Is it fair for public institutions to compete?
The Sierra Sun’s My Turn column of July 7, in disagreeing with Tahoe Forest Hospital’s venture into certain areas of private practice, raises a valid question: Is it “fair” for publicly funded institutions to compete in private enterprise?
Historically, the precedent is well established. Consider Northern California several years ago when U.C. Davis used public funds establishing its own HMO to compete with the private hospital systems in Northern California.
On the other hand, is it fair for private practices (or hospital systems) to compete with essential public hospital services? Can this not be viewed as a threat to the public hospital ” hospital with a social contract to support its community’s state of health and well-being?
Looking at the issue a little differently, we might ask whether it is fair to have any public service ” such as access to essential health care ” administered or funded in the private sector. With fewer restrictions on funding, management, and operations, does this not give the private for-profit institution or practitioner an “unfair” advantage?
Our North Tahoe Area, as beautiful and desirable as it is, comes with its own special set of problems. The biggest is that we are under-populated and under-funded relative to the type and quality of essential services we expect to receive and need to provide.
The bottom line for fine public hospitals like Tahoe Forest Hospital is that it cannot limit the funding of its mission to what is dolled by government alone. If it does, it will fail.
The reality is that we must also support our public institutions with private revenue sources and foundation support. Taxes and bonds aren’t enough.
-A further reality is that competition improves the quality of care, just as it does the quality of athletics. This is why American public hospitals and care givers are so much better than those in socialized systems.
But, to return to the original question, it would seem that, community health and welfare being the ultimate concern, in our current system, not only is it fair that public hospitals compete in the private sector ” it is essential.
Lawrence A. Danto, MD, has a practice in Truckee and lives in Northstar.
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