Economists on academic medicine: elephants in a porcelain shop?
نویسندگان
چکیده
The nat i on ’ s academic health centers (AHCs) educate and train our health professionals, and many from other nations. They provide cutting-edge tertiary care for Americans and for many desperate foreigners who have lost all hope for relief at home. Finally, they are the locus of the basic and applied biomedical research that advances the state of the art in medicine for the world. AHCs’ highly skilled clinicians and researchers are dedicated and not excessively paid—certainly not by the standards of their intellectual peers in other fields. Furthermore, in a nation whose political leaders have become comfortable with having health care be a private-consumption good to be rationed by price and ability to pay, academic medicine remains the most important champion of the idea that health care is inherently a social good to be made available to all, rich and poor. Academic medicine demonstrates its allegiance to this ethical precept by having become, by default of both public and private health insurers, the cornerstone of the nation’s safety net for the uninsured poor. It is this informal, catastrophic health insurance system that emboldens politicians to assert, with a straight face, that “health insurance is just Washington-speak”—that “to be uninsured” does not mean “to go without care.” Persuaded by the virtue of academic medicine’s three-prong social mission, convinced that the mission was being pursued at worldclass standards of excellence, and excited by diagnostic and therapeutic innovations, both the public and private sectors had for decades shown remarkable generosity toward the profession, trusting that resources allocated there would be spent wisely. For example, it was deemed perfectly acceptable that AHCs would extract sizable profit margins for some of their services to subsidize other components of their social mission.
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عنوان ژورنال:
- Health affairs
دوره 20 2 شماره
صفحات -
تاریخ انتشار 2001