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It's not polite yo say so, but perhaps it's worth considering that a for-profit Healthcare system is not necessarily aligned with a "optimal outcomes" system.

It's not polite yo say so, but perhaps it's worth considering that a for-profit Healthcare system is not necessarily aligned with a "optimal outcomes" system. In other words you can have a system which prioritizes profit, or you can have a system that prioritizes care. But you can't prioritize both.

solidsnack9000 2y ago
These hospitals are actually subject to regulation, though, and the regulation does not actually condition funding on spare capacity. That's just going to lead to broken results. A completely publicly funded healthcare system without spare capacity requirements would falter in the same way.
cmrdporcupine 2y ago
Our hospitals are not for-profit here in Canada, but they still have clusterfucked emergency rooms. (In some places, probably worse.) There's always some kind of rationing of the limited resource. There it's based in large part on you or your insurance's ability to pay. Here it's based on how much the government/taxpayer is willing to shell out.
- quacked 2y ago
  Canada has also experienced record rates of recent population growth, so even at historically normal building levels (which are artificially suppressed) there would be a lag time between demand and availability.
  - cmrdporcupine 2y ago
    Nah, this is a problem going back to the early 90s, when governments got the neo-liberal austerity thing going. Especially the huge mid-90s cuts to federal health and social transfers to the provinces, by the federal Liberal gov't under Jean Chretien. Health care is the biggest portion of every provincial gov't budget, and always a point of contention.
    - bruce511 2y ago
      The priorities of govt are always the priorities of the electorate. At least until the next election. If one party gets elected on the promise of lower taxes and lower spending, then the people cannot complain when there is lower spending. If the spending gets too low, and health, education, housing, and infrastructure start creaking, well, who's to blame for that?
worik 2y ago
> It's not polite yo say so, but perhaps it's worth considering that a for-profit Healthcare system is not necessarily aligned with a "optimal outcomes" system. Polite? I cannot day Obviously true, but
amy-petrik-214 2y ago
The core philosophical truth of healthcare is you can never have a system that prioritizes care above all. Such is economically intractable. Imagine millions of immortals with artificial heart/lungs (called ECMO, exists for a long time), artificial kidneys (dailysis), etc, costing LOTS Of econonmic resources per day, living for years. The truth of this transcends government. A communist or socialist government still must confront resource allocation. What we need is something that looks at that efficiency-care-quality tradeoff curve and finds something like the markowitz efficient frontier. Now.. that hospitals operate at such efficiency ought to be a consequent of capitalistic competition even in a for-profit context. The american health system is so crooked and bureaucratic and overpriced, perhaps the most we can do is demand our hospitals be non-profits. Many "non-profit" hospitals seemingly have megabooms in growth, which makes me wonder where the money is coming from to fund the growth, if not profit.
- bruce511 2y ago
  Prioritizing care does not mean everyone lives forever. Hospitals do not have a magic wand to wave. Equally it does not mean unlimited resources. Clearly we live in a real world, and Healthcare will always be resource constrained to some degree. Those who allocate resources still decide priorities, and clearly health becomes balanced with education, justice, military and so on. So perhaps in deciding between for-profit and non-profit it's really a decision between who gets to allocate the resources. Do we prefer people out to squeeze every last dime out of you, or people looking to get re-elected by their constituents?
- Alpha3031 2y ago
  The "prolonged" when used to describe ECMO means days or weeks. Economics are not the problem here, it is currently technologically impossible to provide ECLS for an indefinite period of time without escalating risks of complications, including immediate failure as well as issues that result in death post-decannulation. There have been individual cases where patients were put on such treatments for months and have survived, but it is in fact medically extremely risky and should not be done unless there was absolutely no other choice. "Immortality" through such a means is almost certainly going to kill you within years. Quality of life while undergoing treatment is also entirely non-existent, trust me, you to not want to be "immortal" if it required indefinite ECMO. Unless you enjoy living in hospitals I guess.

solidsnack9000 2y ago

These hospitals are actually subject to regulation, though, and the regulation does not actually condition funding on spare capacity. That's just going to lead to broken results. A completely publicly funded healthcare system without spare capacity requirements would falter in the same way.

cmrdporcupine 2y ago

Our hospitals are not for-profit here in Canada, but they still have clusterfucked emergency rooms. (In some places, probably worse.) There's always some kind of rationing of the limited resource. There it's based in large part on you or your insurance's ability to pay. Here it's based on how much the government/taxpayer is willing to shell out.

quacked 2y ago
Canada has also experienced record rates of recent population growth, so even at historically normal building levels (which are artificially suppressed) there would be a lag time between demand and availability.
- cmrdporcupine 2y ago
  Nah, this is a problem going back to the early 90s, when governments got the neo-liberal austerity thing going. Especially the huge mid-90s cuts to federal health and social transfers to the provinces, by the federal Liberal gov't under Jean Chretien. Health care is the biggest portion of every provincial gov't budget, and always a point of contention.
  - bruce511 2y ago
    The priorities of govt are always the priorities of the electorate. At least until the next election. If one party gets elected on the promise of lower taxes and lower spending, then the people cannot complain when there is lower spending. If the spending gets too low, and health, education, housing, and infrastructure start creaking, well, who's to blame for that?

worik 2y ago

> It's not polite yo say so, but perhaps it's worth considering that a for-profit Healthcare system is not necessarily aligned with a "optimal outcomes" system. Polite? I cannot day Obviously true, but

amy-petrik-214 2y ago

The core philosophical truth of healthcare is you can never have a system that prioritizes care above all. Such is economically intractable. Imagine millions of immortals with artificial heart/lungs (called ECMO, exists for a long time), artificial kidneys (dailysis), etc, costing LOTS Of econonmic resources per day, living for years. The truth of this transcends government. A communist or socialist government still must confront resource allocation. What we need is something that looks at that efficiency-care-quality tradeoff curve and finds something like the markowitz efficient frontier. Now.. that hospitals operate at such efficiency ought to be a consequent of capitalistic competition even in a for-profit context. The american health system is so crooked and bureaucratic and overpriced, perhaps the most we can do is demand our hospitals be non-profits. Many "non-profit" hospitals seemingly have megabooms in growth, which makes me wonder where the money is coming from to fund the growth, if not profit.

bruce511 2y ago
Prioritizing care does not mean everyone lives forever. Hospitals do not have a magic wand to wave. Equally it does not mean unlimited resources. Clearly we live in a real world, and Healthcare will always be resource constrained to some degree. Those who allocate resources still decide priorities, and clearly health becomes balanced with education, justice, military and so on. So perhaps in deciding between for-profit and non-profit it's really a decision between who gets to allocate the resources. Do we prefer people out to squeeze every last dime out of you, or people looking to get re-elected by their constituents?
Alpha3031 2y ago
The "prolonged" when used to describe ECMO means days or weeks. Economics are not the problem here, it is currently technologically impossible to provide ECLS for an indefinite period of time without escalating risks of complications, including immediate failure as well as issues that result in death post-decannulation. There have been individual cases where patients were put on such treatments for months and have survived, but it is in fact medically extremely risky and should not be done unless there was absolutely no other choice. "Immortality" through such a means is almost certainly going to kill you within years. Quality of life while undergoing treatment is also entirely non-existent, trust me, you to not want to be "immortal" if it required indefinite ECMO. Unless you enjoy living in hospitals I guess.