hope of saving when the attempt would cost others their lives.
If you are breathing (and hence not black tagged), but will live if you do no receive immediate treatment, then you are tagged yellow, or "delayed", as the only remaining option. (Remember, "walking wounded" or green, have already been cleared out, so the only options are black, red, or yellow.)
Re:Wrong! (Score:5, Insightful)
Re:Wrong! (Score:3, Informative)
-Colin [colingregorypalmer.net]
Re:Wrong! (Score:3, Funny)
Make sure you remember to keep breathing!
Not ER settings - disaster settings (Score:5, Insightful)
You're damn right it's scary, but the scary part is the disaster that's already happened, not the cold calculus of triage. Spock would understand - the good of the many outweighs the good of the few, or the one.
If you're one of the walking wounded, go find some black-tagged person and give CPR if you are able.
Mass Casualty Situations only, not normal practice (Score:3, Informative)
Re:Huge Scam, IMHO (Score:3, Informative)
First off, claiming that Canadian hospitals will leave you in the emergency room to secure funding is complete bull. Individual hospitals are not even funded in such a manner, they are not entitled to more money if people have to wait. In fact, Canadian doctors are paid by how many people they treat, which has major flaws but if doctors want more funding
a suggestion (Score:5, Funny)
Outsourcing (Score:5, Interesting)
Another example of what happens when the primary corporate philosophy is predatory and parasite friendly.
it is a result of black and white accounting values, instead of seeing a full spectrum color photo of the situation, which means acknowledging more than personal selfish goals as important.
Survival is a multidimensional activity. Otherwise you sacrifice everyone else's quality of life for your selfish ends. Do that too often and you end up living inside a toliet bowl with the only rope out tied off to the toilet handle.
Flexestaff.com (Score:3, Informative)
Is the program in question the listed on the site Flexestaff.com [flexestaff.com]. You'd a thought the /. submitter would have looked up and linked to the web site that makes the product...this being a web site about technology and all.
The article sounds like the primary purpose of the program is to give nurses greater flexibility over their schedule and not just bid down wages. The primary cost control is that the program is giving internal nurses a shot at the shifts hospitals were outsourcing.
Re:Huge Scam, IMHO (Score:3, Insightful)
I understand that currently there are not enough nurses, so, with a system like this one, undesirable shifts will go unfilled or pay will go up (because nobody wants to work certain time slots).
Once pay is (way) up, it hopefully creates enough incentive for more people to study nursing, etc.
A free market with a well trained and (reasonably) flexible work force should be able to work well like that.
One concern
Re:Huge Scam, IMHO (Score:5, Interesting)
Here everyone wins, the hospital gets their hard to fill slots staffed, the nurses can command a higher rate for those premium shifts.
The healthcare industry has to be creative to cover those hard to fill shifts. my mom works at an RN at a nursing home, the home had a hard time getting weekends covered, people would call in sick etc, so they offered her a sweet deal. She contracts to work every weekend, no excuses, for 2 15 hours shifts, inexchange they pay her for 40 hours. This way she gets her whole week free, the home gets the shift filed, and the residents win because they have a consistent presences every weekend with a nurse who knows them and their history. If they used a agency nurse or rotated the schedule, the patients would have different nurses every weekend. As anyone who has worked with alzheimers patients can attest, a very structured, consistent environmnet can help immensely,
Re:Huge Scam, IMHO (Score:4, Insightful)
The nursing schools are running at full capacity. New nurses are entering the job market every year.
Yet the shortage persists, and the hospitals import nurses from everywhere on the planet.
There has been at least one case of a US hospital ward where the operating language was Tagalog, not English, and the few nurses on those wards who didn't speak Tagalog were at a severe disadvantage getting patient care information from the Filipino nurses.
When the faucet is turned on, full force, and the basin continues to be empty, you have to wonder why the drain isn't closed.
The underlying problem is that nurses are overworked and underpaid, across the board, in the name of cost control and managed health care. The nurses get disgusted, realizing in many cases that overwork, exhaustion, and, oh by the way, SKELETON CREWS ON THE WARDS, is making it impossible for them to provide quality patient care, and they quit.
I believe it was Milton Friedman who said "If you have a shortage of people willing to do a job, it is usually because you aren't paying enough."
The hidden danger of the situation is that it is the experienced nurses who are leaving, and being replaced by inexperienced nurses. Or, in a lot of cases, not replaced, and the ward runs shorthanded.
I had occasion to observe some of this firsthand, in the course of several hospital stays over a period of some years.
The nurses are dedicated, they try HARD to do the best they can, but there is only so much one person can do.
Couldn't tell from article: (Score:4, Insightful)
Re:Couldn't tell from article: (Score:5, Insightful)
Collusion inevitable. (Score:5, Insightful)
Well this is nothing new and it been dealt with (Score:4, Insightful)
These kinda things only work when there are people willing to undercut the rest and think they can make a living that way. In a world where you gotta work with the people you undercut that might not be to enjoyable. Especially if you consider that there always is someone willing to work for less.
I also see another problem. The old army joke tells you to remember that your weapon was made by the lowest bidder. Now your life is in the hands of the lowest bidder far more directly.
Nurses have a lot of power and responsibilty. Why do you think we keep hearing these stories about a nurse getting away for years killing 20+ patients?
All that the nurses need to do is to make sure no-one undercuts the organized bid. Good job america, you just invited the mafia into your hospitals.
Re:Confusion with other nursing-like occupations (Score:3, Interesting)
I believe this comment is obsolete in many places now. My mother used to be a nurse, and at her hospital there were no aides or orderlies. They laid them off to save money, and gave their jobs to the regular nurses. Somehow, they thought that lifting 300-lb patients was
What about the unions? (Score:2, Interesting)
Re:What about the unions? (Score:3, Insightful)
What happens when the system fails? (Score:5, Insightful)
This kind of system is great to use when there's more labor supply than demand, but seems dangerously close to a colapse should the staff decide they want to cause a problem... no need to give two weeks notice or even to quit, just refuse to bid on the designated day and therefore nobody will be assigned to work that day.
Having an unmanned checkout at Wal-Mart is one thing, having not enough nurses to cover all of the patients in a hospital is quite another.
Re:What happens when the system fails? (Score:4, Insightful)
Re:What happens when the system fails? (Score:5, Insightful)
Re:What happens when the system fails? (Score:5, Insightful)
Um, the hospital administration takes note of that fact and raises the max available rate for those particular slots until enough workers are found, and/or outsources to an outside agency if really desperate, or even forces staff nurses to work overtime in unfilled critical slots (as they already do now)?
Really, I don't know what so many of you are so disgusted by; this is Capitalism 101 "supply and demand" in fairly benign form (given the relative shortage of nurses). Frankly, it seems like a pretty good win-win solution to fill chronically unfilled spots for everybody except the temp agencies (aww... poor middlemen.)
What? You say nurses deserve more stability, and should only work if they've got guaranteed full-time jobs? Fine. $37/hr (or whatever rate is negotiated by the local nursing union for that particular type of nursing) still gets them that full-time work. How? Why? Because none of this eliminates the power of the unions, and overall system stability is still in everybody's best interest, most definitely including that of the hospitals.
As to the idea that nursing quality will suffer any if the lowest bids determine who works, I've gotta say that you've either never worked in a hospital or never paid attention. If you had, you'll know that it's not like many not-so-great nurses are being weeded out by existing market forces; if you've got the necessary quals for a particular job (ER, critical care, scrub, floor, dialysis, whatever) and you do that job without doing anything egregiously stupid/dangerous, you remain employed. Nothing in this system of labor allocation gives nurses the power/right to work in positions they're not already fully qualified for.
Comment removed (Score:5, Insightful)
Re:What happens when the system fails? (Score:4, Interesting)
Somebody gets it. Capitalism says nothing about restricting criminal intent. In fact, it encourages it. Capitalism rewards those who find innovative ways to compete and make more money than those they compete with. Crime is not a bad thing to the practitioner until they get caught, and even then, it may be a slap on the wrist, or a reprimand.
Communism and all the other *isms out there are all vulnerable to the same issues. If they were not, we never need the police, FBI or other agency. And, I believe if we did not need them, we would not tolerate their expense.
I can think of many examples where the lowest bid creates a problem. Can you imagine getting McService at a hospital? That truly scares me. Fries with your morphine?
Capitalism is a pie in the sky ideal. Ideals like that are good, as they define objectives to be debated and fought for. Never had any idea like this (Capitalsim, Socialism, Communism, Monarchy, ...) truly worked when applied 100%.
Think about what you are saying. The people who are typically the least qualified in job skills (which by definition of Capitalism) will be the ones with the most critical jobs, and in charge of you at a time when you potentially have no ability to question their actions, have a second opinion, or check with your legal expert before proceeding. Most muck-ups happen in the medical profession from inadequately trained/attentive practitioners. They are the ones who are typically at the bottom of the scale.
InnerWeb
Re: (Score:3, Insightful)
Re: (Score:3, Interesting)
Re: (Score:3, Interesting)
Re:What happens when the system fails? (Score:4, Insightful)
I suspect the maximum will be set at, or just below, the level it costs to bring in an outside nurse from an agency. Essentially the logic will be "It would cost us $20/hr to bring in an outsider - is anyone on-staff willing to do the extra shift instead?" The hospital probably saves a couple of dollars, and is getting one of its own staff (who already knows the people, procedures, where everything's stored etc) instead of an outsider; their own staff can get some extra money when they need it - everybody wins, except the agency which is losing some business to the full-time nursing staff. Sounds OK to me.
Where I'm from, Nurses are unionized. (Score:2)
Jobs (Score:5, Insightful)
We keep playing the game like it's an open system, and it never was, and now we are quickly discovering the end stops.
Designing an economic model which awards wealth to those who grow, is doomed when a company, any company reaches market saturation.
The American economy no longer exists, American business is multinational, global, and not limited to our borders. It finds cheap labor and brings the saving in production back to the U.S. where American consumers rejoice at the low cost of service and goods. Sadly it's all a sham. It's as unsustainable as a constant diet of junk food. It tastes good while you're eating it, but it's slowly killing you. It's all take and no give, the dollars fly out of the country faster and faster, until the nations fundamental wealth is gone, and the citizens of the nation notice they are now the collective bag holders.
* Money that leaves never supports U.S. economy and infrastructure. * Money that leaves undermines U.S. labor, costing jobs and quality of living. * The growing gap between haves and have nots in the U.S. suggest a growing economic instability. Loss of jobs starting with manufacturing, but now quickly moving up through intellectual "white collar" professions, points to a growing joblessness with no end in sight. As the government services fail (and if you haven't been reading the paper or watching the news at 11:00, local government everywhere in this country is on the verge of collapse), the means to manage and provide basic life needs to the growing disenfranchised evaporates. The middle class vanishes. We are all reduced to the same level of living enjoyed by billions of starving people all over the world. Already 3% of our population owns 75% of the wealth, this is the greatest desparity in wealth in our history. And still the insanity accelerates. This is just the beginning ladies and gentlemen. What will you do, when your kids fresh out of college, with hundred thousand dollar college loans to pay, can't find work. What will you do, when you haven't received a raise in 4 years, and the boss says "Sorry, the work is heading to China."
I've personally spent the last 6 months looking for work, I've had my resume tuned, I have 25 years of technical experience, and I've made it clear I'll do almost anything, and I have not had a single interview. I'm not alone, I have a couple hundred friends and acquaintances who've been unemployed for between 2 and 3.5 years.
I keep hearing neocons mouthing the lines of Scrooge from a Christmas Carol... "the surplus population shold just get on with the business of dying...", or some variation of that. It's not bad yet. It may well get there. If it does, our government, is going to have a very bad time. Our society is going to have a very bad time. We need to begin addressing sustainable business practice from an economic, environmental, and ethics based context. To simply let the train go where it will is to insure a crash none of us will walk away from.
bw
Re:Jobs (Score:3, Insightful)
These multi-nationals are the real beneficieries of the US Legislature, as becomes obvious every time a choice of either/or is made in the House/Senate: us individuals get sold up the river. Along with the economy and our economic powerbase. The duchies are forming their alignments, and it's time to get out or be a peasant...
It's not like we have much choice: a vote for Bush is a vote for the milita
Re:Jobs (Score:4, Insightful)
Wrongo. If it's true that US dollars spent abroad never come back to the US, why would anyone abroad perceive dollars to have any value at all? Don't say, "because you can convert US dollars to local currency!" This is an effect of the fact that foreigners perceive dollars as valuable, not a cause.
The ultimate value of a US dollar, anywhere in the world, comes from its power to buy goods and services from US businesses, period. Those dollars being spent overseas find their way back to the US. Perhaps indirectly, perhaps over many years, and perhaps passing through many hands (and foreign reserve banks) on the way. But if they weren't ultimately headed back into US pockets, nobody overseas would bother exchanging them.
We are all reduced to the same level of living enjoyed by billions of starving people all over the world.
Really? ALL of us? ARE already reduced. Hmm. It seems like you, at least, haven't been reduced quite to starvation level yet. In fact, you seem to have enough surplus time and energy to be posting to a rather wanker-y tech website. I'm sure the world's (very real) starving multitudes don't appreciate being equated with disgruntled, laid-off HTML jocks who had to buy a less nice car than they'd hoped for.
Before you starve to death, don't forget to hock the computer you're posting to slashdot from. It'll buy a lot of happy meals.
Re:Jobs (Score:3, Interesting)
Hey, dip stick, your last comment is way outa line. If you thought you were being funny, let me set you straight, it's sick. I was out of work for 12 months and now I am a hiring manager and I can tell you, while things are getting better, there are a huge number of very qualified candidates who have been looking for a very long time. The last thing these people need is a cheap
Re:Jobs (Score:5, Insightful)
No, it was the original poster who was way out of line. Many, many people in this world really do run a risk of losing their own or their families lives to starvation. The originial poster, and I would claim, you and the candidates you're seeing have trouble finding jobs, are not among that unlucky many. Claiming to be so is shameful, and cheapens the suffering of those for whom starvation is more than a metaphor.
Re:Jobs (Score:3, Funny)
Re:Jobs (Score:3, Insightful)
This is the most wrong thing I've ever read in one of these discussions. Personally, i've not made up my mind one way or another regarding the situaiton and am playing a wait and see from afar game. However, our
Re:Jobs (Score:3)
As for the US currency value in other countries: if you think about countries where US jobs are "exported" (Pakistan, China, India etc.), there people use it NOT for buying US products of any kind. They use USD as a form of stable currency where they can keep their savings, but when it comes to spending, only local goods are bought, as they are much cheaper than US goods. Meanwhile, the USD is suffering from a a mild inflation.
Adam Smith... (Score:3, Informative)
This is a really interesting question, and one that we should all be asking ourselves. Why the hell is the dollar so strong? Our increasing trade deficit, skills deficit, and now labor deficit are all symptoms of a too-strong dollar: if the dollar weren't too strong, then it wouldn't make sense to export all of our production and some of our service to a foreign land.
Re:Jobs (Score:5, Insightful)
Not really the system might be breaking, but if it was broken then we would be in a full recession and reverting to cannibalism to feed ourselves. The system works. It has been working for hundreds of years now.
Which would be what exactly?
You seem to be confusing your terms here. Market saturation is something that happens when a market is fully developed. So when all possible consumers are fully aware of a product and buy all the product that they ever will buy. Market saturation is technically impossible unless you come up with a product that is so good that it never has to be repaired or replaced, or the product serves absolutely no purpose.
You may be refering to a monopoly which is when a single company provides all or nearly all product for a specific market. A company that by itself caused market saturation would work quickly to create more demand or it would go out of business.
Here I think you are referring to the US's large trade deficit which currently stands at 50 billion USD. While this isn't really a good thing. It isn't as bad as you are making it out to be. Mostly it is a symptom of living in a large mostly urban country.
If you think of the US as a large city sitting among a number of rural areas it seems only natural that the city will tend to lose more money due to importing the supplies needed to care for more people then it will get from the poorer farmers that surround it. (This is a crude abstaction, but anyways.)
Oh no where will it end?
No seriously this is a problem. I mean this has happened since what? 2004 B.C.? The beginning of civilization? This happens largely because those who fight their way to the top of the heap know how to stay there. Its not a "good" thing, but it is a "natural" thing. It can be stopped, but doing so involves a lot of work by the people in the bottom to claw their own way up.
Most millionaires own their own businesses. The one main difference between the rich
And another thing... (Score:5, Insightful)
The loss of US manufacturing jobs essentially started in the '70's and finished in the '80's. You might as well be wringing your hands about the "loss of jobs" in agriculture in the 1940's. Guess what: those manufacturing workers haven't just been sitting around unemployed for 20 years. They have gotten into different careers, relocating if need be.
To put things in perspective, the recent tech downturn is MUCH smaller in its impact on employment than were the end of manufacturing and agriculture. Both of those fields shed 10's of percentages of the country's total population in employees in just a few short decades, and yet the 20th century in America was hardly one of starvation and rampant joblessness. The move from agriculture to manufacturing, and from manufacturing to services, were profound shifts in the nation's output. What has happened in tech, on the other hand, is kind of a sidenote. It's comparable in scope to what happened on Wall Street in the '80's. In both '90's tech and '80's Wall Street, a media-propelled hoard of prospectors crowded into a field that was perceived as "lucrative", creating a glut of workers for relatively specialized fields. This glut, coupled with an eventual market down-cycle, made the field less lucrative than many had hoped, and lots of people lost their jobs. But guess what: both the computer industry and finance have carried on, and just as the world isn't crowded with unemployed bond traders who lost their jobs in 1988, I strongly doubt 2020 will see us with a surfeit of unemployed web developers who just never found anything else to do.
Re:Why stopping global trade has problems (Score:3, Interesting)
You've never actually been to Texas, have you? There's still a bit of money to be made in oil and natural gas to be sure, but we have the largest collection of tech and telecom companies in the U.S. outside of California. Think world headquarters for TI, AMD, and Dell; think major operation centers for Cisco, Ericsson, Rockwell, Honeywell, Tekelec, Lockheed Martin, IBM, HP, and Nortel. The list goes on.
Radical U.S. protectionism would
Maybe they could advertise this at the hospital... (Score:5, Funny)
Re:Maybe they could advertise this at the hospital (Score:5, Insightful)
If you were going to stay a hospital for a few days for a surgery or illness, Would you rather have a nurse that values her skills at $10/hour or one that thinks she is worth $50/hour. Also, a nurse that works for less will put in longer hours to maintain the same standard of living. She is more likely to be tired and overworked.
Re:Maybe they could advertise this at the hospital (Score:5, Interesting)
Re:Maybe they could advertise this at the hospital (Score:3, Insightful)
Would you rather be cared for by a nurse who was considered good enough to have a steady job at the hospital and just wanted to pick up a extra shift here or there? Or perhaps
Well.... (Score:3, Interesting)
I liked it better (Score:2)
Not good for any industry (Score:3, Funny)
It's basically a 'market price' (Score:4, Insightful)
Isn't that basically market forces at work?
IMHO probably; doesn't make it right or wrong- it may well work better than a fixed price though. But it's going to be vulnerable to all the normal market problems.
Lowest bid = lowest quality (Score:5, Insightful)
By making people bid, they are literally making them demean themselves - and those that offer their services low are probably not going to be the better ones.
Ofcourse, this will make others bring down their rates too, and everyone loses -- well, everyone except the top management who make a shitload of money at the expense of their employees.
This is just wrong and absolutely disgusting. I'm a PERSON - not a thing. My services will be charged what I feel are appropriate, and not being forced to BID like a slave. Sheesh.
Re:Lowest bid = lowest quality (Score:4, Informative)
Re:Lowest bid = lowest quality (Score:5, Insightful)
Not true, just setting a value on good shifts (Score:5, Insightful)
This just lets the poor lady who works nights get a little more compensation relative to her peers...why not?
As for you being a "person"...well, don't get too involved in being very sick in the US, you will find out quickly it is a business, and yes they basically will let you die in favor of a better funded or insured patient. If you have HMO, they must clear every procedure. This means your treatment is waiting on a claims agent who dropped out of high school in Alabama. Don't think people haven't died while waiting on treatment clearance.
Re:Not true, just setting a value on good shifts (Score:3, Insightful)
Right, that's why thousands of Canadian nurses have fled to the American system, because they want to give up the great socialist health care system here for the low paying, wage slave conditions of the United States.
Re:Lowest bid = lowest quality (Score:4, Insightful)
Oh, horseshit. I spent most of my career bidding myself. I just don't go lower than I want. How the hell, exactly, have I demeaned myself?
I didn't bring down my rates because some low-caliber bid low. They typically didn't get selected anyway.
"My services will be charged what I feel are appropriate, and not being forced to BID like a slave. Sheesh."
Wow, what sanctimonious pap. You know when they ask you for your hourly charge? That's a bid, chum.
You DO understand that there are some who will underbid you who are actually better than you, don't you?
Well there's nothing wrong with a bidding process (Score:2)
Re:Well there's nothing wrong with a bidding proce (Score:2)
What? (Score:3, Funny)
You're new here, aren't you?
Too bad for nurses (Score:2)
For those in the Technology sector, lets all collectively agree right now to not allow this to become a common practice for IT jobs. If quality people do not participate, then the companies that host this kind of charad
Re:Too bad for nurses (Score:3, Insightful)
Ha! Does the phrase "herding cats" mean anything to you?
Wait a second here... (Score:4, Insightful)
I especially don't see how this is a problem as it appears to be a "who wants to work overtime for the lowest amount of money" contest. How bad do you want the extra money? Maybe applicant number 1 needs a new car and will do it for 30 bucks an hour but applicant number 2 has 4 kids at home and his wife just got laid off so he will do it for 25.
Next thing you know companies will just ask, "Ok, before we hire you we need your salary requirements and the salary requirements of 4 of your peers."...Just like Progressive car insurance.
economically efficient (Score:5, Insightful)
Businesses should bid for workers (Score:2)
We can make it happen, people, if only we want to make it happen, and believe in ourselves.
Create laws so that the citizens are the owners, and that our time is valuable. Pay a basic minimum income to all citizens. Slow down immigration. Offer tax-funded national healtcare. Build public subsidized housing. And make all these govt programs transparent and effective. Government is just a
You mean like Canada? (Score:4, Insightful)
That sort of health care?
Right. (Score:4, Informative)
Doctor shortage cripples Canadas free health care [startribune.com]
Broken health care system [washingtontimes.com]
Canadian health care deal adds $14 billion to ailing fund Pact
Just because people want something for free, doesn't mean they can actually get it.
*cough!* (Score:2)
I know not everyone would join, but have you ever tried to work in the auto industry w/o being in a union!? Your co-workers go ape-nuts. This is just encouraging (better?) nurse unions, and if it catches on other unions as well.
I don't understand... (Score:3, Insightful)
"Imagine a company telling you, 'Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash.'"
I live in a state with at-will employment. In EVERY single interview I've ever had, the interviewing company has asked me what salary I wanted. They know how much they're willing to pay, and my answer to that question will pretty much always be a bid - if I name too high of a price, I generally don't get a call back. If it's low, they're more interested (or suspicious if it's too low).
Of course, this bidding process exactly how it works with a contract company; the client asks me to do something and wants to know how much it costs.
As I understand, this nurse bidding process is for extra shifts; you're already getting paid for a normal job and they have an extra shift. The person willing to work it for the least is going to get it.
I had a problem with it.... (Score:3, Informative)
There is a minimum rate that if you opt for, you are guaranteed the shift. The variance seems to be about 10% from the top rate. So I really don't see a problem when the minimum you can be paid is 90% of what the max is. This won't lead to constantly lowered pay until you are basically working for free, it means you will work the shift for always a minimum of 90% of the market rate. I would venture to guess that the 90% rate is probably more than the standard hour rate. I see it as a win-win both for the nurses and for the hospital.
You will also likely see no decline in care quality, maybe even an increase as it is mostly people who are bored or have nothing better to do on that shift because they CHOOSE to be.
auctions on coding (Score:3, Informative)
Huh? (Score:3, Insightful)
That's what you do for the middle to high end of the middle class. You only auction off low-paying jobs (after lobbying congress to loophole away minimum wage for auctioned wages, of course).
Notes to Roland (Score:4, Insightful)
Unless you do more than wave hands, yes. They get extra income for doing what they're trained for.
"Or safe for you?"
Why not. It's not like a nurse will be doing a job for which they're untrained.
"And what will happen if other industries also adopt auction systems?"
Software already does. It's called asking for hourly rate. Same for plumbers, carpenters, lawyers, accountants, etc. Pretty pandemic, if you ask me.
"Imagine a company telling you, 'Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash.'"
I don't have to, because that doesn't make sense. Nurses aren't being asked to do something they aren't trained for, why pretend that's the case?
"What do you think of this bidding process?"
Reasonable, what rational reasons would you have against it?
shifts power to employers (Score:5, Insightful)
The root problem is that the employer is a large aggregate body while the employee is just a small ant. This is the key reason for having unions in the first place. You don't have unions in the tech industry because the salaries are high enough that employees aren't being marginalized (i.e. employees actually have a lot of power, relative to most jobs).
Having said this, bidding for jobs in already here and will simply spread. It is inevitable! Business contracts (not talking about job contracts) are generally won through some bidding process. Therefore, it wouldn't be unusual to have job contracts also won through bidding. Already employees in certain industries work by bidding all the time (an example is artists and the art industry in general).
I think the key change that will occur as bidding gains prominence is that salary will matter more than "skill" in the future. Right now, "skills" are what get you hired but I imagine salary will start to play a major role under bidding (since modern capitalist bidding is all based on price; no way to quantify skills). This is not to say that someone who can't do the job will be hired but that the difference between getting hte job and not getting it will depend far more on the salary than now...
It's already the current system (Score:3, Insightful)
There may not be an auctioneer but it's still the same market mechanism at work. You might not think you're competing against other workers, but you really are.
But don't look so glum! Price isn't the only thing labor consumers (employers) care about. If all other things are equal, then the person willing to work for the lowest wage will get hired. Fortunately for us all other things are NOT equal.
This is good (Score:4, Interesting)
I would tell my wife "name your price". Seriously. The manager doesn't want to waste literally hours trying to get someone to come in. Tell her you'll work for an extra $10/hour, and she would likely jump on it.
In the hospital, it's worse. If they can't get staff, they have to go to an "agency" and pay $50-$60/hour, about twice what a staff nurse costs. It just makes sense to meet your own staff half way- pay them $40/hour and both end off better.
It's economics 101. If you have trouble getting enough staff members to work for you, then by definition you aren't paying enough. Period. The stark reality for a hospital is that they can either raise pay a little and actually get the staff that they need, or they can pay out the ass for agency nurses. The solution is obvious.
An auction system makes good sense.
Illegal in many countries (Score:3, Interesting)
In Australia and many European countries holding this kind of reverse auction for pay rates is illegal. The reason is quite simple - in occupations like nursing where there's an oversupply of willing workers the employers are able to use a reverse auction to bid wages right down to the breadline. Employees will be desperate enough to bid themselves into poverty just to get their next meal. This makes employers happy but results in a lot of employees suffering greatly.
The alternative is a "minimum wage" system which we've traditionally used here in Australia. This more egalitarian approach reduces the incidence of poverty in the country but also reduces the chance for employers to get incredibly rich.
We used to have an oversupply of doctors and nurses here and (cutting a long story short) we now have shortages of doctors and nurses due to many leaving the profession. This in turn is starting to drive their wages back up again. Most importantly due to our minimum wage policies, unemployment benefits and the unions they didn't all starve during this adjustment.
Having said all that stuff about minimum wage, Australia is gradually trending towards an individual employment contract model more like the US - and as a result the social divide here is increasing. Thirty years ago true poverty and homelessness were rather rare here - a very different situation to the US. Trailer parks were almost unknown here compared to the US. Homelessness was also comparatively rare back then. The visible rate of homelessness here is now maybe ten times what it was back then. It's still a small fraction of the US rate though - I was shocked to see the number of homeless people when I visited San Francisco. This change in Australia is partially due to changes in employment policies and partially due to reduction of benefits. Government policies have reduced unemployment benefits and tossed people out of mental institutions as well as allowing individual pay negotiation in some cases.
So I guess whether you allow employment policies like reverse auctions is a matter of "What kind of society do I want?" If you want a comfortable country where no-one suffers too much then you need more left-wing policies like minimum wages and strong welfare. If you want to encourage the profit making possibilities of a free market economy then you should allow policies like reverse actions and reduced welfare.
As a point of comparison the US spends about half its tax on the military. Australia spends about half its tax on welfare instead. The US allows employers to get people to bid themselves into poverty. Australia doesn't. As a result it should surprise no-one that Australia has a vastly lower rate of poverty than the US and much fewer incredibly rich people. The cost of some of these policies is pretty high taxes compared to the US. People here seem to be willing to pay that price to have a relatively egalitarian society.
Re:Illegal in many countries (Score:3, Interesting)
That also allows US to offer protection to certain royalites in middle east to get better oil prices (at least compared to the rest of the world) to meet the citizens' thrust for gas guzzling SUVs and trucks, not to mention that oil prices seem to have almost one-to-one relationship with the economy.
The US allows employers to get people to bid themselves into poverty.
If you
Put your tinfoil hats away. (Score:4, Informative)
Here's three things I know to be fact about this practice:
1. In our case - the nurses in question are all RN's and are all contract nurses. These hospitals are being billed $60+/hr and the nurses paid $30+/hr. On the low end, $30/hr is $57,600 per year. That's way more than most occupations pay so for the people that said nurses are underpaid - you're way wrong. On the flip side, the hospital is paying $115,200/yr for that same nurse. That's a big bill to pay.
2. Since these nurses are all contract nurses, there aren't very many that actually work 40 straight hours in a week - there are a few that do and there are a few that work more than that but they are a very small percentage.
3. The reason for this practice in the first place is due to the national nursing shortage. If you think there is an over-abundance of nurses in the U.S., you're wrong. Nursing shortages are approaching a crisis level in many parts of the country. Nurses are being offered big time incentives such as apartments, cars, per-diem, and good wages to travel to different hospitals within certain regions. If there weren't such a disparity in supply and demand, this wouldn't even be an option or sustainable for that matter.
Also, since they are contract and part of a pool, most of them get to demand what hours they work, what department they work, and what days they work. How would you like to say, I'll work MWF, 6a-3p in the dept of my choice and that's all I'll work - perfect for mom's and dad's or anyone else that needs a flexible schedule.
At first glance, it sounds like a terrible, capitalist, predatory practice. In reality, it's a necessity for these hospitals to be able to staff their departments to the minimum standards. It allows nurses that are more flexible and willing to work the chance to pick up the hours when they want them and the hospitals to keep staffing levels adequate. I'm not saying there aren't nurses that pick up their 50th hour (or more) this way but the actual times that happens is extremely low - I have payroll figures to back me up.
I wouldn't get overly concerned about it or start comparing it to IT or trying to draw any other conclusions other than the obvious supply and demand conclusion.
I invite you to google for variations "Nursing Pool", "Contract Nursing Pool", "Traveling Nurses", etc. and read up on how this works.
Cheap. Quick. Quality. Pick one. (Score:3, Insightful)
In all other cases, I'll take quality.
In no circumstance will I ever want my healthcare to be delivered as cheap'n'nasty as possible.
On-call (Score:3, Insightful)
You know, this method could be useful in an on-call situation that traditionally has rotating shifts (like systems administration).
I personally detest being on call and would much rather avoid it. If instead of having everyone participate and having it (supposedly) built into your salary, having the people who don't mind (or even like) being on-call, or need the extra money, can bid for it. Those who don't want to be on-call can just not bid, or bid really high.
Of course, unless a max bid is set, companies wouldn't go for this, because it virtually guarantees they would have to pay more than in the current system.
Shouldn't it be the other way around? (Score:3, Insightful)
Either the nursing shortage doesn't exist, which goes against what I've been reading in the news for at least several years, or this is some scam to bring in more less-qualified nurses and push out the more experienced (and therefore more expensive) ones.
Boards of Directors being what they are, I'm guessing the latter. These are two hospitals I would not want to wind up at after an accident.
Re:well (Score:5, Insightful)
Re:Wow (Score:3, Insightful)
But then, we're both posting comments on the Internet, shows where our priorities
Re:The free market system JUST DONT WORK (Score:3, Insightful)
If there is a shortage of nursing staff the solution should be to raise the incentive to be a nurse. That incentive is pay and benefits. If the industry needs more nurses it either needs to fragment the job description so that the qualified nurses can concentrate on skilled tasks while orderlies and candy stripers handle lesser tasks OR it needs to make nursing a more attractive profession.
Instead, somehow, they have managed to convince the employees to sign on to this overtime for less plan that depri