Future of Healthcare

Should Hospitals Be Public Utilities?

September 4, 2013

Would you write a check to a charity that pays its top executive $3 million a year? Does that charity really need your money?

You turn on the faucet and scoop up a cool splash of water onto your face.

How’d the water get to your faucet?

For most, the water got there via a public utility, a regulated business serving all comers. Regulated rates. Run by bureaucrats with bureaucratic salaries. Or, in some places, run as a public department. Again with regulated rates. Run by bureaucrats with bureaucratic salaries.

Recent news reports have revealed that some non-profit hospital CEOs have received up to 40% increases in salary over the prior year, with some CEO’s compensation hitting the $3 million mark.

Perhaps all hospitals should be public utilities. Controlled profit. Open not only to all patients at regulated rates, but open to all physicians who qualify for staff privileges. Or, if not public utilities, at least facilities with open medical staffs.

Maybe hospitals as utilities is the wrong approach. Perhaps they should be non-profit cooperatives, with physician members. Or perhaps they should be like state courthouses, open to all licensed physicians in the way that all members of the bar can appear in court. Or what if they continue to operate in the current fashion, but with an absolute prohibition on the corporate practice of medicine — a true wall between healthcare facility and physician?

I don’t know how I think about this. I certainly don’t believe that the provision of healthcare professional services, as opposed to the factories in which healthcare professional services are sometimes delivered (i.e., hospitals), should be regulated nearly as much as it is now.

So, I’m not lecturing. I’m not even giving my opinion (for once). I’m just thinking out loud.

What do you think?

But something is broken here. I think we should view it as a healthcare crisis. A real one this time.

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