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Public vs. Private Non-Profit vs. Private-For-Profit HealthcareResearch Paper

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Profit vs. Non-Profit Healthcare

Within this section, there will be an exploration of the monetary side of healthcare. In the United States, there is a fairly diverse mix of for-profit and non-profit endeavors but the former seems to dominate the latter in many respects. This part of the American healthcare paradigm concerns some people because it raises the possibility of cost-cutting and other monetary choices having an effect on quality of care and costing lives. To help explore this paradigm, the authors have chosen a number of resources that will shed some light on the scholarly perspectives related to the topic in question. Indeed, the opinions in the scholarly sphere are quite varied but many of them sound the proverbial alarm bells mentioned above.

Case Analysis

The first source consulted for the profit vs. non-profit debate actually presciently points out that there are three types of healthcare providers. Of course, profit-based companies are one of the three. However, when it comes to the non-profit organizations, those would include publicly ran and operated agencies as well as private agencies and organizations that are not directly part of or affiliated with the government. This same study came to the conclusion that private-for-profit (PFP) providers seemed to have the worst overall outcomes as compared to the other two types of hospital and healthcare ownership or organization Herrera, Rada, Kuhn-Barrientos, Barrios, 2014). However, the evidence does not all point that direction as a study done in 2012 noted that private-for-profit hospitals in India actually did quite well in terms of patient satisfaction (Kumar, Haque & Tehrani, 2012).

Regardless, another way in which public sector hospitals seem to be different is in terms of the human resources aspect of the business. A study on this subject was centered in Greece. They found that even those employees that did not work for the government's National Health Service directly but rather for a non-profit hospital were generally quite happy with their job status and were generally satisfied (Souliotis, Mantzana, Rekleiti, Saridi & Contiades, 2014). Further, it matters a great deal who is running a non-profit business and this goes all the way up to the Chief Executive Officer. Sass, Liao-Troth & Wonder (2011) noted that there needs to be modicum of what is known as equity sensitivity. Further, people that are known as "benevolent" executives are more likely to seek non-profit positions while "entitled" executives will gravitate more towards profit-based organizations (Sass, Liao-Troth & Wonder, 2011). A related but different point to make is that stated mission statements and what actually happens within an organization may or may not be the same thing. Indeed, state values and underlying values may not be congruent (Vandijck, Desmidt & Buelens, 2007). Further, many profit-based healthcare organizations thrive while many of the people in the same countries struggle (McLaughlin, 2012).

When it comes to compensation and expenditures, for-profit organizations are not the only ones that should be scrutinized. Indeed, there are reports filed with the IRS call Form 900's and they are used to track the highest paid non-C-Suite physicians at non-profit hospitals and other medical organizations. Some of the results of auditing those reports are a bit eyebrow-raising and perhaps unethical for what should be seen at non-profit institutions, healthcare ones in particular ("Highest Paid," 2014). Even so, these non-profits tend to have higher patient satisfaction scores than for-profit hospitals. Indeed, a research study in Finland noted that "clients of the INPO (non-profit) generally rated the service more positively than clients of publicly provided services." Indeed, there seems to be a tiered ranking whereby for-profit is generally not as favored sometimes but government agencies and hospitals would seem to trail private non-profits, at least in this case (Laamanen et al., 2006).

The profit-based hospitals and other centers seem to have the most explaining to do, however. A comparison of dialysis centers showed that educational quality for patients in terms of teaching them their care and so forth varied with the profit performance of the center (Bulhara, Kucirka, Jaar & Segev, 2012). However, the government sometimes applies too much scrutiny to private non-profit groups when the attention is not warranted or fair. For example, the government will sometimes designate some of the money and assets of a private non-profit healthcare organization in a manner known as charitable trust. Indeed, many non-profits abuse their tax-exempt status and pay their executives or physicians entirely too much in salary. However, the Internal Revenue Service and other tax agencies are often inept and they quite often harass and harangue people that are doing no wrong (Peregrine & Schwartz, 2004).

In terms of the overall analysis for this section, the analytical examination of the evidence is started above and will continue here. It is clear from the above (and a lot of other) evidence that while all three systems of healthcare have their flaws, they all tend to thrive in their own ways. Indeed, a lot of innovation comes from private profit-based healthcare companies. Also, many non-profit private companies are doing great things and they are ostensibly dumping all their profits into expansion and improvement of facilities and care. As for the government, they act as the social safety net for the people that cannot provide for themselves due to monetary or physical problems. As for the negatives, some profit-based organizations focus too much on the bottom line. Many non-profits do not allocate and spend their funds the way they should as they sometimes end up paying exorbitant salaries and they enjoy non-tax status all the while. Lastly, many government agencies are not funded adequately and/or are managed poorly to begin with. As for recommendations, non-profits should be allowed to enjoy their non-profit status and do their good work but they should not be harassed and it should not be presumed that they are pilfering money. At the same time, they should be required to be very transparent and noble with what they are doing, why they are doing it and so forth. As for government agencies, that would go double. Money should be well-spent and not wasted. For-profit companies are going to expect to get a profit. This can be a good thing when they spend the money on new innovations but it is absolutely a bad thing when patients suffer.

Issue Background

The literature review above centered on all three types of healthcare organizations but the primary focus of this report would be the private non-profit healthcare organizations. As noted in the literature review, they do get a little too much static form regulatory and tax agencies from time to time. However, they handle much the same level of cash as profit-based hospitals but they pay none of the taxes. While one might assume that non-profit employees would be paid lower and would not be seeking to enrich and empower themselves, this does seem to happen quite a lot at many non-profit healthcare organizations. Of course, the people that work for those groups need to make a living and they deserve to make at least a fairly competitive salary for what they do. However, they are less employees and more servants in the grand scheme of things of they work for an organization that is not paying corporate taxes. Indeed, it is a sad state of affairs when private non-profit hospitals and healthcare organizations are accused of being the ones that are "money-driven" when that accusation is usually levied at the profit-based groups.

Analysis & Solution Building

When it comes to solutions and ways to move forward when it comes to these issues at private non-profit organizations, there are a few suggestions that can be offered

Private non-profit healthcare organizations can and should be audited when their salaries are too high. This can be true when any one (or small group) of people are being paid too much or it can be an issue when too many people in a group are all being paid too much. Indeed, there can be explanations such as the market rate/demand for the people setting that price, the cost of living, etc. However, people that work at non-profits should not be enriching themselves at the expense of those that donate

Any anomalies in reporting (or absence of reporting in general) should always go off as a red flag

The public should be empowered to do their due diligence on the organization before they fork over any money

Politicians should be mindful of what non-profits are doing but they should not pander or otherwise impugn organizations with little to no proof of wrongdoing.

Drawing Conclusions & Making Applications

The authors of this report will be concluding this section with the conclusions drawn and the making of applications. The insights and topics that will be covered will included leadership, organizational integrity, the making of ethical decisions in a complex world, the developing of professional/civic/economic and political perspectives and practices that benefit the common good, how to overcome present-day obstacles and how this report (and beyond) has impacted the individual perspective(s)… [END OF PREVIEW]

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