Goals · 5

Reducing problems at their causes

Goal: reduce problems at their causes, not only at their symptoms.

Draft. This article puts earlier texts of this site into the new order of goals and observations. It has not been reworked yet and awaits the author's review.

Problems form networks: some cause others, some are only symptoms (see Foundations). An effort can reduce a problem, or only its symptom.

Supply and demand needs scarcity. In care, this scarcity causes bad conditions, suffering and avoidable deaths. A price only moves when something is scarce, so a market reacts to a shortage once it is felt, not before. The shortage of nurses grew as a by-product of such a system. Nobody built it out of malice.

Illustration: shows what follows from these assumptions; not evidence.

A model of care over thirty years. Need grows slowly as the society ages, which is known decades ahead, and an epidemic comes that nobody could foresee. Training takes three years. Overload makes people leave. Three ways of supplying care are compared: a market where pay rises only once a shortage is felt; a predictive system that trains from a forecast and brings back trained people who are not working as soon as need jumps; and the same predictive system with a poor forecast.

Care needed vs care given — Care needed against care the active nurses can give, over 30 years. Grey band: an epidemic nobody could foresee; the ageing trend was known all along.

Workload, reserve, training — Workload per nurse, trained people not working, and new trainees.

Care totals — Unmet care, idle trained people and the highest workload, in total.

Because a single epidemic might come at a lucky or unlucky time, it is moved to every possible time. Averaged over all of them, the market leaves 419 units of care unmet, the predictive system 183. With a poor forecast, the predictive system does worse than the market, at 752: planning ahead is only as good as the communication of what is needed. The market also keeps many trained people idle.

Depending on when the epidemic comes — The same, with the epidemic moved to every possible time, so luck in timing does not decide the result.

Without education and resilience, people build means that care only for themselves. They don't see how dangerous the structures needed to shut others out are.