Opinions - On Private Healthcare

 Opinions - On Private Healthcare

I was challenged this morning where someone wanted very passionately to debate the merits of a privatized healthcare setup in Alberta.

I uh. Went off on them.

Their salient point was, "It appears that different facilities charge different amounts. Just like coffee is different prices at different places. My point is that we are not charged for anything else from that coffee place, to get the coffee.

With AHS, we also pay the employees, supplies, hospital fee…"

What I wrote in response follows:

And I'm pointing out that when a private facility does a service, they ALSO are going to factor those costs for employees, supplies, rent, services, utilities into their fee. They just don't have to be transparent about it. When you create a private business, you essentially do so with the aim of making profit. The only ways to get profit are to do so through a blend of believing you can innovate, reducing the amount you pay your staff, or charging the consumer more for any number of reasons. Now I won't disagree that there are probably some efficiencies to find over a government run public setup, but I don't think there are THAT many. The problem exists with the other two. 

To remain competitive, you must pay your staff less. You outsource your staff, you go with non-union staff, you go with less trained staff, you make less staff work more hours for coverage, you coerce staff somehow (like by buying them visas to work in the country and tying them to your organization so they have no choice about where to work or how to work) or you get questionably accredited staff. Often private companies doing theses services don't pay their staff less initially. They pay more, just to entice public workers to private enterprise. But then they aren't unionized. These organizations fight against unionization, they slow the rate of pay raises, they provide bonuses instead of increasing pay (wooo pizza party).

Now you could be innovative, but you can only innovate so far in a medical service industry because the practices are on a timeline that is lengthy when it comes to human trial. You can't simply start inventing new ways to say...cut out cancer...without a great deal of oversight. On the bottom end of 'innovative' when it comes to oursourcing for cheaper product, there's only so far you can go. A bandage is a bandage is a bandage. At some point or another, if you pay too cheaply for a bandage, it may or may not be sterile, or may or may not be appropriate for your patient's needs.

Finally, you can raise prices to make money. Again, like paying staff, you probably don't START with having high prices, you have relatively comparable prices to public services. But at some point, you start raising prices to cover costs. Only all your costs are rolled into that. Unless the government mandates the exact cost for a service (like how pharmacy rates are now capped), you are otherwise ultimately free to charge as you will for things and extras. Because you need to pay for your staff. You need to pay the rent on your building. Those things don't just spontaneously appear. You still have to pay them. And where else to raise that capital except from patients? Now where this becomes unethical is that a lot of medical issues have to do with quality of life, or even worse, with life or death. Now let us make a moral consideration about whether it is ethical to present someone with only x weeks to live a fee schedule, and the friendly caveat that they could 'shop around' if they so saw fit. Shopping around is for cars and dresses. For the price of soup or a new mattress. It is not for when a person is facing down stage 2 cancer treatment and every day could introduce complications.

Remember, unless said private organization is incredibly alturistic, they are in it to MAKE MONEY. They have inserted themselves into the process to raise capital by some means. I posit to you, that inserting a third party between yourself and a medical practicioner like a DOCTOR, is almost never useful. Especially when that third person is EXPRESSLY INTERSTED IN MAKING MONEY. They are in it to make money. Either for themselves, or for their shareholders, or for their owners, or otherwise. You said its an agreed to amount, but right now that agreement is between whom? The facility and the government. The government who has on the sly taken fiscal compensation to side with the facility. So are YOU the patient being fairly represented in this agreement?