The role of public health facilities

My latest Kaiser Health News column is co-authored by Rex Santerre. It’s about the role of health facilities of different ownership types, including public facilities. It begins,

In late August, the Wall Street Journal reported that government-owned hospitals are “drowning in debt” due to high health care costs, high rates of uninsured patients and cuts in public payments. Some government facilities are closing while others are being sold to private-sector firms. These developments may result from normal market competition that tends to drive inefficiencies from the system. But something important could be lost when public facilities disappear from the marketplace: access.

Read the rest here.

It’s worth reminding readers, and myself, that the problems with the U.S.’s current health care system can be organized into three broad categories, those pertaining to cost, quality, and access. The ACA largely focuses on access, though it promises a bit on cost and quality too, just not nearly enough.

I am guilty on this blog and in my work of an almost exclusive focus on cost, a little on access, and almost nothing on quality. And yet, if quality were higher (by which I mean the achievement of better health outcomes) I’d be a bit less concerned about cost. Spending a lot on health care isn’t so much a problem as spending a lot to get so little.

Aaron tells me he’s got a series in mind on quality, to compliment his ongoing one on costs. Looking forward to it! He also tells me we have to do one on access too. Stay tuned …

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