David W. Young, DBA
Professor of Management, Healthcare Management Program, Boston University School of Management
During his 2006 State of the Union address, the President, as many predicted, threw down the healthcare gauntlet. As a result, during the current legislative session (and perhaps the next), we can expect to see some heated debates about how to contain rapidly escalating healthcare costs while simultaneously providing access to the healthcare system for the currently uninsured.
On the surface, the goals of expanding access and containing costs would appear to run contrary to each other, but both can be achieved with a little creative thinking. That creative thinking must address several contentious issues involving cross subsidization that no one has wanted to discuss for decades. Yet, these issues are the dry rot of the healthcare system; until we eliminate (or at least minimize) them, we will not be able to make progress in any meaningful way toward expanded access and reasonable costs.
In this posting, let’s take just one of these types of cross-subsidization: subsidies for nonprofit hospitals. (I'll cover more of these missing elements in the healthcare debate in a forthcoming article in hfm magazine.)
