Sad Story at Tampa General

Sad story.

The problem, which is not mentioned in the article, stems from a nationwide lack of psychiatric hospital beds (pdf).  Deinstitutionalization was a terrifically humanistic improvement.  But it also significantly reduced psychiatric beds—a problem that has manifested into patients sleeping in the hallways or spending days in the emergency department (quite possibly on a gurney in the hallway as well).

As you may have guessed, psychiatric services are not well reimbursed, which contributes to the problem as well.  Raising nurse salaries, as the lawyer in the article suggests, goes against common business sense. It becomes quite difficult for hospitals to offer services on which they don’t at least break even.

This would help.  Here is an explanation.

But our entire system still boils down to a misaligned system with improper incentives for providing the appropriate care for each patient.  Until we change that, stories like the one at Tampa General will persist.