Over the weekend my Morning Readings included a lesson that economists teach called the Cobra Effect. Jon Miltimore is the Managing Editor of the Foundation for Economic Education in Atlanta and his FEE.org is a highly respected conservative libertarian economic think tank. In his story you are about to read, he claims economists around the world speak often on The Cobra Effect.
You see, every human decision brings about consequences, intended ones and unintended ones, Jon writes. Unintended consequences are so common economists often call them Cobra Problems, after an interesting historical event in India that occurred when the British Empire tried to eradicate cobras, the deadly snakes, by putting out a bounty on them. (the unintended consequences won that one!)
In two weeks we are told CHI Memorial Hospital will fire any employee who has not been vaccinated with the COVID shots.
Yet if you feel we have mandate problems, read what Mr. Miltimore writes about Houston:
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COMMENTARY: MASSIVE NURSES SHORTAGE HITS HOUSTON, WEEKS AFTER 150 UNVACCINATED NURSES AND HOSPITAL WORKERS WERE FIRED
by Jon Miltimore, writing on August 23, 2021
Jennifer Bridges knew what was coming when her director at Houston Methodist hospital called her up in June to inquire about her vaccination status. Bridges, a 39-year-old registered nurse, responded absolutely not when asked if she was vaccinated or had made an effort to get vaccinated. She was terminated on the spot.
We all knew we were getting fired, Bridges, 39, told CBS News. We knew unless we took that shot to come back, we were getting fired today. There was no ifs, ands or buts. Bridges was one of more than 150 hospital workers fired by Houston Methodist hospital.
All last year, through the COVID pandemic, we came to work and did our jobs, said Kara Shepherd, a labor and delivery nurse who joined Bridges and other workers in an unsuccessful lawsuit. We did what we were asked. This year, were basically told were disposable.
PLEASE SEND HELP NOW
Shepherd and her colleagues may be disposable in the eyes of hospital administrators, but they are perhaps not as easily replaced as she or Houston Methodist thought.
Two months after firing unvaccinated hospital staff, Houston Methodist is one of several area hospitals experiencing a severe shortage of medical personnel. Media reports say hospitals have reached a breaking point because of a flood of COVID-19 cases.
In an editorial published Tuesday, the Houston Chronicle said the 25-county hospital area that includes Houston had more patients in hospital bedsmore than 2,700than at any point in 2021. News reports make it clear that hospitals are struggling to keep up.
KHOU-11, a local news station, says medical tents have been erected outside of Lyndon B. Johnson Hospital but are vacant because of a shortage of nurses.
Please send help now, said Dr. George Williams, chief ICU medical officer for LBJ Hospital.
While most media reports focus on LBJ Hospital, reports also make it clear other hospitals, including Houston Methodist, are experiencing similar struggles. The Houston Chronicle says Harris Health System (which includes LBJ) is short some 250 nurses, while the University of Texas Medical Branch has requested an additional one hundred nurses to help address staff shortages at four hospitals.
Baylor St. Lukes Medical Center, a private Houston hospital jointly owned by Baylor College and a local healthcare system, said the hospital is definitely being impacted by the nurse shortage.
As for Houston Methodist, the hospital is reportedly struggling as wellalthough theyve yet to admit it publicly.
An internal memo at Houston Methodist Hospital said it is struggling with staffing as the numbers of our COVID-19 patients rise, the Chronicle reports.
Public officials are scrambling to address the shortage, which has created a massive patient backlog throughout the Houston area. More than a week ago, Texas Gov. Greg Abbott requested out of state assistance for the statewide crisis, including 2,500 out of state nurses. LBJ Hospital officials said those nurses have not yet arrived.
The metro-wide shortage of nurses reportedly came to light when an ER doctor emailed a state senator about the dire situation in hospitals.
The combined increase in volume from (COVID and) existing normal volume (and) nursing shortage has made this a terrible disaster at every ER and hospital in the city of Houston, the physician wrote, according to the Chronicle.
THE COBRA EFFECTS
Its unclear to what extent Houston Methodists decision to fire 150 unvaccinated medical workers exacerbated the nursing crisis. For perhaps obvious reasons, hospital officials have been mum on the issue.
What we know is that Houston hospitals that did not abruptly fire 150 employees struggled to deal with the COVID spike, and in some cases people died as a result. So, its safe to presume that Houston Methodists decision to fire 150 employees a few weeks before the Delta variant arrived in force didnt make the situation any better and probably made it much worse.
Some may be tempted to think Houston Methodist was able to quickly replace the workers they lost, but evidence suggests this is unlikely. Apart from the broader shortage, front line nurses are burned out, they say.
We are all tired of this; nurses are tired of this, Texas Nurses Association CEO Cindy Zolnierek wrote in a recent public letter.
That Houston Methodist hospital didnt intend to exacerbate its shortage of hospital staff goes without saying, but its also an important reminder about what economists call the Cobra Effect.
Every human decision brings about consequences, intended ones and unintended ones. Unintended consequences are so common economists often call them Cobra Problems, after an interesting historical event in India that occurred when the British Empire tried to eradicate cobras by putting out a bounty on them. (Can you guess what happened?)
When hospital administrators set their policyget vaccinated or lose your jobtheir goal was to increase vaccination rates of hospital staff. The unintended consequence was a shortage of nurses and other hospital workers during a deadly pandemic.
In June, Houston Methodists president, Marc Boom, sounded confident that his coercive methods were effective, noting that almost 25,000 of the health systems 26,000 workers were fully vaccinated.
The science proves that the vaccines are not only safe but necessary if we are going to turn the corner against COVID-19, Boom told employees in a statement.
Other Houston hospitals saw things differently. Two months before Houston Methodist fired its workers, Harris Health System officials announced they would not be requiring hospital workers to get vaccinated, noting none of the vaccines were fully approved by the FDA.
Americans will, of course, disagree about which CEOs approach was the correct one. The pandemic, after all, has been bitterly divisive because were deeply divided over this very question: should coercive means be employed to achieve certain desired healthcare outcomes, and if so, to what extent?
In 2020, political leaders around the world said yes to this question, and the results were disastrous. A year later, private companies are playing a different version of the same game: take the vaccine or get fired.
Like the lockdown champions of 2020, corporate leaders no doubt believe their action is moral, proper, and will achieve their desired result. But as the Cobra Effect reminds us, focusing strictly on desired outcomes and ignoring potential unintended outcomes is a good way to get bitten.
* * *
The Foundation for Economic Education (FEE) is an American conservative libertarian economic think tank. It is a member of the State Policy Network. Its mission is to promote principles of "individual liberty, free-market economics, entrepreneurship, private property, high moral character, and limited government". Headquartered in Atlanta, it was established 75 years ago. It is considered the oldest free market think tank in the United States.
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