On Tue, Nov 25, 2014 at 10:25 PM, Shemano, David B. <[email protected]> wrote:
> Raghu writes: “Anyway, I don't think the relevant factor is necessarily > public v. private, but rather not-for-profit v. for-profit.” > > > > Imagine the hypothetical Dr. Smith who owns his own practice. After > paying rent, his staff, etc., his business has a profit of $250k. Several > years later, sick and tired of dealing with insurance claim administration, > he closes his office and joins the staff of Cedars-Sinai (a prominent > non-profit hospital in LA) in exchange for a salary of, you guessed it, > $250k. > > > > Why do you think his move from profit to non-profit is a good thing, will > result in any improvement in patient care, will result in reduced cost, > etc.? > I'd have thought the answer was obvious: where do you think there is a stronger pressure to cut costs and increase your income, which will frequently conflict with your professional obligation to serve your patients? It is not hard to think of examples where such conflicts will occur. It is not even hard to find real-world examples of such conflicts. See e.g.: http://kaiserhealthnews.org/news/study-costly-breast-cancer-treatment-more-common-at-for-profit-hospitals/ http://www.northjersey.com/news/a-new-playbook-for-hospitals-how-investors-pursue-a-financial-turnaround-1.1072991 http://www.marketwatch.com/story/community-health-systems-to-pay-98-million-to-settle-charges-of-submitting-false-medicare-and-medicaid-claims-by-systematically-over-admitting-patients-2014-08-04 http://www.healthbeatblog.com/2013/06/medicare-fraud-and-for-profit-hospitals-a-story-that-never-ends/ And on and on. Here are a couple of large-scale studies of this phenomenon. Not that I think any of this will convince you.. http://www.murphy.senate.gov/newsroom/press-releases/murphy-releases-report-on-impact-of-for-profit-medicine http://www.pnhp.org/PDF_files/ForProfitCare.pdf -raghu.
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