Friday, February 15, 2008
Corruption and politics as usual
Should the number of hospitals in Illinois be based upon patient needs, or should hospitals be built based upon political payoffs to government officials?
In 2008, we have already seen a vigorous debate over different ways to expand the government’s role when it comes to our personal health-care options. Many of these debates involve hypothetical forecasts into the future. Here in Illinois, however, we need no such forecasts. We already have evidence of what happens when the government makes decisions over health care, providing us with interesting — and frightening — insight into how an expansion of the government’s role may impact us all.
Let us consider the Health Facilities Planning Board. This is a government-run central planning agency that determines whether or not a health facility or major piece of equipment is needed in a particular community. The rationale behind it is that experts can make the right economic decisions without the wasted efforts of competition. A great analogy to this system would be an event in which all the experts gathered to name the New England Patriots Super Bowl champions without having to play the Giants. The problem, of course, is that the experts are often wrong — even more so in politics than in pro sports — or, as in the case of Illinois, they often just don’t care.
Those who follow state politics closely know that federal prosecutors have long been investigating political insiders for demanding kickbacks from firms doing business with this particular planning board. If a hospital wanted to expand, it was more likely to get approval if the right contractor were used. We’ve already seen one board member convicted and another member was re-indicted last month. This kind of corruption makes for exciting, breathless news stories.
However, there is another, more subtle form of corruption taking place, and it’s just as pernicious and just as threatening to our health and our pocketbooks. It, however, is treated as business as usual. It’s called protectionism. Protectionism is a term we usually use when discussing international trade restrictions to limit competition in business, allowing a protected class of people the right to demand a higher price for goods and services than otherwise would be the case with competition. Quotas or tariffs on steel or sugar are well-known examples. It’s a common practice, but also economically disastrous. Protecting those selling sugar or steel is one thing. But given that health care is a life-and-death issue — not to mention the angst over rising health-care costs — protectionism in this arena is quite another.
Protectionism also exists when an established special interest captures a government agency and uses the power of the state to block competition. Imagine if McDonald’s could petition a government agency to stop any other restaurants or grocery stores from opening in your area. Sound crazy? Well, that’s exactly what happens when someone wants to open a hospital or purchase expensive diagnostic equipment in Illinois.
Edward Plainfield Hospital in Joliet is a great example of this. It has been in a drawn-out battle since 2003 to add 162 beds for the acutely mentally ill and an ob-gyn clinic for underserved mothers and their babies. According to news reports in the Joliet Herald-News, "Rival hospitals in Aurora, Joliet, Bolingbrook and Morris continue to oppose the project."
