I've had the 99.9% of my experience with hospitals in Houston, so when I think of "public" hospitals, the first one to come to mind would be Ben Taub. I realize they've cleaned up their act some over the years, but overall, that place is a warzone and no one I know would ever elect to go there. Perhaps there are some government-run hospitals in the U.S. that are good, but in my experience, I have not seen them.
The type of patients entering the hospital do matter to some degree. If the patients coming into the hospital cannot afford to pay for their care and are, for lack of a better word, criminals (I realize homeless individuals aren't breaking the law, but drug pushers and pimps/hookers are), it's never too long before violence tends to erupt. In Ben Taub, for instance, it's not uncommon to see people walking in holding firearms or even, at times, taking a pot shot at one another. You'd be hard-pressed to see this at a private institution in an upperclass area.
As for hospitals making money... yes, the main reason hospitals exist is to house the sick while they are being treated. However, they must receive funds from somewhere. Unless they are being completely subsidized by the government, they need to gain income from patients using their facilities. It costs a lot to run a hospital -- how do you think they make use of their medical technology and employ their large staff, which is needed to work around the clock? If a hospital can't make a profit, it will ultimately be forced to shut down and then no one gets care. I fail to see how that benefits society.
The type of patients entering the hospital do matter to some degree. If the patients coming into the hospital cannot afford to pay for their care and are, for lack of a better word, criminals (I realize homeless individuals aren't breaking the law, but drug pushers and pimps/hookers are), it's never too long before violence tends to erupt. In Ben Taub, for instance, it's not uncommon to see people walking in holding firearms or even, at times, taking a pot shot at one another. You'd be hard-pressed to see this at a private institution in an upperclass area.
As for hospitals making money... yes, the main reason hospitals exist is to house the sick while they are being treated. However, they must receive funds from somewhere. Unless they are being completely subsidized by the government, they need to gain income from patients using their facilities. It costs a lot to run a hospital -- how do you think they make use of their medical technology and employ their large staff, which is needed to work around the clock? If a hospital can't make a profit, it will ultimately be forced to shut down and then no one gets care. I fail to see how that benefits society.
I live in a physician-centric world so my frame of reference will likely be different than yours. I agree with what you say about some public hospitals. VA hospitals are some of the worse. The Walter Reed embarassment is still fresh in my mind.
I know of shootings inside hospitals in DC (actually inside the OR) so I know what you say about the violence extant in some hospitals.
My biggest concern (the GAO as well) about private hospitals is not in the staff or necessarily the physicians, it is management and concomitant waste. Who do you think actually pays for it? A hospital should not make a profit, if at the end of the day all costs have been accounted for then that's fine. How many nurses or lab techs equal the salary of one CEO? I know the answer but then again, I've seen the exact figures. Who else has? If the argument is proffered that without a motive for profit there will be no more hospital construction, I would remind those who make such contentions that there will always be a need for the greater good and the tax breaks in medically underserved areas ameliorate any such concerns.
If that doesn't work, just build a Starbucks in the lobby.
