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(Circulation. 2004;109:2381-2385.)
© 2004 American Heart Association, Inc.

Mini-Review: Expert Opinions

Doctors and Hospitals

Healthcare’s Rubik’s Cube

Dean J. Kereiakes, MD; James T. Willerson, MD

From The Lindner Center for Research and Education/Ohio Heart Health Center (D.J.K.), Cincinnati, Ohio, and St Luke’s Episcopal Hospital/Texas Heart Institute (J.T.W.), Houston, Tex.

Correspondence to Dean J. Kereiakes, MD, The Lindner Center for Research & Education, 2123 Auburn Ave, Suite 424, Cincinnati, OH 45219 (e-mail lindner@fuse.net) or James T. Willerson, MD, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, Room B524 (MCI-267), Houston, TX 77030-2697 (e-mail suzy.lanier@uth.tmc.edu).

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Nearly all sectors of the US economy (except health care, which accounts for one seventh of the US gross domestic product) are consumer driven on the basis of accepted tenets of quality, cost, and value. Executives integral to corporate success are not prohibited from equity ownership in the companies they direct. Why then, should physicians who are integral to the process and practice of medicine be prohibited by the federal government from equity partnership in the very facilities in which that care is provided? Both this question and its answer(s) are complex. The diverse facets of this problem are examined in the present issue of Circulation by Regina Herzlinger, a Harvard business school professor, and Stanley Hupfeld, the chief executive officer of a nonprofit healthcare system who was specifically chosen to represent the American Hospital Association. Few issues have been more contentious or hotly debated. On one hand are the accepted "American" doctrines of personal liberties, free market competition, and capitalism, while on the other are concerns about "social responsibility," access to health care for the disadvantaged, and the provision of services for which there is no market incentive. Professor Herzlinger admonishes the arbitrary prohibition of physician ownership in subspecialty hospitals and recommends correction of the current disproportionate healthcare reimbursement scheme.¹ Credible arguments made on behalf of social responsibility must take into account that nearly 43 million Americans are uninsured. Similarly, the legislation that prohibits physician ownership does not address Mr Hupfeld’s concerns about poorly reimbursed care for burn or . . . [Full Text of this Article]