I am often asked why, if health care is a business, Golisano Children’s Hospital needs to raise funds for what, in other arenas, would be called “operations”. “After all,” people say, “other corporations don’t ask the public for donations to pay their employees or to buy their equipment and supplies. Why should a hospital need to do so?”
I suppose health care is, at some level, a business. But it is not solely a business and it does not operate by the same market forces that govern other business enterprises in the U.S. There are three fundamental differences between children’s health care and most businesses that drive the critical need for your generous donations.
First, we cannot allow the financial balance sheet to be the only determinant of the services we offer to the public. If a manufacturer sees that a particular product does not sell well enough to offset the cost of its production, that manufacturer can decide to discontinue production of that product. But imagine going to a hospital with your child and being told that, while there is a treatment for your child’s condition, we cannot provide it to your child because it costs more to provide than we can recoup from your insurer.
Second, public demand cannot be the only driver of the services we provide. Most children are healthy. Most important contributions to child health are preventive and drive down demand for “high-end” health care services. Unlike the case for adults, most preventive and screening health care in children does not involve a procedure or sedation or a hospital stay. This is by design because it is in the best interests of children. But this means that the costliest components of child health care – the PICU, the surgeries, the new imaging modalities like PET-MRI scanning, the genetic therapies – are low-volume, low demand propositions. But imagine going to the hospital with your critically ill child and being told he or she cannot have the test or procedure called for because it was not sufficiently in demand to warrant its continuation.
Finally, we alone do not set the charges for our services or reap all of the direct financial benefits of the wonderful work we do. The equation for determination of charges and receipts for health care services is indeed extraordinarily complex in the current fee-for-service environment. And who knows how much longer fee-for-service will be the order of the day! In addition, if we are the very, very best pediatricians and we prevent any child from getting ill, we make or save health, workforce effectiveness, and, yes, money for the community at large, but not for our “business”!
The bottom line, as any of the Miracle Makers and Miracle Kids in this issue can tell you, is that we need you and are so very grateful to you for giving us the ability to do what we do for all of our children. As you read about each of our wonderful children and families, ask yourselves how many of them would still be here today – healthy and happy – if they had to depend on market forces to fund the seeds for their recoveries. As we plan to build a children’s hospital for today’s and tomorrow’s children, we honor our Miracle Kids and their families and our Miracle Makers, and ask that each of you give whatever you can to ensure the health of our community for many, many years to come.
All the best,
Nina F. Schor, MD, PhD