Health Care: For-Profit or Government?

Introduction; Food For Thought

In Alameda County, a hospital surgeon sent a patient who had been stabbed in the heart to a county medical center after examining him and declaring his condition stable. The patient arrived at the county medical center moribund, suffered a cardiac arrest, and died.

In Atlanta, Georgia, a private hospital turned away a woman in labor because the hospital's computer showed that she didn't have insurance. Hours later, her baby was born dead in a county hospital.

These two hospitals shifted these patients to county facilities not for medical reasons, but for economic ones -- the receiving hospitals feared they wouldn't be paid for treating the patient. These patients simply weren't "good business." (Sen 860-861)

The Health care Industry: Profit Making vs. Government

With little public warning, a concern for "good business" has moved to the heart of health care, a sector once relatively insulated from the pursuit of profit that drives the rest of the U.S. economy. Throughout our history, medical institutions have largely been "charitable," nonprofit establishments existing primarily to serve the community (Anand 299-303). But during the past 20 years, the number of for-profit health care facilities, ranging from national hospital chains affiliated with major academic institutions to local dialysis centers, has grown at a rate exceeding even that of the computer industry.

The ethical implications of the growing commercialization of health care have become a matter of heated controversy. Those favoring the trend toward health care for profit claim that an increased role for entrepreneurs and competition in the delivery of health care will result in a more efficient and effective health care system. For others, the pursuit of profit is antithetical to the values central to medicine.

Opposing the commercialization of health care are those who base their arguments on considerations of justice. They argue that a society as wealthy as ours has a moral obligation to meet the basic needs of all of its members. Every American, rich or poor, should have access to the health care he or she needs (CMS web 87). The escalating costs of care and a growing unwillingness of insurance companies to cover these costs, along with government budget cutbacks, have severely restricted access to health care for the poor, the aged, and those with catastrophic health problems. The rise of for-profit health care only exacerbates the growing problem of access to care.

Studies show that the growth of for-profits decreases the availability of health care for "unprofitable" patients. Traditionally, non-profits have financed care for the poor by overcharging paying patients to subsidize services for the poor. For-profits, by refusing to serve nonpaying patients while at the same time taking a great share of paying patients, leave non profits with more of the poor to serve but with fewer paying patients to subsidize their care. Furthermore, by serving only profitable patients and offering only profitable services, for profits are able to generate high revenues, which enables them to charge lower prices for their services and to invest in attractive facilities ...