I believe the GP is arguing that the same exact motives can happen in non-profit hospitals (as in the tax designation). This amounts to (at most) no more than a different route for the profits to those setting these policies. IMHO seeing this as a separate issue makes about as much sense as seeing false advertising to be separate problem depending on whether the corporation files as a C-corp or S-corp.
I for one think it is very important that any attempts to prevent this behavior don't leave loopholes for non-profit hospitals, so keeping this in mind here is actually very important.
Well, I don't agree with that. I see generous salaries as being exactly the same thing as profit (they are just taxed differently). I also have difficulty with the idea that only de facto agents of the state can deliver healthcare (care only available at fixed prices, etc).
So my point is that you need external controls regardless of the motivations of the actors inside the institution.
> I also have difficulty with the idea that only de facto agents of the state can deliver healthcare (care only available at fixed prices, etc).
It seems that they aren't the only difficulties you have. In a social health-care system, possession of a medical license doesn't entail one's employer. You're more than welcome to set up private practice, though you'll have less chance of the career defining cases, as the majority of patients will not be using your one-man-band practice. Thus many doctors in the UK, split their time between their private practice and public services. The only thing that's "de-facto" is the need to be qualified to treat people.
It's implicit in the argument I replied to that the side practice better not deliver excess economic benefits (profits!) compared to working in the public facilities.
I'm arguing that compensation and profit are actually the same thing.
They are both economic benefits from providing a valued product or service. Saying that the one is evil while ignoring the other doesn't make any sense at all. It's the opposite of being beside the point.
Take the case of 2 doctors that have the same price list. One is better at doctoring and sees more patients. Because there is only the other doctor, their faster appointments represent a higher income than the other doctor. The second doctor still manages to provide competent care to all the patients they see, but they are capturing less economic benefit than Dr. Speedy. Is Dr. Speedy evil for charging the going rate?
That's true, but removing the profit motive of the facility removes one major incentive for coordinated, large scale corruption like this. Other incentives (like production-based compensation being gamed by unscrupulous individuals) will have to be dealt with in other ways.
"This graph depicting
revenue reveals that
the maternity ward is
quite the cost center. It
should be going up and
to the right!
Smithers, why are there
so few pregnancies? We
need more in-patients,
otherwise our overhead
starts eating away at
our profits."
"Well, sir, I suppose
there aren't as many
teen pregnancies as
there used to be, and
with the benefit of
modern procedures, the
pregnancies we do see
are fairly uncomplicated..."
"Uncomplicated?! Why,
everyone knows live
vaginal births are the
devil's causeway. Those
infants can't be as
healthy as these so-
called 'doctors' seem
to believe. See to it
that more tests are
performed. I'm sure we
can find something wrong
with some of these
freeloaders."
You'll just need to have permission before you can get pregnant; cost problem solved (except for the expanding bureaucracy to manage the rules and operations of maternity).
Just trying to point out that human action without profit requires something else to account for the costs; otherwise there is no way to judge comparatively how limited resources should be applied. So if there isn't going to be profit driven activity, what will be the metric for success? If it is "outcomes", then we should start plowing everything we've got into it. Of course, should that mean we stop plowing resources into other endeavors? Do we make a vote of it? A law case?
People associate everything with the hospital and don't realize that doctors are frequently part of independent practices.
I remember vividly when my grandmother was in an awful hospital in NYC dying, I found the hospitalist to talk about her situation. He claimed to not Treating her and had no idea who was and directed me to another doctor. Yet he was standing at the station, with my grandmother's chart open with marking that he had just added her condition.
He actually told me the truth, but he was sitting there with a stack of files defrauding Medicare. Whatever profit the hospital was or wasn't making, the doctor was ringing his till.
This is colloquially known as "whataboutism".
The fact that there are other pernicious motives is completely irrelevant. For-profit medicine constitutes a pernicious motive -- that's the point.