The solution is this: every sector of the economy has been optimized to extract as much money from everyone as possible. This is the implicit role of government--to help the rich get richer. Have an idea that makes money? The government will help you make it happen. Does it materially harm the public, like sports gambling? Then you better make a lot of money to pay off the politicos!

This through-and-through corruption means that we now graduate in lifelong debt, working jobs that don't cover the rent of places we can never own and spend money on health insurance we can never use because we can't afford the co-pays. We are forced to finance expensive car because that's the only way to get to work because the bus routes have all been purchased by car companies and liquidated long ago while regulations keep out cheaper foreign cars for "safety" while massive trucks and SUVs are killing pedestrians and cyclists at record rates. Forced to work longer hours and with less money in our pockets, our third spaces disappear. Now stuck at home, we are forced to buy electronics now at inflated prices because of the AI bubble and use oligopoly internet that should have long ago been regulated as a utility but for the massive campaign contributions those companies make to politicians to have a shadow of a social connection with each other.

We are no longer citizens. We are livestock.

This is unsustainable.

Thats the billionaires squeezing profits out of every transaction, not just the enrollment fees, the rent on the property, the Healthcare and insurance premiums for the staff and the operation.

Everything they do is being optimized to squeeze wealth Into the mouths of billionaires.

Tax wealth not work.

I skimmed the comments and didn't catch this, but don't forget about all the PRIVATE EQUITIES buying up nursing home facilities, banking on SSI, Medicare and Medicaid funding, upcharging perscriptions, "maximizing efficiencies" (aka paying as little wages as possible), and the revolving door of customers...

This makes me think of an issue we had around here recently. We have a public company running the majority of school buses in our area. They receive funding from the government that should be enough to pay their drivers around 24$ an hour. Yet, they've been paying them 18$ or less for years.

This year the drivers tried to negotiate for a higher wage and the owners weren't even willing to go over 19$... So they went on strike and buses stopped; parents had to make alternative arrangements. This went on for weeks, the employer just kept playing hard ball and not budging.

Surprisingly, parents were overwhelmingly on the driver's side which I was happy to see. It reached a point where the owners almost had their contract taken away. After about 2 months, they finally gave in and agreed to an increase to about 21$.

What kills me is that in another town nearby with a different company running the buses, divers are being paid 23-24$ an hour like they're supposed to. So the employer still came out ahead after everything was said and done. Apparently, the owners are from Toronto (about 3-4 hours away from us) and are just using this company to make money which explains their unwillingness to increase their workers pay.

Unrelated rant: Typical big city rich assholes fucking over people in smaller communities. It happened during covid with housing, they came over and scooped up every house they could just to rent them out for profit. I was paying 1000$ for a 3 bedroom apartment and some asshole from Toronto came over and bought it. Then when I moved out, they increased the rent to fucking 2500$....

The USA is just 3 Corporations in a trench coat. And corporations are just pyramid schemes.

People will lose their minds if you suggest giving someone medical care for free, but they keep ignoring all the landlords and CEOs and private equity groups and all the middlemen extracting the vast majority of all the wealth out, while also contributing the absolute least.

The fact that we have a system where one person works every waking minute of their life and still can't afford basic food and housing and another person sits around all day on their 3rd yacht sipping one of a kind wines and rakes in billions is insanity.

Labor $200 Land $150 Materials $800 CEO pay and profits $1,000,000,000 Utility $150 someone who is good at the economy please help me budget this. my family is dying

It adds up...

It adding up is the problem.

Because it means "job creators" who do nothing but posses titles to land and company stocks are syphoning off money.

If they need 3 staff for 21 kids, they're going to pay as little as they can to keep 3 staff. And charge as much as they can to keep 21 kids.

There's no correlation between what staffing costs and what prices are charged, why would there be?

Both are just line items, and the person in charge just wants the profit line to have the biggest number.

The larger the company is, the worst that becomes. Or if the company is small, but owned by someone with a dozen other companies.

Expecting salary to match what people pay is toddler logic, sure it would be great if it worked like that, but any adult thinking more than 2 seconds can see why that's not related in the modern age. Hell, its been decades since the "if we pay workers a living wage a value meal goes up $0.02!".

Americans literally all said they were fine with that, almost zero companies increased pay, and all of them.increaswd prices anyways

There's obviously no correlation

Sadly this math adds up. In my country those are public services. So no corporate greed is involved and no significat ammount goes to corruption or overpaid management.

Sadly this formula for example in daycare is true:

("Huge payment from us" x "number of kids") / " number of people getting paid" = "low number"

We usually just do not account for cooks, cleaners, janitors, administration in our intuition.

It's rent, and advertising. Shit costs so much and yet the landlord's and advertising industry makes ya think it's the cost of labour. I know alot of restaurant owners who work 5 days a week(alot close two days a week) and only vacation once a year just to visit family. they have steady business but still struggle due to costs. Only places I know are doing well are ones who own their building.

Same with universities and overworked, underpaid professors without tenure, doctors getting minimum wage out of medical school. Really any industry parasitized by Wall Street.

We were paying double daycare until recently. While it was never inexpensive, it was more manageable when our daycare center was locally owned. Then Kindercare came in and bought 80% of daycares in my major city. When we tried changing daycares we found that many daycares not explicitly named Kindercare were still under the Kindercare umbrella but retained their old name. I guess they caught on.

As SOON as the corporate takeover was complete they started increasing rates 8% per year BEFORE we had high inflation, instituted mandatory annual fees just to enroll, and mandatory fees for supplies that we use to be able to bring but now they charged us MORE than the supplies cost and they were super shitty quality items. So if you wanted to bring in supplies for your kid, you still got to pay the fee for supplies but then also had to buy the non shitty quality ones and bring them in.

To the point of the topic though, what pissed me off the most was that even though we paid 3k/month for two our center started bleeding employees because they simply wouldn't pay them anything. So what this meant is veteran teachers left for more pay and new ones were only there long enough to get experience.

This is tangential, but I recently learned quite a bit about hospice care in Oregon. I was dating someone who worked in the industry. She said that private equity was buying up the industry, intending to bill Medicare for as much as possible. I asked why she and her hard-working co-workers didn't start up their own hospice. Don't quote me on the specifics, but 1) a new hospice here has to generate no profit for the first X years and 2) you have to have something like half a million in reserves in order to be allowed the license to start one.

The laws were well-intentioned, but they end up being a way for the wealthy to continue generating income on the backs of everyone else. If you have the industry knowledge and funding to start a hospice, you can do it, then sell it off to private equity after a few years. Rinse and repeat. The rich get richer and we all pay for it, largely via Medicare.

I think a lot more people would be willing to swallow the cost of a nursing home, if the loved one was guaranteed proper care and respect.

And let me tell you, I've worked in a lot of nursing homes (not in a medical position), and it doesnt matter how high end the nursing home is, the treatment is the same across the board.

There are ways you can try to tip the system in your favor to increase the chances of getting better care for your loved one.

1. Visit Frequently. Every Day is best (but if you had that kind of free time you'd probably have your loved one at home instead of a facility). Residents who get frequent, regular visits tend to get better taken care of.

2. Try not to have a visitation pattern, To avoid staff taking care of your loved one in preparation for that day. If you do have a schedule to visit every saturday, then atleast a few times a month try to pop in on different day at random (and don't make it a pattern)

3. If your loved one can not advocate for themselves, put a granny cam in the room. You can decide if you want an overt one or a hidden one. Preferably one you can log into from home/where ever and monitor live, though this may require some kind of subscription.

3a) If your loved one can advocate for themselves, make sure they feel safe and secure to tell you any mistreatment/bad things/unacceptable response times they may be suffering. You'd be surprised how hard it can be to get an at risk relative to confess any mistreatment to you.

1. Be respectful to the staff until they prove otherwise. Sometimes sucking up, and little gifts, and just generally getting to know the staff involved in your loved one will get your loved one better treatment.

2. Do not hesitate to take issues up with the building administrator. The administrator is the highest authority in the building, and doubly do not hesitate to escalate things to your state oversight agency if the administrator fails to satisfy the issue.

4&5 TLDR) Be sweet and kind to staff, but don't hesitate to be a roaring asshole when needed.

and I want to be clear, none of this will guarantee good/better treatment for your loved one. It just increases the chances of good/better treatment. Some people are just too lazy, cruel, and lack a single ounce of give-a-fuck to care. and some facilities try to cut costs by hiring only people that have all but been blackballed from other facilities, at low wages, because the choice for worker is either continue to use the education and experience they have or start over at even lower wage in a whole new job they know nothing about, which means they are typically at the end of their give-a-fuck. But sometimes you can have a facility run by absolute goddamn angels.. and its too random to be able to predict.

Edit

Oh, and one last thing..if you do have something you need to elevate to regulatory boards, make sure you get photo/video evidence if you can. and I mean of bed sores, unattended diapers, personal diary logs of wait times when the clal nurse button is hit, etc etc etc. Evidence is key.

You see, honey, when a billion dollars and a billionaire love each other very much ...

First, there is corporate gouging. Anyone owning stocks wants to see a return, not a moderate one but a big one, on their investment. Second, it isn't a straight one to one employee to patient ratio. 24 hour care is 8760 hours per year and full time work is 2000 (with 2 weeks paid vacation) meaning 4.38 employee years for 24hrs, 365 days. It isn't quite that much because staffing is never 1:1. If it were 1:1, at $20 per hour paid to the caregiver, with vacation, sick days, health care, CPP, EI, WCB, it is a minimum of $58,000 per employee. That alone would work out to $4800 per month without housing, food, cleaning, equipment. It isn't cheap to house people who cannot live independently. We need a different model for care to keep the costs lower while providing care that is necessary. This used to all be "free" in-home by older women (Boomer, Silent Gen, Greatest Gen) and still often is, if they cannot access care for family members. Much like child care, that again women used to do for 'free", it costs real money to have someone else cover that work.

Tangentially related a bit, but I feel like this is part of why the "no one wants to work" became a meme after COVID.

Because everything shutdown, some of these people realized just how much they were paying for day care and getting lunch and gas, and how little they made formit, that they realized they were better off just, not working that secondary income job and didn't go back.

owners of these establishments are removing money from your pocket to there’s and their shareholders. Us common folk always get the shaft

Long-term direct care for humans at any stage of life in the US (that aren't of extreme wealth) is both obscenely expensive and yet woefully inadequate. I work in brain and spinal rehab AFCs and we're far worse than most average nursing homes.

Services are expensive. Where I'm from daycare is socialized but still considered expensive. I imagine a full price in for profit daycare must be brutal.

The math definitely adds up.

Shit Policies + Shit Wages = Shit Country

*boomers finally cashing in there absurd housing appreciation

Younger generations: we can finally use some of our family money to get on the housing ladder

Private equity nursing homes: not so fast, you gotta give us half of that or grannies going to the streets.

Look up Welltower Inc. According to equilar, welltower's CEO, Shankh S. Mitra, received $821 million in compensation last year. Welltower boasted $10.8 billion in earnings.

Middleman economy.

I would seem to me, there's a market for opening a daycare that pays livable wages, and another where you could both undercut nursing facilities and pay the staff living wages.

I'm not a fan of capitalism by any means, but it does seem that this should market correct no? What's stopping that from happening?

Nursing homes in my area are like $3500 a month and they'll have one or two people working the 12 hour shift from 7pm to 7 am making jack shit who don't know a damn thing and then call the fire department for free labour if an elderly person has fallen to the ground and needs help getting up. The nursing home doesn't want the financial risk of their employees getting hurt, or hurting a patient getting them off the ground. That might cost them a tiny sliver of the profits they take in.

You forgot to add the billionaire shareholders variable to the equation

Factor in owner profit and executive compensation and it all sums up.

Oversimplifying but I think it's worth thinking about an angle I haven't seen here yet:

People to tend to trust Big Corporate care-givers and distrust private individual caregivers.

There are of course Good Reasons for this (Who do you sue if they hurt your loved one? Who licenses and trains them?), but among the Bad Reasons are: People just inherently trust a big name they've heard of before, especially if that big name has similarly gargantuan PR and legal departments who scrub any bad press away.

In other words, you could hire your neighbor to take care of your kids all day, but most people choose not to, and instead send much more money towards big businesses with massive overhead costs because people trust So And So National Healthcare more than Jane Doe.

You can't wrap your head around the economy being a wealth extraction system Masquerading as a functional society?

!twnw@fedia.io

The money is flowing upwards

Jesse Welles - The Poor

I think someone wrote a manifesto about this once.

Just like with everything, the US economic system creates a bunch of rent-seeking middle men who need to get paid to deliver any service that the public needs. The more necessary the service the bigger the piece they get, we call these "insurance companies" and their job is to take money out of every public service and they are effective because they can get the government to create a system that makes the mandatory in order to conduct business.

I'll never understand the economy. To me it's just imaginary money. I did understand some parts of it thanks to the explained with bananas videos by Primate economics but that's about it.

The 'I just don't understand' shit pisses me off so much.

Corporate greed pal. No one tell Luigi

What’s the cost difference between this and hiring rotating shifts of nurses anyway? I know the equipment wouldn’t be there but yeah

I've said for years that daycares and nursing homes are extremely expensive, and they're probably not charging enough. The profit margins for both of these businesses are extremely thin.

I think posts like this are narrow-minded because they don't take into consideration the cost of operating these kinds of facilities.

Fundamentally, the reason daycares and nursing homes are so expensive is because the overhead is insane, much like in the American healthcare industry. A portable X-ray machine at a hospital can cost over $100,000, and even the metal slab they slide under you can cost around $10,000.

These machines don't cost nearly that much to produce. The manufacturers are milking the system.

My gas company charges a minimum monthly fee. I've never paid less than $70, no matter how little gas I use.

If you want to make these kinds of services cheaper, especially in America, you have to start with the fundamentals and bring down the cost of the things these businesses are forced to buy and pay for.

I'm making ~10-15% off stocks while putting 1hr of slow chilly work a month into it. Guess someone had to actually earn that for me.

And no, while I highly profit off this rotten system does not mean I love it. I do not, and would gladly trade my wealth for a normal society, in which everyone is equally happy and content. But noone wants my input on dismantling the system and start anew.

It adds up when you consider the parasites.

Something something government is bad something something private industry.

A lot of it (definitely not all of it) seems to be that Americans want things and don't want to pay for them. They demand care for the elderly but refuse to pay what it costs to staff a decent facility. They want healthcare but refuse to pay what healthcare workers are worth. But far more than that, they refuse to pay more than absolutely minimal taxes, unless they are terrified into doing so--fear of foreigners, Black people, immigrants, communism, etc. They've been believing politicians for decades who promise them the moon with no tax increases.

So Americans want healthcare but refuse to vote for a candidate who will divert money from cops or weapons toward making it affordable. They want college education for all their kids but keep voting for candidates who are Tough On Crime and Tough On Government Corruption while dodging questions about funding public education. They want better wages and jobs but keep voting for "pro business" candidates who remove regulations so companies can outsource the jobs to nations with cheaper labor. They want cheaper prices on everything but keep voting for candidates who block antitrust regulations and remove barriers to shareholder stock buybacks.

There's just enough distance between the voting decisions and their consequences that voters can convince themselves--they're motivated to--that the consequences are not connected to their decisions, and they're always provided with a raft of rationalizations in case they figure it out. It's motivated reasoning on top of ignorance. Like all good cons, these prey on the selfishness and greed of the hundred million or so marks.

The rent is super expensive, that's the answer

Well, let’s look at the math briefly.

First, what should a nurse make?

Add 20% cut to this for your risk and management.

Then, how many people should the nurse care for?

(Nurse pay * 1.20)/patients=cost per patient

(22*1.20)/5=5.28 per hour 24 hours per day So 126.72 a day Roughly 3,8000 a month per patient just for nurse care. Not including housing, utilities, food, or medication.

Alternatives could be mandatory civic or military duty at 18 for a few years and nursing duty could be in there?

Another alternative could be inmate care, paying minimum wage in municipal bonds, as a way to work off a sentence?

Pay nurses less, requiring less certification?

Outsource nursing to countries where wage arbitrage can be leveraged?

Obviously this was fast and dirty but illustrates the expense.

I'm no libertarian, but a major problem is that a lot of our industries are severely over regulated. Regulations are usually a good thing, but often they are pushed by big business to prevent future competition. If the only way to comply with the law is to retain a staff of lawyers, then it becomes impossible for individuals to set up small operations.

For example, there's no reason we couldn't have micro nursing homes set up in individual private homes. Maybe a trio of licensed nurses can operate one out of a home. Maybe they can care for up to half a dozen patients.

Yes, this does induce additional risk of abuse and neglect, but I would argue that is probably less likely to occur at such a human facility than one run by a big corporation. And maybe accepting a bit more risk is worth it if it allows people to get card they otherwise would be shut out from.