[R-G] if Canada went with for-profit hospitals it would add $7.2 billion to the public health care bill

[aaron at istop.com]

Dear friends... An excellent and politically powerful study has just been 
>published by the Canadian Medical Association Journal. It shows that if 
>Canada went with for-profit hospitals it would add $7.2 billion to the 
>public health care bill. 
> 
>It is getting almost no media attention. 
> 
>Given that Stephen harper has indicated he will open the door for for-profit 
>hospitals (Martin will too, he is just being coy) the  key results of this 
>study MUST get out there in every forum you can think of: all candidates 
>meetings, talks shows, letters to the editor, challenging candidates at the 
>door, demanding of editors that they cover the story. News release and 
>backgrounder below. 
> 
>You know what to do...start by sending it to your lists... 
> 
>cheers, Murray 
> 
>For the whole study referred to below go to: 
> 
>http://www.cmaj.ca/content/vol170/issue12/index.shtml and click on public 
>"health" 
> 
>or go directly to: 
> 
>http://www.cmaj.ca/cgi/search?andorexactfulltext=and&resourcetype=1&disp_typ 
>e=&sortspec=relevance&author1=+Devereaux.+&fulltext=&pubdate_year=&volume=&f 
>irstpage= 
> 
> 
> 
>Canadian Medical Association Journal 
> 
>Press Release & Backgrounder (June 7, 2004) 
> 
> 
>Health Care costs more, delivers less at investor-owned 
>private for-profit hospitals, major study finds 
> 
>TORONTO, June 7, 2004 - Canadian governments would pay an extra $7.2 billion 
>in annual health care costs if Canada switched to investor-owned private 
>for-profit hospitals, according to a major study to be published in the 
>Canadian Medical Association Journal (CMAJ) tomorrow. 
>The research builds on earlier findings released in 2002 by the same 
>McMaster University research group that revealed higher death rates in 
>investor-owned private for-profit hospitals and kidney dialysis centres in 
>the United States. 
>"Our previous study showed the profit motive results in increased death 
>rates, and this one shows it also costs public payers more," said Dr. P.J. 
>Devereaux, lead author of the study. "With for-profit care, you end up 
>paying with your money, and your life." 
>The systematic review is based on a study of over 350,000 patients between 
>1980 and 1995 who were treated in private for-profit and not-for-profit U.S. 
>hospitals. The study found that care cost the patients 19% more at 
>for-profit hospitals. In an accompanying CMAJ editorial Drs. Steffie 
>Woolhandler and David Himmelstein from Harvard University described the 
>systematic review and meta-analysis by Dr. Devereaux and colleagues as, 
>"meticulous." 
>"Patients pay more for care at investor-owned for-profit hospitals because 
>the for-profit hospitals have to generate revenues to satisfy investors, 
>high executive bonuses, and high administrative costs," said Dr. Devereaux. 
>"Not-for-profit providers charge less for care because they do not have 
>investors and have lower executive bonuses, and administrative costs," he 
>adds. 
>The results of this review are directly relevant to Canadians for three 
>major reasons: 
>·? The statistically significant higher payments for care at a wide range of 
>investor-owned hospitals spanned a 12 year period, despite significant 
>changes to the American health care system 
>·? The results were demonstrated among both publicly funded patients and 
>among privately funded patients. 
>·? If Canada moves to for-profit hospitals, the same large American hospital 
>chains included in the review would be purchasing Canadian hospitals. 
>"Health care is a central issue of the federal election campaign. As well, a 
>number of provinces have allowed for-profit surgical facilities and 
>radiology facilities and the Conservative party advocates a permissive 
>stance with regards to investor-owned private for-profit health care 
>facilities," notes Dr. Devereaux. 
>"Our results should raise serious concerns about moves to private for-profit 
>care, whether in hospitals, day surgeries, or other outpatient facilities. 
>Evidence strongly supports a policy of not-for-profit health care delivery." 
> 
> 
> 
> 
>- - - - - BACKGROUNDER - - - - - 
>Study: Payments for care at Private For-Profit and Private Not-For-Profit 
>Hospitals: 
>A Systematic Review and Meta-analysis 
>Advocates of investor-owned private for-profit health care delivery argue 
>that the profit motive optimizes care and minimizes costs. However, some 
>fear for-profit facilities are more likely to respond to financial pressures 
>by cutting the quality of care and charging more to maintain shareholder 
>returns. These viewpoints have resulted in a heated debate. 
>An experienced research team from McMaster University conducted this study 
>to determine the impact of the profit motive on costs to patients or third 
>party payers - that is, insurance companies, or governments. The current 
>study builds on prior work by the same McMaster University research group 
>that showed higher death rates in investor-owned private for-profit 
>hospitals and kidney dialysis centres in the United States than comparable 
>not-for-profit facilities. 
>When discussing our health care system it is important to distinguish 
>between funding (who pays for our health care) and delivery (who owns and 
>runs our health care facilities). Currently, hospital services in Canada are 
>publicly funded - we pay through our taxes. In terms of delivery, although 
>commonly referred to as public institutions, Canadian hospitals are almost 
>all private 
>not-for-profit institutions owned and operated by communities, religious 
>organizations, and regional health authorities. 
>The debate concerning for-profit versus not-for-profit provision centers on 
>delivery: whether we should introduce investor-owned private for-profit 
>health care facilities into our dominantly private not-for profit health 
>care delivery system. This study compared how much care cost in U.S. 
>for-profit versus not-for profit hospitals. 
>The study used a methodology called systematic review and meta-analysis 
>which synthesizes the results of existing high quality studies that all 
>address a single question, in this case: "is there a difference in payments 
>for patient care received at private for-profit compared to private 
>not-for-profit hospitals?" The research team developed explicit criteria for 
>deciding whether a study was eligible; conducted a comprehensive search to 
>identify all relevant studies; applied eligibility criteria to potentially 
>eligible studies in an unbiased manner; examined the quality of the eligible 
>studies; and conducted a rigorous statistical analysis of the data from the 
>studies that ultimately prove eligible and of adequate quality. 
>In this case the McMaster team identified 7,500 medical articles through an 
>extensive search. Over seven hundred of these passed an initial eligibility 
>screen. The team then undertook an extremely important measure to eliminate 
>bias in the selecting which studies to include in the systematic review. The 
>team trained research staff to read through all the articles and use a black 
>marker to obscure the results of the studies. Two reviewers then dependently 
>examined these articles with the results blacked out and determined study 
>eligibility. As a result of this process the researchers could not select 
>studies to reach a specific conclusion. Eight studies including data on over 
>350,000 patients met eligibility and quality criteria for the systematic 
>review. Given the approach the investigators took, it isn't surprising that, 
>in an accompanying editorial in the Canadian Medical Association Journal, 
>researchers from Harvard University described the systematic review and 
>meta-analysis as "meticulous." The results show that care costs health care 
>payers 19% more at for-profit than not-for-profit hospitals. Canada 
>currently spends $120 billion annually on health care, and hospital care 
>accounts for 32% of overall expenditures. Therefore, if Canada switched to 
>investor-owned private for-profit hospitals the Canadian governments would 
>pay an extra $7.2 billion in annual health care costs. 
>Why do investor-owned for-profit facilities cost payers more? Private 
>for-profit facilities have to generate profits to satisfy shareholders, pay 
>high executive bonuses, and have high administrative costs. Not-for-profit 
>providers do not have investors and have lower executive bonuses, and 
>administrative costs. In their editorial, Harvard researchers Woolhandler 
>and Himmelstein provided an additional explanation: greed. 
>The U.S. results are directly relevant to Canadians for three major reasons 
>·? The statistically significant higher payments for care at a wide range of 
>investor-owned hospitals spanned a 12 year period, despite important changes 
>to the American health care system during this time 
>·? Payments proved greater in for-profit facilities among both publicly 
>funded patients and among privately funded patients. 
> 
>·? If Canada moves to for-profit hospitals, the same large American hospital 
>chains included in the review would be purchasing Canadian hospitals. 
>This systematic review shows substantially higher payments for patient care 
>at private for-profit hospitals. Combined with the previous two studies that 
>showed higher death rates in private for-profit hospitals and dialysis 
>centres, this research raises serious concerns about moves to private 
>for-profit care. Evidence strongly supports a policy of not-for-profit 
>health care delivery. 
>