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Nonprofit hospitals spend billions on consultants with no clear effect

uchicagomedicine.org

51–60 of 84 posts

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#51
post #15
post #10

Not to be glib, but is there any industry where management consultants have been shown to make a statistically significant difference either way?

In, fire 30% of the workforce, new logo, out. You are now a fully trained management consultant. (Alan Johnson, Peep Show)

In the good old time you at least had to spend some time coming up with the inspirational slide deck to explain the meaning of the new logo! Now even that part has been automated :(

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#52

Earlier quoted context omitted.

Do for-profits become altruistic when corporations get tax breaks? Edit: I’m replying to the “reasonable one” point.

Not sure why this would matter. You know that implication is directional, not symmetric, right? To be more explicit: Given that for-profits can be given tax-breaks for (hopefully) good reasons, what would be the reason to give non-profits tax-breaks, if not for altruism? After all, as you point out yourself, you can get tax-breaks also as a for-profit, so you don't need non-profits just for that reason.

I’ll ask my mother if I was dropped on the head as a child.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#54

Earlier quoted context omitted.

Not sure why this would matter. You know that implication is directional, not symmetric, right? To be more explicit: Given that for-profits can be given tax-breaks for (hopefully) good reasons, what would be the reason to give non-profits tax-breaks, if not for altruism? After all, as you point out yourself, you can get tax-breaks also as a for-profit, so you don't need non-profits just for that reason.

I’ll ask my mother if I was dropped on the head as a child.

Oh, I am sorry if that was the case. I amended my answer to be more explicit, as I already anticipated that you are not into logic.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#55
post #49
post #45

Earlier quoted context omitted.

Why should there be any profit in healthcare.

Why should it be illegal to help people for profit? That is what doctors do, they profit a lot when they help people, they could live on much smaller salaries than they currently have but of course market economics makes it so we want to pay doctors higher salaries than they really need.

I think you’re addressing a different point than the person you responded to. They are asking for a positive argument regarding why healthcare itself should make a profit. That doesn’t imply banning profit, or that doctors aren’t compensated at market value

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#56
post #49
post #45

Earlier quoted context omitted.

Why should there be any profit in healthcare.

Why should it be illegal to help people for profit? That is what doctors do, they profit a lot when they help people, they could live on much smaller salaries than they currently have but of course market economics makes it so we want to pay doctors higher salaries than they really need.

People don't seem medical services because they want to, they do it when they need them. It is the only industry where there price list might as well be replaced with "we will take as much as you can afford". No one can afford to be stingy with money with health and live of their loved ones on stake. It is very asymmetric situation, so it is clear to me why someone would want to ban for profit hospitals.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#57

Earlier quoted context omitted.

Assuming that non-profits are altruistic seems fallacious. Granted, I don’t know why they are assumed to be by some; it’s just presented as such because it seems obvious, no arguments need to be given. It’s clearly fallacious to assume that non-profit is altruistic just because, I don’t know, for-profit is assumed as a premise to be about egotistical money hoarding.

I think the assumption about non-profits being altruistic is a reasonable one, because what would otherwise be the justification for giving them tax breaks? If the reality is different, then maybe there shouldn't be non-profits anymore. In the UK for example, there are no non-profits, there are only charities. And clearly, the expectation of altruism is explicit here.

There are non-profits in the UK. Some of these structures are over 100 years old at this point.

Expectations are completely irrelevant. Charities steal, in the UK the largest charities are essentially run as private companies except the shareholders are employees. Same thing with government, there was a unit of the government that spun out to a "non-profit" structure, some of the civil servants ended up becoming shareholders, and they now lobby their friends in the civil service to use their services...afaik, the government is still their only major customer and they were at, for example, all the pandemic meetings. Just generally, the UK has a vast network of these organizations that have a significant role in government policy but are totally outside the government (this is also true, actually even more so, in devolved countries...to a large extent, government policy there is formed by unelected private institutions).

There are no real rules here beyond humans act self-interestedly. No structure will contain this. This happens in for-profit companies with shareholders too. Principal-agent problem.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#58
The whole premise of 'for-profit' healthcare stinks to high heaven. Regardless of hospitals calling themselves 'non-profit', they behave like profit seeking enterprises. This is the ultimate corporate double speak.

The bottom line is that - people do not get to choose their illness. So a capitalist model in Adam Smith's sense where people get to 'choose' their 'insurance' based on price and benefit is an illusion. It would be like having identical futures contracts on a commodity from different brokers with the only difference being the commission structure. The underlying product is the same and in fact regulated by law.

Legally, are non profits allowed to do mergers and acquisitions ?The hospitals are becoming monolithic monopolies.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#59
post #49

Earlier quoted context omitted.

Why should it be illegal to help people for profit? That is what doctors do, they profit a lot when they help people, they could live on much smaller salaries than they currently have but of course market economics makes it so we want to pay doctors higher salaries than they really need.

People don't seem medical services because they want to, they do it when they need them. It is the only industry where there price list might as well be replaced with "we will take as much as you can afford". No one can afford to be stingy with money with health and live of their loved ones on stake. It is very asymmetric situation, so it is clear to me why someone would want to ban for profit hospitals.

Nothing you said there is related to for profit hospitals, I live in Sweden and we also have for profit hospitals here, wanting to ban for profit hospitals is just stupid. There have been many in Sweden who want to ban profits in healthcare so that you can't go and get a private doctor, do you really want to do that?

If you want to make progress in USA you must separate the crazy left from the moderate left, if you defend the people who want to ban private medicine then you aren't going anywhere. Those aren't your allies even if they pull in a similar direction, even if they sit in the same party in the two party system.

Re: Nonprofit hospitals spend billions on consultants with no clear effect

#60
post #55
post #49

Earlier quoted context omitted.

Why should it be illegal to help people for profit? That is what doctors do, they profit a lot when they help people, they could live on much smaller salaries than they currently have but of course market economics makes it so we want to pay doctors higher salaries than they really need.

I think you’re addressing a different point than the person you responded to. They are asking for a positive argument regarding why healthcare itself should make a profit. That doesn’t imply banning profit, or that doctors aren’t compensated at market value

> They are asking for a positive argument regarding why healthcare itself should make a profit. That doesn’t imply banning profit, or that doctors aren’t compensated at market value

That is what it implies, there are many in the world who want to ban for profit healthcare and end pay discrimination between jobs. Nobody would ask that question in earnest, its just a rhetorical question to make a point.

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