On Wed, 5 Feb 1997 12:01:55 -0500 Blake Poland
<[log in to unmask]> wrote:


> As many of you know, public-private "partnerships" are one of the
> cornerstones of the Health Services Restructuring Commission, and of the
> Policy Group on Health Reform (1996), on grounds of improved "efficiency",
> "client satisfaction", etc.

Similar government policies are being propagated here in
Victoria (Australia) you may be depressed to know.

> I concede there may be some merits to some private sector
involvement, but
> I'm skeptical of much of the rhetoric of "win-win partnerships", and I'm
> troubled by the openness with which the dismantling of the welfare state is
> being discussed and celebrated.

I think we have to be clear that much of this celebration
is based on the triumph of a particular ideological
tendency and the subsequent increases in the flow of
revenue to particular destinations rather than a
celebration of rational or efficient outcomes.

> This seems all the more disturbing in the light of the revelations from a
> hospital-based physician two weeks ago about backroom administration
> meetings involving the buying and selling of proceedures in order to
> balance the books, and clear cases of the mismanagement or refusal of care
> in order to balance short-term accounts.  Is US-style "managed care" really
> what we want here?

Case-mix funding has been introduced in Victoria and has
produced a number of revelations of officials in hospitals
fiddling the numbers to enhance outcomes and "make the
numbers".

The really scary part of it is that any unbiased
assesssment of the health-care system here would indicate
the development of inequity between the public and private
with the total cost to society increasing rather than
decreasing through "market efficiencies".

A clear contrast was provided in an article in "The
Australian" recently which compared the cost of health in
Australia (approx 8-9% of GDP) versus the US (approx 13%
of GDP) and their health system is not as good or efficient
or equitable as is ours (or was :->).

In summary, the disasterous experience of the US
indicates there is an ABSOLUTE inefficiency in privatising
health care provision.

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Include: Standard Disclaimer -
These views are my own, and not those of my
employer.