March 26, 2013

Government Nurses Joining Quarter-Million-Dollar Club

Justin Katz

The Ocean State Current has an article up by Suzanne Bates (freelancing from Connecticut's Yankee Institute) detailing the sky-high overtime that some staff at the state-run Eleanor Slater Hospital take home.

These numbers come to light every now and then — usually with just a glimpse because a nurse or two makes the top however-many list of state employees. The folks on the government side will typically throw up their hands and mumble something about being short-staffed and hemmed in by union rules and hospital regulations.

In the wake of Ken Block's waste and fraud report, however, two angles become more prominent: First, we now know that this inefficient labor expenditure is a regular feature of state government, year in and year out. It's not a temporary difficulty of an inadequate workforce and some contract language in need of renegotiation, but an expected part of the budget (even as the budgets are exceeded by millions of dollars every year).

Second, we're beginning to see that the way the hospital bills the taxpayer, by way of Medicaid, both disguises the cost and distorts the economics. With the federal government picking up a large chunk of the tab, and with union benefits (especially pensions) driving up the non-salary parts of employee compensation, the incentives of government are to tax more and give more away.

The numbers are outrageous enough, and — as we'll be making evident in the days and weeks ahead — they expand beyond just a single hospital or even a single department. But as government works its way more thoroughly into healthcare and every other aspect of our lives, these examples are a cautionary tale of the distorted incentives that will ultimately bring down any centrally planned system.

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"We're understaffed."
"It's a matter of life and death."

Where have we heard all of this before? Expect a retread of all the same arguments as were fought with the rife-with-abuse municipal fire departments.

In the case of the firefighters union, the cleansing light of public scrutiny was met not with the welcome one should expect from a public service-oriented organization, but instead with the screeching cult-like resistance of an anti-intellectual "brotherhood" that worshiped its own profession as a priesthood and can best be analogized as a modern-day incarnation of Zoroastrianism or the Religion of Fire and Shadow in George R. R. Martin's fantastical land of Westeros.

We are unlikely to encounter that particular brand of self-centered fanatacism with the nurses union, but expect the path to good government to be essentially the same. Just remember that the facts are on our side and they have the interest of the facts not coming to light. Present the publicly available information and let people decide on the merits. That's how the outrageous firefighter disability rate was finally reduced, overtime was cut, and 5-6% COLAs were eliminated.

Posted by: Dan at March 26, 2013 10:36 AM

Parkinson's Law:

Work expands so as to fill the time available for its completion.

The Economist, 1955.

Posted by: Dan at March 26, 2013 1:07 PM

Dan is correct. The recipients of that pay will have come to regard it as a "right'. They will defend it. If I understand it correctly, changing opportunities for women have resulted in a shortage of nurses.

A history lesson. When I was in school I did an internship at Boston City Hall. During a City Council meeting a councilor rose to report on his investigation of Suffolk County Jail. He reported that three cells were set aside for sick inmates, they were being used to store paint. Two dentists were on full time pay but there was no dental chair. Two nurses were on full time salaries but had not been seen in 3 weeks,While he was reporting this, the lights for the TV cameras went out and the "reporters" left. I asked the City Councilor I worked for why this was. He told me "it's federal money and nobody cares".

Posted by: Warrington Faust at March 27, 2013 10:38 AM
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