[nograpes]

A good way to address your point would be to compare the situation to Canada.

In the province of Quebec, where we have a highly vaccinated population, the intensive care units (ICUs) in all hospitals will be full within two weeks, if the rate of transmission and hospitalization continue this way. Demand greatly outstrips supply.

In Canada, the financial incentives for hospitalization and discharge are very different. Physicians get paid by a complex mix of hourly pay in addition to a fee-for-service schedule, both paid by the government. Hospitals get paid by the type of patient they admit, and their length of stay, but not always in a straightforward way.

In Canada, because of the remuneration system, physicians are the most influential decision-makers in deciding who gets to use the ICU. Roughly, no one doesn't get admitted "because they can't pay", and no one gets admitted "because they have money" .

Since hospitals are overwhelmed in Quebec, physician's incentive would be to discharge patients rather than admit. Their hourly wage wouldn't rise if they got more patients. Indeed, there is some evidence that as ICU capacity drops, physicians start discharging patients from the ICU earlier.

I should be fair to physicians in Quebec: their behaviour reflects a deep concern about the public health emergency rather than their financial gain.

I believe that, in Canada, all hospitalized patients in the ICU really need to be there.

Source: I have been studying hospitalizations due to COVID-19 illness in Quebec, Canada, and providing forecasts to the local government since the start of the pandemic.