Monday, July 28, 2014

Lambert Strether — Money vs. Mission: How Generic MBAs vs. Physicians Think about Health Care

Lambert here: Many of us still think of the medical system as a source of health care enabled by MDs, much as many of us still think of the university system as a source of education enabled by professors. That is, both institutions have considerable “good will” on what we might call society’s balance sheet (were society to have such a thing). In health care, as in education, MBAs trained in the ways of neo-liberalism are busy transforming that good will into institutional power for themselves and profits for their masters. Of course, neither institution will be able to function well for long with a degraded product and without “good will” (we might also use the word “trust”) but by the time society comes to that realization “I’ll be gone; you’ll be gone.” This post explains how MBAs are crapifying health care in detail from a physician’s perspective. 
By Roy M. Poses, MD. Originally published at Health Care Renewal.
This has been in the works since the Eighties, concurrent with Reaganism. I wonder if there is some connection with neoliberalism? Again, another example of money and machines over people and the environment, and why neoliberal capitalism is antithetical to popular democracy.

Naked Capitalism

7 comments:

Matt Franko said...

"According to the AHA, about 18 percent of U.S. hospitals are private, for-profit hospitals, while 23 percent are owned by state and local governments. The rest are private, nonprofit facilities. This means they're exempt from federal income tax—and often other taxes as well."

http://healthnetpulse.com/broker/2013/10/11/did-you-know-for-profit-versus-nonprofit-hospitals/

I guess that 18% is somehow able to control the prices for care delivered by the other 72%.....

????????????

Tom Hickey said...

Not the price but time that physicians spend with patients. My sister-in-law was a psychiatrist and she was complaining about this shift decades ago.

I saw it as professor, too. Faculty senates used to have a lot of say in administration but that's over for some time with "professional" administrators in charge.

Tom Hickey said...

In the new admin jargon, doctors and professors are "providers." that is, commoditized.

Matt Franko said...

Tom,

"Time is money..." according to these MBA people...

http://www.youtube.com/watch?v=8Moh7DXMk8g

;)

And these MBA people and the govt people also think "we're out of money!" so accordingly the time has to be cut back... simple...

rsp,

Tom Hickey said...

Right. Providers are costs and the low-hanging profit comes from cost cutting.

A friend of mine was an operating room nurse for a long time and loved it. They a new hot-shot CEO was hired and he changed the shift from eight hours to twelve hours to "increase efficiency."

She quit, saying it was putting patient's health at risk. This was state non-profit hospital. The "savings" went toward the new CEO's expanded compensation package.

Matt Franko said...

Same thing going on wrt top-heaviness with universities imo Tom... only there the students are having to pick up the increased tab with the big student loans.... in healthcare the "payers" are just refusing to pay...

I dont see us getting out of this as long as these people keep believing "we're out of money!"...

From the "Piketty perspective" could your friend just kept working the 8 hour shift but we could have just raised her taxes so that she ended up making the same net $/hr as the 12 hr shift and she would have been ok with that?

My hunch is not... these "providers" if you will all just want to be paid decently for what they do like anybody... if the "payers" are all morons and all think "we're out of money!" this becomes the problem across the board imo....

Not necessarily a "neo-liberal MBA conspiracy" unless to get to be a neo-liberal person you have to also be a card carrying member of the Debt Doomsday Club and think "we're out of money!"...

I can see legitimate uses for MBAs in healthcare if they are looking at outcomes/$ to gauge comparitive efficiency between systems for instance ie "doing things right"... which is one of the reasons for employing a system of state currency in the first place... but of course not as hatchet-men for morons which is how I have to look at Lambert's piece here......

rsp,

Tom Hickey said...

She got out of it due to her concern with safety. She was already concerned with no time leash on doctors, some of whom work 18 hrs straight in the operating room.