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Feds probing psychiatric hospitals for locking in patients to boost profits

arstechnica.com

11–20 of 89 posts

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#11
post #3

A great example of how for-profit healthcare (or anything else) can fail. Corporate entities have an obligation to do whatever they can legally get away with in order to maximize profits. They do not have a prerogative to benefit society, or help human beings apart from what they choose to do. Every country has to decide whether the benefits of privatisation of the various services outweighs the societal costs caused…

Public psychiatric institutions suffer from the same problem though, because the salaries of the employees running the institution are dependent upon a consistent occupancy.

There's a difference though- if their boss finds out that they did this, in the private sector they'd be rewarded, and in the public sector they'd be fired.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#12
post #11

Earlier quoted context omitted.

Public psychiatric institutions suffer from the same problem though, because the salaries of the employees running the institution are dependent upon a consistent occupancy.

There's a difference though- if their boss finds out that they did this, in the private sector they'd be rewarded, and in the public sector they'd be fired.

That's a pretty bold assertion, do you have any basis for it?

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#14
post #7

Private prisons profit from recidivism (rather than rehabilitation) just as psychiatric "hospitals" do. Though at least in a private prison, you know how long your sentence is, it is an objective measure. When imprisoned in a mental asylum, you don't know how long you will be in there for , because your release is dependent on the subjective whim of those who stand to profit from the continued occupancy. There are no…

This is why there needs to be third-party monitoring, with enormous penalties for misconduct. Public or private, there is no way to make sure this isn't happening unless a hostile party is watching everything.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#15
post #3

A great example of how for-profit healthcare (or anything else) can fail. Corporate entities have an obligation to do whatever they can legally get away with in order to maximize profits. They do not have a prerogative to benefit society, or help human beings apart from what they choose to do. Every country has to decide whether the benefits of privatisation of the various services outweighs the societal costs caused…

Public psychiatric institutions suffer from the same problem though, because the salaries of the employees running the institution are dependent upon a consistent occupancy.

Not really. Public sector employees aren't as incentivised to maximise profits for their employer as private sector employees are. This ultimately makes some public services superior because the employees have no reason to pretend you are are walking wallet instead of a human being.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#16
I'm a psychiatrist, and there are a few things to consider about this story:

1. The bulk of people in a psychiatric hospital are there voluntarily. They can walk out the door at any time.

2. When a patient is in a hospital involuntarily, their stay is subject to state laws about involuntary hospitalization. This, as far as I know, universally requires 2 independent professional opinions that a patient is actively suicidal, actively homicidal, or overtly incapable of taking care of themselves to the point it puts their health at risk.

3. Psychiatric stays are generally very short (less than 5 days), despite the fact that most medications don't start working that quickly. Stays have become unrealistically short.

4. Despite the general outcry about involuntary hospitalization, most family members of a person with a severe illness will tell you that they struggle to get their loved ones admitted even when the situation gets dire.

5. Again despite the outcry, a number of states have been expanding the liability of psychiatrists for the actions of their patients. For example, if my patient were to hurt themselves or someone else, I can expect years of depositions and lawsuits. This does not justify hospitalizing someone who does not need it, but does speak to a double standard about our role in protecting society.

THIS LIABILITY STILL APPLIES WHEN AN INSURANCE COMPANY TELLS ME THEY ARE GOING TO STOP PAYING FOR HOSPITAL TIME 2 DAYS AFTER SOMEONE TRIED TO HANG THEMSELVES. If I release them, it's on me. If I keep them, they face huge bills even if they have insurance. This sucks.

6. MOST IMPORTANTLY, WITHOUT INVOLUNTARY COMMITMENT MANY PATIENTS GO TO JAIL OR PRISON. I work in correctional settings. The decline in psychiatric beds is strongly correlated with the spike in mentally ill people behind bars. Without an avenue to get them treated, they end up getting arrested for their behavior, when they should have gotten treatment instead.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#17
post #3

A great example of how for-profit healthcare (or anything else) can fail. Corporate entities have an obligation to do whatever they can legally get away with in order to maximize profits. They do not have a prerogative to benefit society, or help human beings apart from what they choose to do. Every country has to decide whether the benefits of privatisation of the various services outweighs the societal costs caused…

And if you want to see examples of how government run healthcare (or anything else) can fail, just look at the history of atrocities of public psychiatric hospitals.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#18

Earlier quoted context omitted.

Public psychiatric institutions suffer from the same problem though, because the salaries of the employees running the institution are dependent upon a consistent occupancy.

Not really. Public sector employees aren't as incentivised to maximise profits for their employer as private sector employees are. This ultimately makes some public services superior because the employees have no reason to pretend you are are walking wallet instead of a human being.

The history of public institutions has shown otherwise.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#19
post #3

A great example of how for-profit healthcare (or anything else) can fail. Corporate entities have an obligation to do whatever they can legally get away with in order to maximize profits. They do not have a prerogative to benefit society, or help human beings apart from what they choose to do. Every country has to decide whether the benefits of privatisation of the various services outweighs the societal costs caused…

Public psychiatric institutions suffer from the same problem though, because the salaries of the employees running the institution are dependent upon a consistent occupancy.

Not to anything like the same manner and extent. In almost all public systems the salaries are dependent upon political considerations first and actual demand is a long way down the list - the system tends to be underprovisioned and demand rarely falls unless there is mass exodus from an area.

Re: Feds probing psychiatric hospitals for locking in patients to boost profits

#20

I'm a psychiatrist, and there are a few things to consider about this story: 1. The bulk of people in a psychiatric hospital are there voluntarily. They can walk out the door at any time. 2. When a patient is in a hospital involuntarily, their stay is subject to state laws about involuntary hospitalization. This, as far as I know, universally requires 2 independent professional opinions that a patient is actively sui…

Correction: psychiatric stays are generally very short with private insurance, and months long with state insurance. May vary with the level of corruption in your area.
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