It all boils down to greed; sorry JT. Free-market, for-profit traditional capitalism will never work for healthcare. Satisfied customers? That's why this model of sickcare doesn't work and never will...the less satisfied (i.e. sicker) the customer, the higher the profit. Its inverse. For me to be perfectly healthy for the next decade is the best-case-scenario for me, yet the worst-case-scenario for them.
Cosmos - 2 years ago
We've tried this before, and it doesn't work. The "Free Market and For Profit" approach incentivizes cost-cutting, discrimination, and scams in pursuit of profits. We've also tried the reverse (value based care / Medicare part C) and it doesn't really work either - venture capital firms will prey on nursing homes and hospice care in pursuit of guaranteed revenue streams.
What we haven't really tried yet is regulating health care like a public utility. Most of the country can reliably count on electricity, gas, phone/internet, and water delivery with good quality and a reasonable price....why can't healthcare work the same way?
Jeremy C - 2 years ago
I see lots of emphasis on the "for profit" part of the poll but I object to the "free market" part. I'd love to see a day when healthcare returns to a free market. Certificate of Need laws is just part of the barriers to the healthcare market that create a wall (and a moat) preventing new companies and disruptors from participating. We spend lots of time on the demand side and how to provide funds for the demand to buy services but how often do we talk about the cost to increase the supply?
Adam Smith - 2 years ago
A "For profit" (or a shadow "for profit" as a 501c3) motive isn't the issue, it's the free market aspect. Few people actually want healthcare for themselves. What they want is to feel better, hurt less, look better, etc. A true free-market system would prioritize services that cater to the things on which people are willing to spend disposable income, such as Lasik, aesthetic surgery, and other cosmetic procedures. Public Health, emergency services, and other services that support the common good would be even more starved than they are today.
Marci - 2 years ago
Healthcare is not balanced. People who are not paying for things, want everything done for them regardless of the potential outcome. Insurance companies who have to pay for things want evidence based care at best and complete cost containment at worst. Medical providers are stuck in the middle trying to thread the needle between.
HealthCareCynic - 2 years ago
The question you ask is straightforward though I’m not sure how anyone could think that for profit motives wouldn’t have a negative effect on quality equitable care.
What your question doesn’t ask is whether comprehensive accessible compassionate health care can be delivered within the US health care delivery system at all.
I’m not talking about the people in any system who try to go the extra mile for patients but end up overburdened and burned out. Positive experiences and good care can always happen due to the sacrifices of individual health professionals but the US system is set up so that organizations are always looking for an edge in a competitive environment and the existence of for profit entities means that the nonprofit organizations have to stoop to the free market level as well. Even at my nonprofit academic institution they spend tons of effort and money on inane marketing campaigns to try to preserve our referral streams and cash flow and keep up with the local for profit groups. We are also at the mercy of for profit insurers and undercut by for profit level salaries in recruiting and retaining good people. Everyone is looking for a pot of gold at the end of the rainbow without realizing that it’s an illusion for most and ends up hurting patients and health professionals in the pursuit of financial windfalls.
MikeM - 2 years ago
The growing trend of balance billing and aggressively suing patients for collections proves that compassion is not a priority for healthcare organizations, whether for profit or "non-profit."
JT - 2 years ago
My first tendency was to say No, but in thinking about it, I don't think it's the profit motive that determines whether "comprehensive, compassionate, and accessible healthcare" is provided. I think it's more related to excellent leadership, vision, setting the right strategy and executing it and rewarding those who deliver on it. Sounds easy enough, right? I just shake my head anymore at the lackluster healthcare I see being provided all around me anymore. I say this of hospital care, outpatient services, pharmacies, etc. I observe it through the people delivering it so I have no idea what the messaging they're hearing and the 'incentives/disincentives' they're receiving. It always reminds me of the concept we've all heard about: Happy, Satisfied, and Recognized employees will result in Satisfied Customers. Apparently, that's not happening right now. It does worry me.
Frank P - 2 years ago
Define 'for-profit'? Having been a CFO at a "non-profit' we had to make sure we earned a "profit" - but referred to it as a margin. Decades ago a very competent nun that was CEO of a Catholic hospital said to me "no margin - no mission". If there is no margin you do not have the ability to invest in new capital or new technologies and will pay higher interest on bonds/loans (if you can get one!)
On the other hand, if you narrowly define "for profit" as putting the bottom line first, before patients, community, etc. that's the real question or issue, and that's very easy to answer.
It all boils down to greed; sorry JT. Free-market, for-profit traditional capitalism will never work for healthcare. Satisfied customers? That's why this model of sickcare doesn't work and never will...the less satisfied (i.e. sicker) the customer, the higher the profit. Its inverse. For me to be perfectly healthy for the next decade is the best-case-scenario for me, yet the worst-case-scenario for them.
We've tried this before, and it doesn't work. The "Free Market and For Profit" approach incentivizes cost-cutting, discrimination, and scams in pursuit of profits. We've also tried the reverse (value based care / Medicare part C) and it doesn't really work either - venture capital firms will prey on nursing homes and hospice care in pursuit of guaranteed revenue streams.
What we haven't really tried yet is regulating health care like a public utility. Most of the country can reliably count on electricity, gas, phone/internet, and water delivery with good quality and a reasonable price....why can't healthcare work the same way?
I see lots of emphasis on the "for profit" part of the poll but I object to the "free market" part. I'd love to see a day when healthcare returns to a free market. Certificate of Need laws is just part of the barriers to the healthcare market that create a wall (and a moat) preventing new companies and disruptors from participating. We spend lots of time on the demand side and how to provide funds for the demand to buy services but how often do we talk about the cost to increase the supply?
A "For profit" (or a shadow "for profit" as a 501c3) motive isn't the issue, it's the free market aspect. Few people actually want healthcare for themselves. What they want is to feel better, hurt less, look better, etc. A true free-market system would prioritize services that cater to the things on which people are willing to spend disposable income, such as Lasik, aesthetic surgery, and other cosmetic procedures. Public Health, emergency services, and other services that support the common good would be even more starved than they are today.
Healthcare is not balanced. People who are not paying for things, want everything done for them regardless of the potential outcome. Insurance companies who have to pay for things want evidence based care at best and complete cost containment at worst. Medical providers are stuck in the middle trying to thread the needle between.
The question you ask is straightforward though I’m not sure how anyone could think that for profit motives wouldn’t have a negative effect on quality equitable care.
What your question doesn’t ask is whether comprehensive accessible compassionate health care can be delivered within the US health care delivery system at all.
I’m not talking about the people in any system who try to go the extra mile for patients but end up overburdened and burned out. Positive experiences and good care can always happen due to the sacrifices of individual health professionals but the US system is set up so that organizations are always looking for an edge in a competitive environment and the existence of for profit entities means that the nonprofit organizations have to stoop to the free market level as well. Even at my nonprofit academic institution they spend tons of effort and money on inane marketing campaigns to try to preserve our referral streams and cash flow and keep up with the local for profit groups. We are also at the mercy of for profit insurers and undercut by for profit level salaries in recruiting and retaining good people. Everyone is looking for a pot of gold at the end of the rainbow without realizing that it’s an illusion for most and ends up hurting patients and health professionals in the pursuit of financial windfalls.
The growing trend of balance billing and aggressively suing patients for collections proves that compassion is not a priority for healthcare organizations, whether for profit or "non-profit."
My first tendency was to say No, but in thinking about it, I don't think it's the profit motive that determines whether "comprehensive, compassionate, and accessible healthcare" is provided. I think it's more related to excellent leadership, vision, setting the right strategy and executing it and rewarding those who deliver on it. Sounds easy enough, right? I just shake my head anymore at the lackluster healthcare I see being provided all around me anymore. I say this of hospital care, outpatient services, pharmacies, etc. I observe it through the people delivering it so I have no idea what the messaging they're hearing and the 'incentives/disincentives' they're receiving. It always reminds me of the concept we've all heard about: Happy, Satisfied, and Recognized employees will result in Satisfied Customers. Apparently, that's not happening right now. It does worry me.
Define 'for-profit'? Having been a CFO at a "non-profit' we had to make sure we earned a "profit" - but referred to it as a margin. Decades ago a very competent nun that was CEO of a Catholic hospital said to me "no margin - no mission". If there is no margin you do not have the ability to invest in new capital or new technologies and will pay higher interest on bonds/loans (if you can get one!)
On the other hand, if you narrowly define "for profit" as putting the bottom line first, before patients, community, etc. that's the real question or issue, and that's very easy to answer.