Wednesday, May 29, 2002

Some U. S. and Canadian university researchers have done a study (published in the Canadian Medical Association Journal) of American patients to determine whether patients in for-profit hospitals have survival rates as high as patients in hospitals run not for profit. If it weren't for the general neo-con ideology that infects all traditional economics, it should be obvious that hospitals which don't have to lose 10 to 20 percent of their operating revenues each year to profits, and don't have to pay taxes, should do much better at keeping their patients alive. However, the neo-cons insist, in the face of all evidence, and in particular anecdotal evidence in the form of horror stories coming out of for-profit American hospitals (not to mention the universally dreaded HMO's which own a lot of the hospitals and 'manage' their patients to death), that the efficiencies of the market will provide both healthy profits and healthy patients. In fact, despite the fact that patients in not-for-profit hospitals are generally sicker when they go in, they are more likely to walk out alive (there is a 2% difference, which seems low, and the real difference may in fact be higher because of the conservative assumptions on which the study is based). It has been calculated that if the now not-for-profit hospitals in Canada are turned over to for-profit ownership, 2,200 more people a year will die in Canadian hospitals than die now. That is a figure in the general range of Canadian annual death rates from colon cancer, suicide, or automobile accidents. Sadly, you can be sure that the quibbling (here is a good summary of what the quibbling will look like, and here is what the neo-con arguments look like from the most neo-con of Canadian sources) about this study will drown out its common sense, and the struggle of the big American insurance companies to bring the Canadian health care system down to American levels will continue (since the study is based on American data, Americans should also be thinking about how they want their hospitals to be run). The study makes the important point that we have to distinguish the funding source for health care, on which much of the current Canadian debate centres, from the ownership status of the health-care delivery system. Regardless of who provides the money to pay for the system, not-for-profit hospitals will still do a superior job at delivering health care. Canadians are still going to have to fight long and hard to keep the evil (and 'evil' isn't too strong a word) U. S. insurance companies out of the current single-payer system. All Canadian health care delivery options are currently being studied. Even though the whole issue has been opened at the behest of the U. S. medical-pharmaceutical-industrial complex (in my opinion, currently the most corrupt of all the American 'complexes'), there may even be hope for improvement if Canadians can get a national pharmacare system out of the current debate.