Katrina showed that for-profit medical care produces a more dangerous frame of mind

Though I disagree with the conclusion of this post on the blog 'corrente' (the blogger opposes HR 3200 on the grounds that it doesn't include mandating that only non-profit hospitals be allowed to operate; I support HR 3200 because I recognize the difference between what is possible now and what one might wish),

the blogger lays out very clearly the difference in mindset between what happened at two New Orleans hospitals-- one for-profit and the other non-profit in almost identical situations in the days after Katrina four years ago. Both hospitals lost all power, were flooded out and the staff was desperately short having to care both for sick patients who were already in the hospital and others who were arriving from out of the storm.

In New Orleans Memorial Hospital, a for-profit institution that since 1995 has been under the management of the hospital chain TENET, the staff, operating under the for-profit model imposed by management stretched to the breaking point, literally making decisions about which patients were worth saving and which ones had to die so they could care for the others. One doctor, Anna Pou, even was accused of making arbitrary decisions to end patients lives because of the lack of adequate resources during the disaster. Dr. Pou was eventually not indicted by a grand jury given the horrific circumstances she had to work under but nevertheless you did have a single doctor at the hospital making that decision on behalf of patients. Patients awaiting evacuation were assigned to one of three groups, '1,' '2,' or '3' depending on their health. Patients assigned a '1' were the healthiest and were evacuated first. Many of the patients assigned a '3' were the sickest and received little care and were evacuated last. A significant number of them died.

In contrast, at New Orleans Charity Hospital, a non-profit institution that has always served primarily the poor, the goal (achieved almost to perfection) was very simple. It was to save every patient. Both hospitals were evacuated on about the same schedule but at Charity hospital it was the sickest patients, rather than the healthiest who were tabbed to evacuate first so they could be transported to a facility with electricity, clean water and adequate staffing.

Now, it is easy to sit here online four years later and second guess tough decisions that were made in a truly horrible situation (one of the reasons the grand jury declined to indict Dr. Pou for murder.) However, one has to wonder how much previous training and priorities played into it. At Charity the priorities were pretty clear-- save the lives of the patients, and not decide that any one patient was more or less worth saving than any one other patient. At Memorial the mindset was different. Patients could be prioritized, and in an emergency this priority could even extend to the point of hospital staff deciding that some should die so that others might live.

People first or a system in which some are more equal than others when it comes to receiving care? Which kind of health care system would you rather be a patient in?