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.