Thursday, May 07, 2015
Non-profit vs For-profit
There is concern in Massachusetts about a reported decline
in the quality of care following the purchase of ten nursing homes in the state
by Synergy Health Centers, a for-profit nursing home chain (Woes follow nursing home chain’s arrival,
The Boston Globe, May 5, 2015). The
article discusses similarly reported declines in nursing homes recently purchased
by Genesis Health Care and Zenith Health Care Group, two other for-profit
chains.
It all poses the issue of what role for-profit enterprise
should play in the provision of health care services.
Professionalism is a very important component of our health
care culture. We believe that those who
provide diagnosis, treatment and care should put the patient’s interest over their
own. They should not behave in ways that
are of financial or other benefit to them but are of no value or damaging to
their patients. The reason we don’t let
doctors sell medicine is because we don’t want them to be tempted to make money
by prescribing a drug the patient doesn’t need or might find harmful.
As our health care system moves towards financial mechanisms
that incentivize providers to do less rather than more, we will see whether the
for-profits can discipline themselves to resist the temptation to withhold
needed services in order to increase profits for investors.
To some extent that will also be an issue for non-profit
providers but the absence of private investors looking for a return will reduce
the intensity of the temptation and public ownership will provide a more
effective means of redress if they succumb.
