health care costs (was Soviet and US Economy)

[Patrick Bond]

I think Jay Hecht has got it right here. The overcapitalisation of 
the US health sector -- like the SA private health industry -- is on 
the order of 1/3. But Marxist crits of US health care have focused on 
either the administrative costs associated with fragmentation of 
financing sources (e.g. Navarro) (as did earlier posts in this thread), 
the extent to which the healthcare product has changed with 
technology (O'Connor), the corporate form of health care provision 
(Salmon), or the class character of health services provision (the 
Ehrenreichs). When I had the opportunity to do a year's 
worth of research into the managed care phenomenon in 1995, I 
couldn't locate much of anything drawing upon classical 
Marxian overaccumulation analysis. Yet the need to devalue the fixed 
capital represented by inner city hospitals or teaching/research 
facilities, and in a manner that urgently seeks excessive absolute 
s.v extraction, could not help but lead to a backlash of the 
single-payer form. I think from this analysis it is possible to 
organically link both the production (especially nurses) and 
consumption constituencies, perhaps uniquely...


> Like the RRs from about 1890-1950, the hospitals are saddled with tremendous
> fixed-costs (i.e. rolling stock = beds) that there pricing structure (e.g. DRG
> and other capitation schemes) precludes them from recouping.  In the short
> term, hospitals are trying to reduce the labor content in all services (from
> surgery to bedplans), however, as the lawsuits mount, this strategy will prove
> to be too costly and limited.  There are rumblings from doctors for a single-
> payer system, and it will be interesting to see how the AMA finesses this one!
> 
> Jason 
> 
> Jason  
> 
> 
Patrick Bond
home: 51 Somerset Road, Kensington 2094, South Africa
office: University of the Witwatersrand
Graduate School of Public and Development Management
phone:  2711-488-5917
fax:  2711-484-2729
home phone:  2711-614-8088
email:  pbond at wn.apc.org or bondp at zeus.mgmt.wits.ac.za