Quote-of-the-day mailing list
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Subject: qotd: For patients or profits?
Date: Mon, 14 Jan 2013 13:40:47 -0800
From: Don McCanne <firstname.lastname@example.org>
To: Quote-of-the-Day <email@example.com>
The New York Times
January 8, 2013
Health Care and Profits, a Poor Mix
By Eduardo Porter
Our reliance on private enterprise to provide the most essential
services stems, in part, from a more narrow understanding of our
collective responsibility to provide social goods. Private American
health care has stood out for decades among industrial nations, where
public universal coverage has long been considered a right of
citizenship. But our faith in private solutions also draws on an
ingrained belief that big government serves too many disparate
objectives and must cater to too many conflicting interests to deliver
services fairly and effectively.
Our trust appears undeserved, however. Our track record suggests that
handing over responsibility for social goals to private enterprise is
providing us with social goods of lower quality, distributed more
inequitably and at a higher cost than if government delivered or paid
for them directly.
From the high administrative costs incurred by health insurers to
screen out sick patients to the array of expensive treatments prescribed
by doctors who earn more money for every treatment they provide, our
private health care industry provides perhaps the clearest illustration
of how the profit motive can send incentives astray.
By many objective measures, the mostly private American system delivers
worse value for money than every other in the developed world. We spend
nearly 18 percent of the nation's economic output on health care and
still manage to leave tens of millions of Americans without adequate
access to care.
Today, again, entitlements are at the center of the national debate. Our
elected officials are consumed by slashing a budget deficit that is
expected to balloon over coming decades. With both Democrats and
Republicans unwilling to raise taxes on the middle class, the discussion
is quickly boiling down to how deeply entitlements must be cut.
We may want to broaden the debate. The relevant question is how best we
can serve our social needs at the lowest possible cost. One answer is
that we have a lot of room to do better. Improving the delivery of
social services like health care and pensions may be possible without
increasing the burden on American families, simply by removing the
profit motive from the equation.
Comment: Eduardo Porter's NYT article on the poor mix of health care
and profits resonated with PNHP members, and appropriately so. It
reminds us that our mission is not only to provide an efficient health
care financing system that would cover everyone equitably, but also to
ensure that health care be provided as "a public service rather than
bought and sold as a commodity" (from PNHP Mission Statement). Including
passive investors in health care has moved the bottom line up as the top
priority while relegating patient service to a footnote.