(www.companiesinc.com & other common references)
In the current debate about healthcare, there is a simple question that needs to be asked: where does the real obligation of a publicly traded heathcare provider lie, in maximizing the value to shareholders OR in providing necessary/proper care to subscribers?
In the business of running a for-profit healthcare company, the revenue comes from subscriber payments and the expenses come from providing healthcare services. Now when any of us are faced with a revenue shortfall in our own personal lives, typically one of the first things we look to do is to reduce our expenses, right? Why wouldn't the same hold true for a healthcare company? What's the roadblock that prevents such a company from denying appropriate/reasonable care simply to maximize profits?
I know, I know, the usual retort is one of "well for-profit healthcare providers earn revenue NOT by cutting back on care, but rather by becoming more efficient", which is at least partially true. However efficiency as a concept always curves, meaning that you can never continue to gleam efficiency benefits from a process at a constant rate forever. It's simply not possible, as there are only so many ways that any particular thing can be done "faster, better, cheaper" while maintaining the same rate of quality. What's left is the simple notion that the "real" money to be made in for-profit healthcare lies in finding ways to not provide services, so that the revenue which would have been spent on services is instead returned to shareholders in the form of profits. Sure, these companies can encourage people to be healthier and therefore need fewer services, but that's not nearly as easy as simply denying or cutting back on care. That's not pretty, but that's how business works. The sad part is that most people really don't want to think about this inherent conflict. Personally I've put my money where my mouth is in the issue by not selecting for-profit healthcare providers at work. I want the comfort of knowing that my provider is looking out for me first (not shareholders).
In the end, all of this is summed up in the Gospel of Luke, Chapter 16 verse 13:
"No servant can serve two masters"
More true words have never been spoken.