Academic journal article Frontiers of Health Services Management

Response from a Feature Author

Academic journal article Frontiers of Health Services Management

Response from a Feature Author

Article excerpt

There is general concurrence among all of the authors of this issue that not-for-profit hospitals are no more likely to disappear than are for-profit hospitals. We also agree that for NFPs to survive, they have to act as a for profit and provide the services that the free-market economy will support. The by-product of this for-profit approach is that certain services that the community might need might not be financially feasible for the NFP to provide-hence the public policy debate regarding care to the uninsured.

The key product that NFPs provide is perfectly stated by Valenti when he says that "The most basic fundamental of healthcare is access." I offer the thought that NFPs provide access in many situations where a for profit would not. That in and of itself fulfills the NFP's mission and serves the taxpayer. If an NFP doesn't offer a service that the community might need, it doesn't change the fact that the NFP is providing access.

I firmly believe in the NFP model because I know that the advantage provided by their tax status allows NFPs to routinely go where no for profit would go. I also know that NFPs are more focused on their local communities than are for profits for both philosophical and market reasons.

Yet, the underlying theme to this discussion goes beyond good business operations to care for the uninsured. This is a complex problem and the "easy" answer will be difficult if not impossible to implement. For example, many people have postulated that the American healthcare system is inefficient and that if we wring out these inefficiencies, we could fund more services. Many of these people suggest that a single-payer system would generate these efficiencies.

Absolutely, a single payer can be more efficient if the single payer has one plan, one set of rules, and no need to market its services. …

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