For-Profit Hospitals Are Compatible with Universal Health Care

The Fraser Institute, an independent, non-partisan Canadian public policy think-tank released a study today which found that “based on experiences of other countries, for-profit hospitals and insurers are compatible with universal health care.”

The study analyzed the universal health-care systems of six countries – Australia, France, Germany, the Netherlands, Sweden, and Switzerland.

Bacchus Barua, senior economist at Fraser Institute and co-author of “For Profit Hospitals and Insurers in Universal Health-Care Countries,” said that “Contrary to the way they are often perceived in Canada, for-profit hospitals and insurers are part of high-performing health care systems in other countries.”

One of the reasons that prompted the study was the misperception that a private, for profit medical facility is “incompatible with universal-access health care.” Yet, according to the authors, “poor access to medical services and middling outcomes and safety despite high spending” seem to plague Canada’s health care system which appears in need of reform.

The study highlighted the numbers of hospitals in countries with universal healthcare:

-          Sweden has 77 public, 3 for-profit and 3 not-for-profit  (n/a)

-          France has 928 public, 688 private not-for-profit, and 1041 private for-profit (2012)

-          Switzerland has 61 public,  82 private not-for-profit, and 150 private for-profit (2013)

-          Germany has 833 public, 1,040 private not-for-profit, and 1,356 private for-profit (2012)

-          Netherlands  has zero public, 180 private not-for-profit, and 79 private for-profit (2012)

-          Australia has 753 public, 115 private not-for-profit, and 477 private for-profit (2011)

In Canada private for-profit parallel insurance is not allowed and only a small number of private for-profit hospitals can be found. In the countries studied, the authors found that all “have incorporated for-profit hospitals and insurers into their universal health-care policy framework.”

Universal access to health care is the “principle that all citizens (or residents) can obtain health-care services irrespective of income or pre-existing health status.” A public hospital or clinic is owned and operated by the government with various degrees of efficiency or inefficiency. A private hospital is owned by an individual or a group and it can be either for-profit or not-for-profit. In the case of private not-for-profit hospitals, any kind of profit is reinvested in the hospital or clinic.

The six countries in the study were chosen based on the following criteria:

-          The countries “share a common goal of access to high-quality care, regardless of a patient’s ability to pay” (I note that access to high-quality care does not necessarily mean delivery of high-quality care.)

-          Spending a proportion of GDP on healthcare comparable to Canada’s expenditure

-          The countries “provide similar or superior access to, and quality of care, in comparison to Canada’s health-care system across a range of metrics”

-          Public data is readily available

The metrics criteria included the number of physicians, nurses, MRI units, CT scanners, hospital beds, same or next-day appointments when sick, wait time for specialist appointment (4  weeks), wait time to be treated when sick (2 hours or more), wait time for access to doctor or nurse (6 days), wait time for specialist appointment (2 months), wait time for elective surgery (4 months), post-operative sepsis, retained surgical item or unretrieved device fragments left in a patient after surgery, COPD hospital admission, uncontrolled diabetes admissions, asthma admissions, ischemic stroke 30-day in-hospital mortality, colorectal cancer five-year relative survival, cervical cancer five-year relative survival, and breast cancer five-year relative survival. http://fraserinstitute.org/sites/default/files/for-profit-and-insurers-in-universal-health-care-countries.pdf

The authors describe the types of primary and secondary coverage in each country and how the insurance and the medical costs are being paid – either by direct tax levies, tax surcharges, or government-mandated insurance in which case the government heavily regulates the single insurance-provider and determines salaries of medical personnel, doctors, nurses, and the cost of each procedure, of doctor’s visits, and of medications.

Barua said that, “Clearly, based on the examples of the industrialized countries, private for-profit hospitals and health insurers are compatible with universal health care.” Nadeem Esmail, the study’s co-author, added the “Private for-profit hospitals and insurers support some of the best universal access health-care systems in the developed world – systems superior to Canada’s timeliness, accessibility, and outcomes despite similar or lower health expenditures.”

The Fraser Institute study seems timely as 12 of the 23 Obamacare co-ops that were meant to provide “lower cost health insurance not driven by the profit motive,” are failing so quickly after the implementation of the not-so-affordable 2010 Affordable Care Act (ACA), costing taxpayers $1.2 billion in defaulted loan payments. A long list of patients must now struggle to find health insurance comparable to what they had before and must find new doctors.  As the New York Post is quoted, “Add 250 New York cancer patients on the long list of victims of ObamaCare’s lies – just one more snapshot of the program’s ongoing death spiral. http://thehill.com/blogs/pundits-blog/healthcare/260948-obamacares-predictable-collapse

Who thought that it would be a good idea to “fundamentally transform” and destroy the healthcare of 85 percent of Americans who were happy with their insurance carrier, their affordable premiums, their doctors, their healthcare, their hospitals and clinics, so that 15 percent of Americans, who were either already insured under Medicaid, voluntarily not insured, had pre-existing conditions, or in this country illegally, would have insurance? Would it not have been cheaper to buy insurance for these 15 percent of uninsured, implement tort reform, and allow the sale of health insurance across state lines?

Robbing $716 billion from Medicare (from our elderly population) in order to pay for ObamaCare’s costly implementation was a bad idea, especially at a time when our national debt exceeds the GDP and is thus unsustainable. http://dailysignal.com/2012/08/01/obamacare-robs-medicare-of-716-billion-to-fund-itself/

What good is having expensive bronze, silver, or gold Obamacare insurance through state exchanges if the care is not available and sketchy; nobody can afford the huge premiums even with subsidies; the co-pays are large; patients cannot find doctors and specialists because many have retired or are not accepting Obamacare;  and an insufficient number of new doctors were trained. And is it insurance or is it a tax? It depends on who you ask. At the end of the day, kiss your good medical care good bye and put your worthless plastic card back into your wallet.

As far as the rest of the developed world is concerned, where are their elites going to fly to in order to get the best medical care in the world once America becomes full victim of socialized medicine? Who is going to study medicine if the rewards become so slim and the government will regulate their salaries, services, and fees? And, since Congress and their staff have exempted themselves from Obamacare, how and where are they getting medical care?