Too Small to Succeed (the Health Care System)

Americans may distrust big institutions, and journalists may take most of what Donald Trump says as brummagem, but why aren’t Americans suspicious of the people running the health care system? After all, most times the phrase — flattening the curve — is not about saving lives (as Jay Santos would put it), but about managing the demand for medical care in a hospital. Of course, saving lives is related to access to hospitals, especially in life threatening stages of many diseases and conditions. But flattening the curve also indicates that hospitals are not prepared for a pandemic. That could well be the fault of federal authorities and public health officials. But we are in a privatized system of health care (different from health insurance). And it’s now fairly obvious that hospital CEOs had all sort of financial incentives to handle COVID-19 cases.

Here’s some of the polling data on physicians and research scientists:

The spread of the new coronavirus in the United States comes at a time of low public trust in key institutions. Only around a third of U.S. adults (35%) have a great deal or a fair amount of confidence in elected officials to act in the public’s best interests, and fewer than half say the same about business leaders (46%) and the news media (47%), according to a January 2019 Pew Research Center survey.

Public attitudes are substantially more positive when it comes to another set of participants in the unfolding coronavirus threat: doctors and medical research scientists. In the same survey, 74% of Americans said they had a mostly positive view of medical doctors, while 68% had a mostly favorable view of medical research scientists – defined as those who “conduct research to investigate human diseases and test methods to prevent and treat them.”

Why don’t Pew’s pollsters ask questions about hospital administrators? A story about the differences between non-profit and for-profit health systems indicates that hedge fund types, the folks who gave us (at least partly) the 2008 financial meltdown, may also be responsible for the COVID-19’s economic symptoms:

for-profit health system boards tend to be a blend of investor representatives and community leaders.

At Nashville-based HCA Healthcare Inc., a for-profit health system with more than 180 hospitals, the chairman of the board is Thomas F. Frist III, founder and managing principal of Frist Capital LLC, a Nashville investment firm.

Other members of the HCA board include Nancy-Ann DeParle, a partner at New York-based Consonance Capital Partners, a private equity firm that invests in healthcare companies. Charles O. Holliday Jr., chairman of Royal Dutch Shell PLC, which is headquartered in The Hague, the Netherlands, is also on the board.

Sure, it could be that to make hospitals work, you need bean counters and market watchers and venture capitalists to calculate the allocation of resources. But what if for-profit medicine is not the right model for pandemics?

And what if journalists and Democrats, eager to make the current White House look like a gaggle of idiots (not hard), took a long look not at the way we pay and process paperwork for health insurance companies? What about running stories on the business people who manage and own hospital systems that were interested in profits as much as public health? What about coverage of the sort of contortions imposed on epidemiologists, economists, and elected officials because the people who directly manage and own institutions within the health care system were unprepared for a pandemic? And when will someone point out that again the federal government and its printing presses at the Treasury will save another industry’s CEOs?

2 thoughts on “Too Small to Succeed (the Health Care System)

  1. Sure, it could be that to make hospitals work, you need bean counters and market watchers and venture capitalists to calculate the allocation of resources. But what if for-profit medicine is not the right model for pandemics?

    I don’t think non-profits are any better. When you go to the hospital, they all plug your data into a Nonsensitron that figures out how much money you have and spits out a bill based on how much they need to pay for others who paid less (the insured or Medicare, especially Medicare) or not at all (those with no assets you usually see in the ER waiting room). The guy over at Bury Pensions has several book recommendations if you look back a couple months through his posts.

    And what if journalists and Democrats, eager to make the current White House look like a gaggle of idiots (not hard), took a long look not at the way we pay and process paperwork for health insurance companies? What about running stories on the business people who manage and own hospital systems that were interested in profits as much as public health? What about coverage of the sort of contortions imposed on epidemiologists, economists, and elected officials because the people who directly manage and own institutions within the health care system were unprepared for a pandemic? And when will someone point out that again the federal government and its printing presses at the Treasury will save another industry’s CEOs?

    These people are typically Democrats, sometimes big-donor Democrats, so nothing will be done about them. See Edward Ring’s and Matt Stoller’s latest.

    Liked by 1 person

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