"There are many well-paid lawyers whose job it is to figure out what this hospital did, but in a way that passes legal muster," he said. "If you're complying with the letter of the law but violating the spirit of the law, what good is that? There is a soft creeping corruption in these arrangements all over the country."
Dealmaking of this type is symptomatic of profit-driven healthcare, Saini said: "We have a system in which hospitals really have to compete for revenue and high-margin business because we treat them like a normal business. But healthcare is not a normal economic activity. There is a fundamental disconnect here."
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Local hospitals that treat large numbers of poor and uninsured patients scored the best in a new national ranking that evaluates hospitals based on their commitment to equity, inclusion and community health. Meanwhile, hospitals owned by some of the area's largest chains, including Northwestern Medicine and Advocate Aurora Health, got lower marks from the Lown Institute, a think tank based in Brookline, Mass.
"As a business person, it makes perfect sense to go where the revenue opportunity is," says Lown President Dr. Vikas Saini. "If you say, go where the rich people are or go where the white people are, it doesn't sound so good."
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Public health experts say that while companies may be legally covered, they still have a high degree of interest in showing a vaccine is effective. “For many drugs, trials are oriented to showing efficacy and a minimal level of safety, then our system allows them to be released into the wild, into the marketplace,” said Dr. Vikas Saini, president of the Lown Institute, a nonpartisan think tank in Massachusetts that advocates for health care reform.
If any of the current vaccine trials show high efficacy there could be political pressure to rush it to market to save lives and help return the country to normal. “We desperately need a vaccine. It would be a game-changer,” said Saini.
“So, what we face is a genuine trade off that is now being distorted horrendously by the politics. We may get a signal of efficacy before we get a signal of safety,” said Saini.
That presents a dilemma for whoever is president. "Trying to time good news results around Election Day for political advantage is not a Trump thing or a Biden thing. That’s what politicians do. And it’s been dirty business long before Trump,” Saini said.
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"For any given individual in the short run, going to Canada is a decent solution, but it's not a systemic solution," says Dr. Vikas Saini, a Harvard-trained cardiologist and president of the Lown Institute, a nonpartisan healthcare think tank.
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