How do I start a Health Care Service such as a hospital?

How do you feel about the dichotomy between health care as a business and health care as a human service?

• How do you feel about the dichotomy between health care as a business and health care as a human service? For example, younger people are often prioritized to receive organ transplants, especially scarce organs. But sometimes an aging alcoholic, someone who made self-destructive choices, might receive a scarce organ because he or she is a celebrity and the publicity that is generated may result in more donations. Does this seem expedient, meaning a good means to an end? Where else do you see a conflict between health care as a business and as a human service? Reply

• Answer:

  The entire American health care system is an example of this. For-profit healthcare means health is business. The nonsense about government "death panels" floated in the American debate is laughable - such "death panels" already exist when insurers make business decisions on who to insure and by how much, a power that's exercised daily by bean counters and refuseniks in "customer care" who are trained to spend the very least possible on their client's claim. When health care is a service (e.g., most of the rest of the developed world, with public health care is similar to public education as a civic right, not a privilege) this rarely happens. It does on the edges of care, eg., new drugs, but no more than in private health insurance who won't spend for such things anyway themselves. More people have died directly as a cause of underinsurance in the States than have ever died in Canada due to service limitations, I'd suggest. We at least try to help people out - private insurance has vested self-interests to say no, and do so regularly. And no, we don't kill our old people for public profit. My aunt just went through cancer treatment. As a retiree from public service, if there were death panels here, she'd be a prime target for extermination - not only saving on health care costs, but pension at the same time. She got excellent service and is in remission. Cost her nothing. They even paid for cab rides to radiation to ensure she didn't drive in a compromised state. Try to get that out of a cut-rate insurance company in the USA. Hell, try to get that out of the better ones.