Про госпитали и бедных
В реальности это проблема в стране, где медицинская система - чистый бизнес для получения прибыли без конкуренции со стороны государства, которое бы обеспечивало минимальные потребности всему населению за счет обязательного медицинского страхования за счет налогов (как в большинстве стран мира). Да, в стране есть Медикейд - страховка для бедных, но проблема в том, что она платит не столько, сколько бы хотел доктор/госпиталь и потому любая частная (не муниципальнгая) контора старается всеми правдами и неправдами отказаться от таких пациентов. Учитывая, что медицинский бизнес - это выгодный бизнес, за последние годы много муниципальных госпиталей было приватизировано и доступ бедняков к медицинским услугам сократился ещё сильнее. Все эти бедняки - это в основном убытки, потому от них и избавляются. А ведь здоровье - это не бизнес, это базовая потребность и, в отличие от воды и воздуха, к которым у всех есть доступ, а также еды, где огромная конкуренция с разнообразным и относительно примитивным производством, медицина сложная система и конкуренции мало.
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Over the past four decades, US hospitals have gradually moved from public hands to private ones. The share of hospitals owned and operated by a government body - as opposed to a private entity, either a for-profit enterprise or a nonprofit - declined by 42 percent from 1983 to 2019.
That trend has brought serious consequences for the poorer patients who seek care at these hospitals. When private companies assume control of public hospitals, low-income patients on Medicaid lose access to health care, according to new research on this longstanding but under-analyzed trend in American health care.
A new National Bureau of Economic Research working paper by academics from Stanford, Michigan State, and Penn reviewed the consequences of the 258 hospital privatizations from 2000 to 2018 they could identify using national data. (As there were a little more than 1,000 public hospitals in 1999, that would mean one-fourth of all US public hospitals were privatized over the period they studied.)
These researchers found that after a private company took over a hospital previously controlled by the government, the hospital becomes more profitable. As a public hospital, these facilities lost about $335 on average for every patient. As a private hospital, they earned about $740 per patient.
In an ideal world, hospitals could be operating more efficiently, and therefore more profitably, without sacrificing access to health care. And the researchers do find that the hospitals achieve greater profitability in part by reducing spending on administrative and support personnel rather than people most directly involved in patient care. There was no meaningful reduction in nursing staff, for example, after the transfer of control.
But the other way in which these hospitals increased their profitability is more worrisome. Hospitals taken over by private companies saw an 8.4 percent decrease in overall patient volume, partly the result of hospitals reducing their capacity in a likely bid to improve efficiency.
Admissions for Medicare dropped by only 5 percent, a statistically insignificant change, according to the researchers. But Medicaid admissions fell by 15 percent, as did the decline in “other” admissions (which include the uninsured and private insurance, with the former representing another unprofitable business line for hospitals). Though Medicaid patients made up 20 percent of patient volume at these hospitals, they accounted for 30 percent of the drop in admissions after privatization.
Отсюда
Вот почитать:
Over the past four decades, US hospitals have gradually moved from public hands to private ones. The share of hospitals owned and operated by a government body - as opposed to a private entity, either a for-profit enterprise or a nonprofit - declined by 42 percent from 1983 to 2019.
That trend has brought serious consequences for the poorer patients who seek care at these hospitals. When private companies assume control of public hospitals, low-income patients on Medicaid lose access to health care, according to new research on this longstanding but under-analyzed trend in American health care.
A new National Bureau of Economic Research working paper by academics from Stanford, Michigan State, and Penn reviewed the consequences of the 258 hospital privatizations from 2000 to 2018 they could identify using national data. (As there were a little more than 1,000 public hospitals in 1999, that would mean one-fourth of all US public hospitals were privatized over the period they studied.)
These researchers found that after a private company took over a hospital previously controlled by the government, the hospital becomes more profitable. As a public hospital, these facilities lost about $335 on average for every patient. As a private hospital, they earned about $740 per patient.
In an ideal world, hospitals could be operating more efficiently, and therefore more profitably, without sacrificing access to health care. And the researchers do find that the hospitals achieve greater profitability in part by reducing spending on administrative and support personnel rather than people most directly involved in patient care. There was no meaningful reduction in nursing staff, for example, after the transfer of control.
But the other way in which these hospitals increased their profitability is more worrisome. Hospitals taken over by private companies saw an 8.4 percent decrease in overall patient volume, partly the result of hospitals reducing their capacity in a likely bid to improve efficiency.
Admissions for Medicare dropped by only 5 percent, a statistically insignificant change, according to the researchers. But Medicaid admissions fell by 15 percent, as did the decline in “other” admissions (which include the uninsured and private insurance, with the former representing another unprofitable business line for hospitals). Though Medicaid patients made up 20 percent of patient volume at these hospitals, they accounted for 30 percent of the drop in admissions after privatization.
Отсюда