Editorial Note: Excerpt from an article, republished from Rizospastis, January 13 – 14, 2024.
A revealing example from the USA
Recently, the Journal of the American Medical Association (JAMA) – one of the journals with the largest reach indicators worldwide – published an article entitled:
The subject of this particular article is the relationship of privatization to in-hospital complications (eg, central venous line infections 1 , surgical wound infections, thrombosis, etc.) and patient mortality. According to the authors, “in the landscape of expanded hospital privatization, questions are raised about the quality of services provided, given that private capital’s motivation is to generate profit quickly to recoup the loss from the initial investment (financial returns of investment)” .
Data from this survey were drawn from 51 private and 259 “non-private” hospitals in the United States of America and constitute the first large-scale record of its kind 2 . It should be noted from the outset that within the fragmented and very expensive healthcare system of the USA, the so-called “non-private” hospitals, which are also mentioned in this particular study, belong to insurance companies, organizations, NGOs, etc., operating completely commercially (with patient payments, etc.), while the private ones are bought directly from businessmen – shareholder investors.
In essence, this article compares the results of privatization with those of privatized privatization, that is, the criminal consequences of each subsequent step of strengthening the cost-benefit logic in Health are captured. Regardless of the intentions of the authors of this particular study, which may also echo the rivalries between different segments of capital or who will secure a larger share of the Health market pie, valuable insights can be gleaned about what Health – a commodity means.
The final sample consisted of 662,095 hospitalizations in 51 private hospitals and 4,160,720 hospitalizations in the corresponding 259 control hospitals and covered the time period from 2009 to 2019. The majority of the study hospitals were hospitals (88%) with 150 – 350 beds. Adverse events occurred in 10,091 hospitalizations.
In the USA
- A 25% increase in in-hospital adverse events was observed, mainly attributable to a 38% increase in infections associated with central venous lines, despite the fact that fewer (by 16%) central lines were placed.
- Surgical wound infections doubled in the private hospitals, while they decreased in the control hospitals. In fact, the increase in surgical-related infections occurred while fewer surgeries (by 8%) were performed in private hospitals.
- Nosocomial infections and other complications increased in private hospitals and compared to pre-privatization levels.
- There was a relatively small reduction in mortality but this is explained by the fact that younger and lower risk patients were admitted since the most seriously ill were treated in other hospitals and many were discharged with reduced hospital days (comparisons are inevitable since during the COVID-19 pandemic , and while the public health system was sinking, private clinics were accepting patients who had almost recovered).
Among other things, the authors conclude: “In light of the reduction of staff in private hospitals, in the context of the cost reduction strategy, the observed increase in adverse events can be explained. This factor seems to play a prominent role” .
1. A central venous line or central venous catheter is a special flexible catheter that is inserted into a large vein and is a route for drawing blood, intravenous medication and other services. It is a form of venous access that can stay in the patient for weeks or months
2. According to data from the Health and Human Services, 30 million Americans did not have health coverage in the first half of 2020, while according to research by the Foundation for the Promotion of Health Care Commonwealth Fund, among the eleven richest OECD member states, they have the worst healthcare system.