While healthcare lobbyists search for more reliable sources of support for medical research and charity care, local providers need to reach out. A good place to start is by developing creative philanthropic and gift-giving programs that support these two virtuous components of healthcare.
The issue is becoming more important because of managed care's grip on healthcare, which is sapping these two great strengths of the healthcare industry.
Managed care's cost containment, productivity goals and for-members-only mentality translate into less financial support for science and fewer pro bono hours for physicians to serve the poor, according to two recent studies published in the Journal of the American Medical Association.
The findings shouldn't surprise hospital and health system executives who have been involved in hotly contested negotiations with managed-care plans. Health managers also realize that the federal government's drive to trim Medicare spending makes it more difficult to cost-shift and cross-subsidize social goods.
In one study, the Center for Studying Health System Change estimated that physicians who derived 85% of their incomes from managed care were significantly less likely to provide charity care and services than those less dependent on managed care.
In the other study, a Harvard Medical School-led team of researchers said academic medical centers in cities not greatly affected by managed care, such as Atlanta and Chicago, provided 6.1% of the total research funding awarded to faculty members. But in more-competitive markets, such as San Diego and Minneapolis, the academic hospitals contributed just 2.5% of the total research budget.
Providers have limited options for responding to these stiff challenges. But administrators should not ignore the strong public support for medical research and the real concern for the sick and needy in their communities.