tazzygirl
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Joined: 10/12/2007
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~FR
The following article, i think, hits the nail on the head of the health care issue...
Health Care, Greed and Aesthetics
I recently read an interview with the health researcher Avedis Donabedian just before he died from cancer. Donabedian was the founder of the process-structure-outcome model of assessing quality in health care that is standard fare these days. In the interview he mostly waxed philosophical on the dominance of the profit motive and economic models applied to health care, where the idea that somebody can make money in health care without actually supplying care themselves struck him as "perverse, as a kind of racketeering."
Along those lines, Bruce Vladek, a former HCFA director and a speaker at SLHI's February 2001 conference on employer-based health insurance, noted that the CEO of one of the country's leading health plans made $8 million last year, while the head of Medicare, which covers literally millions more people than any commercial plan, made a tiny fraction of that amount.
At that same conference, Mark Pauly, a leading health economist, expressed his great belief in "the forces of greed in American capitalism" as the antidote to excessive and inefficient government regulation and control.
But what is greed? Eight million a year for a CEO? Drug company profits at two to four times the average of other industries? One million plus in salary for a heart surgeon at a popular boutique hospital?
At some point excessive profit and greed become poor form. They may not be illegal - and they are accounted for by understandable market forces - but the aesthetics are not morally pleasing. This point is easier to draw in, say, sports and entertainment, where even even the average fan ridicules the $20 million salaries of certain ballplayers. It's harder to draw in a field like health which, like education, is viewed as a public good, and therefore operates under a different set of public expectations and values than the private, for-profit business world.
Whether health care ought to operate under a different set of expectations and values is, of course, the issue.
Instead of continuing to swim upstream in the murky waters of social justice and make arguments for the redistribution of social goods on the basis of fairness and equity, it would be interesting to begin a public discussion on the aesthetics of health care: the attributes of sensibility, taste, style and values that comprise "good form." I wonder whether it's even possible anymore to make aesthetic judgments in the public realm, but by framing the debate on resource allocation along some continuum of what is aesthetically pleasing - as distinct from what is fair or legal - we might find more agreement on a set of standards and expectations than we think.
As for myself, I'm not sure it's not fair that a health insurance executive can make $8 million a year when millions can't afford health insurance. But I do find it to be in poor taste.
http://www.slhi.org/publications/drift/11_01_2001.shtml
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RE: A simple idea about healthcare - 
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