Profit Motive in Health Care - Essential, Immoral, or ???

[Makalakumu]

With the health care reform debate raging in the US, I'd like to start a discussion about for-profit health care systems. Is the profit motive essential for new technologies? Is charging money to save lives and/or treat sick people immoral? Or are there some other reasons we should consider or not consider for-profit health care systems?

 

[elder999]

With the health care reform debate raging in the US, I'd like to start a discussion about for-profit health care systems. Is the profit motive essential for new technologies? Is charging money to save lives and/or treat sick people immoral? Or are there some other reasons we should consider or not consider for-profit health care systems?

The profit motive is no more essential for new technologies than it is for new artwork, or novels, or anything creative. It does help grease the tracks in the form of devlopmental funding, but it's not essential: devlopmental funding can and does come from a variety of sources. more to the point, in the area of medicine we often see the "profit motive" leading to less than desirable outcomes, as in the rushing of "bad drugs" to market.

Charging money is the medium of exchange for our society-there is nothing immoral in charging money for services. The usurious profits of the health industy are almost wholly the result of corporate gouging: by the pharmeceutical industry and, most especially, by the insurance industry. It's especially interesting when one considers the insurance industry, which not only is responsible for health care payments for the majority of Americans, but for the cost of malpractice insurance-an additional financial strain on the system. Couple this with corporate control of medical facilities-very often by insurance providers-and you have a defacto shared monopoly of monstrous proportions.

 

[Bill Mattocks]

With regard to R&D, I completely agree with Elder on this.

Profit can indeed bring huge sums of money to bear on problems, which often stand a good chance of then being solved.

Government funding can do the same thing, with the same result.

The problem for both is what gets funded.

Private industry would fund that which it believes it can get the best return on. That means low-cost, common, or non-patentable cures are of no interest to them. Rare conditions which few people have are of no interest to them. What they want to invest in are cures and treatments for problems many people have, which can be dealt with by use of new and expensive drugs or treatments, which can be patented and profit extracted from. Diabetes research is a case in point.

Government funding funds that which politicians, lobbyists, and moneyed constituents find important, which means that politically-charged areas get more funding, and those which are not politically 'sexy' get less. There is no system of putting money where the problems are without regard to politics, because politicians control the funds. AIDS is a case in point.

No good answers.

 

[Steve]

Here in Seattle, the Fred Hutchinson Cancer Research Center operates as a non-profit organization largely on private donations and public grants from the NIH, if I'm not mistaken. Their work is cutting edge.

 

[CoryKS]

Neither essential or immoral, really. If someone has a product, they can give it to you or they can sell it to you. Their choice. If they sell it, they need to price it at a level where people will actually buy it, otherwise they've accomplished nothing.

But here's the thing - you can't force someone to produce something if they don't want to. So it's irrelevant to ask whether profit should be a motive. Either it is or it isn't. The important thing is to identify what it is you want, who has the ability to provide you with it, and what do they want in exchange for their service? If they want money, that's what you give them. If they want more money than you're willing/able to spend, you do without or find a way to allocate funds toward the purchase. Or you can use the government to take the money from other people, which is the increasingly popular approach.

 

[Steve]

Neither essential or immoral, really. If someone has a product, they can give it to you or they can sell it to you. Their choice. If they sell it, they need to price it at a level where people will actually buy it, otherwise they've accomplished nothing.

This is a very different argument then the one made in another thread that, without profit, there would be no innovation.

 

[CoryKS]

This is a very different argument then the one made in another thread that, without profit, there would be no innovation.

There can be some, but not nearly to the same degree that you would have when profit is a motive. Even non-profit organizations derive their success from the profit motive. The organizations themselves may not be making money, but the people they employ do.

 

[elder999]

There can be some, but not nearly to the same degree that you would have when profit is a motive. Even non-profit organizations derive their success from the profit motive. The organizations themselves may not be making money, but the people they employ do.

As I said, money is the medium of exchange for our society. The people they employ make money to live, generally-this is not a "profit" motive, which is more about gain

From the usually excellent Merriam Webster's English Language Technical Manual (that's engineerspeak for dictionary):

Main Entry: 1prof·it
Pronunciation: \ˈprä-fət\
Function: noun
Usage: often attributive
Etymology: Middle English, from Anglo-French, from Latin profectus advance, profit, from proficere
Date: 14th century

1 : a valuable return :gain
2 : the excess of returns over expenditure in a transaction or series of transactions; especially : the excess of the selling price of goods over their cost
3 : net income usually for a given period of time
4 : the ratio of profit for a given year to the amount of capital invested or to the value of sales
5 : the compensation accruing to entrepreneurs for the assumption of risk in business enterprise as distinguished from wages or rent

Indeed, many "non-profits" do, in fact, make a "profit"-these excesses are simply reinvested in their endownment. An example would be the Santa Fe Opera. Many other non-profits in the arts are in the same position-though not lately, of course.....

 

[CoryKS]

As I said, money is the medium of exchange for our society. The people they employ make money to live, generally-this is not a "profit" motive, which is more about gain

From the usually excellent Merriam Webster's English Language Technical Manual (that's engineerspeak for dictionary):





Indeed, many "non-profits" do, in fact, make a "profit"-these excesses are simply reinvested in their endownment. An example would be the Santa Fe Opera. Many other non-profits in the arts are in the same position-though not lately, of course.....

Making money to live is a profit motive.

 

[elder999]

Making money to live is a profit motive.

Simply living is not a gain. While it is a motive, it is not a profit in the strictest sense of the word.

Otherwise, why are so many in debt to do so?

 

[CoryKS]

Simply living is not a gain. While it is a motive, it is not a profit in the strictest sense of the word.

Otherwise, why are so many in debt to do so?

Of course it is. Unless you're suicidal, every day you manage to keep yourself alive is a gain.

 

[elder999]

Of course it is. Unless you're suicidal, every day you manage to keep yourself alive is a gain.

There is no gain in collecting welfare, or social security, or disability-though some might mistakenly equate it with getting something for nothing, and see it that way. There is no gain in working for Walmart. There is no gain in being homeless-where many, many, many people (200,000 schoolchildren alone) are managing to keep themselves alive.

 

[CoryKS]

There is no gain in collecting welfare, or social security, or disability-though some might mistakenly equate it with getting something for nothing, and see it that way. There is no gain in working for Walmart. There is no gain in being homeless-where many, many, many people (200,000 schoolchildren alone) are managing to keep themselves alive.

That's what I'm saying, there is a gain. It's called keeping your *** alive. Gain is relative, and I'm sure they'd all love to have money in the bank, but the bare minimum is to have not died. If you have accomplished that task one day further, you have gained. To say otherwise is to take way too many things for granted.

 

[crushing]

Simply living is not a gain. While it is a motive, it is not a profit in the strictest sense of the word.

Otherwise, why are so many in debt to do so?

People making a living often use their 'profits' to purchase a few TVs, maybe two gaming consoles, cable or satellite TV, a couple computers, cell phones, internet access, MP3 players, a couple cars, leisure activities such as golf or maybe MA, restaurant dinners, wine, beer, and more. Sometimes they even put some of the 'extra' money away for a rainy day or into an emergency fund.

 

[elder999]

That's what I'm saying, there is a gain. It's called keeping your *** alive. Gain is relative, and I'm sure they'd all love to have money in the bank, but the bare minimum is to have not died. If you have accomplished that task one day further, you have gained. To say otherwise is to take way too many things for granted.

To call simply staying alive under the most mundane of circumstances a "net gain", is taking credit for way too much.

People making a living often use their 'profits' to purchase a few TVs, maybe two gaming consoles, cable or satellite TV, a couple computers, cell phones, internet access, MP3 players, a couple cars, leisure activities such as golf or maybe MA, restaurant dinners, wine, beer, and more. Sometimes they even put some of the 'extra' money away for a rainy day or into an emergency fund.

Or a boat, or extra vehicles, or a second home,(or a plane!!!) and that, provided they aren't making those purchases on credit, is profit.

Simple sustenance or subsistence, the basics: food, clothing, shelter-should not be considered "profit" or "gain," but basic needs.

 

[CoryKS]

To call simply staying alive under the most mundane of circumstances a "net gain", is taking credit for way too much.

It is if someone else is footing the bill.

 

[elder999]

It is if someone else is footing the bill.

And I said that some might see it that way....

 

[crushing]

http://www.cnn.com/2007/US/Careers/05/16/cb.profit/index.html

"The great majority of non-profit organization executives do not earn six-figure salaries with substantial fringe benefits," King writes. "Because the chief executive's salary establishes the top pay scale in the organization, most career positions in the non-profit sector cannot compete monetarily with those in the business sector."

I've heard it claimed that the best and brightest people don't get into politics, because it doesn't pay enough. Could that also be the case for non-profits?

It seems to me, in healthcare anyway, one of the most noble causes would be to provide services to the war veterans that so bravely served our country and the place to do that would be the in the VA. Based on the awful and chilling news that has come out from the VA in recent months, it doesn't appear that the VA is attracting those people.

Please don't take my question above as disparaging those that work hard and diligently for non-profits. I know people that work hard trying to make a difference, also I am an unpaid elected officer of a non-profit organization. While I do my best in my capacity, I probably wouldn't be hired into a for profit organization of a similar size doing what I do for the non-profit. Fortunately for me, I also have a paying job at a Fortune 500 company for which feel that I am well qualified.

 

[Dirty Dog]

Speaking as someone with roughly 30 years experience in healthcare (ER/flight nurse) let me just say that the idea that medical care should be non-profit is ludicrous.

On the hierarchy of needs, food, water and shelter are FAR more important than medical care. And yet, I don't see anybody suggesting that Wally World should be required to give away food free, or that they ought not make a profit, nor that the mortgage companies should stop making a profit.

 

[Makalakumu]

I am a certified Wilderness First Responder. Next time I'm on trail, if someone is in need of aid, should I demand that that they pay me first? Lets say I come across someone who is going to die unless I provide some kind of aid. Should I demand that this person enter into a contract with me to pay me before I help him? Should this be a demand at anytime during this process?