Can you explain this a bit further? From what I can tell, the facility reported in the article is funded by the UAE oil money, some of which is paid to MGB and Dana Farber for consulting purposes. What do you think the hospitals do with that money? They are non-profits, so they aren't using it for stock buy-backs or dividends, they are using it to defray their own operating costs providing care to regular people in Boston. That's a good thing.
I hope you don't think that a not-for-profit designation means that behemoths like MGH/B dont have the army of lawyers and MBAs necessary to make them function quite differently from what the spirit of a non-profit is supposed to be. The leadership of prestigious healthcare institutions has been completely replaced by corporate mindset and strategies, which has led to a few things. The stated goals of the institution rarely fully align with what it is actually doing. These hospitals are not benevolent institutions fully prioritizing how to raise the general level of health of their patients. They have underfunded primary care for decades, underpay primary care workers, have minimal clinic space and support dedicated for primary care, community care, preventive care, but all the while expand expensive specialty clinics which, while valuable to a smaller number of patients, lead to both overexposure to expensive and unnecessary treatments provided to people who dont really need them, and moreover, the marketing of the services of the institution to international audiences, many of whom come and pay cash for these treatments, and often come from disreputable countries. You can sit back, shrug and say, "hey, that's capitalism for ya!", or you can step further back and recognize that this has been a growing trend for many years that was
not always the case, and leads to an erosion of genuine, good faith focus on actual healthcare for the people whom the hospital supposedly serves. The occasional smiley ribbon cutting at the community health centers that the C-suites would love to jettison but cant, since they need them to check the box of "giving back to the community", pale in comparison to investment in extremely costly treatments and shiny new objects that ever and always are surging ahead of the crumbling primary care and basic bread-and-butter work of all specialties, not just medicine (basic general care medicine, neurology, pediatrics, psychiatry is all woefully under-prioritized compared to expensive subspecialty clinics of these same specialties). And of course, you have the overcharging of health insurance costs, which they can do because of their commanding near-monopoly and which the state has recognized as a blatant problem by suing and blocking the acquisition of South Shore Hospital and Hallmark Health (the whole Martha Coakley saga).
Then, you have the absurdity of the leadership salaries, multiple millions for many levels of upper leadership, who took
zero pay cuts during the pandemic despite major funding cuts, complete destruction experienced across all clinical settings with enormous distress for all levels of people actually doing clinical work who had to contend with virus risk compounded by massive staffing cuts and loss of resources, and an ongoing salary distribution amidst a monarchical leadership comprising a legion of overpaid MBAs who make policy by fiat with blissful unconcern for what's happening on the ground. Notice that the residencies joined a union last year—unprecedented for an elite institution to have this happen—meanwhile the primary care docs may unionize as well. Annual reports for 3 years running show job dissatisfaction and burnout scores amongst the rank and file to both be in the high 30%s/low 40%s. These numbers are stunning.
None of this is unique to this institution but reflects a deeper process playing out across healthcare and higher education as well, which has identical problems just slightly different configurations. None of this means that people who work at these places are bad people, either. But the overall process and the overall leadership cannot simply hide behind the same old shrug of "well, it's just really
complicated" any longer. I would say this all speaks to the even deeper crisis of late stage capitalism, the failure of neoliberalism, and the ongoing (and what could have otherwise been preventable) rise of right wing politics across the western democracies.
Anyway, rant aside, maybe I can put it more simply. Call me crazy, but I dont think any hospital in the USA should be consulting for—ie, getting money from—a futurist and assuredly elitist (not for "the people") healthcare city development in a country that only passed legislation in 2020 that a woman isn't legally obligated to "obey" her husband and where women still are legally required to maintain the home, whereas real work is done by imported labor who endure racism and structural oppression via the kefala laws (look these up if you want, it's beyond insane), and where technically, homosexuality is punishable by death even though in reality things are enlightened enough where you'd just get fined or jailed. Yay.
This development is not building the BMC or Bellevue of Dubai. It's a shiny, sleek, expensive palace for international medical tourism. In a country with severe human rights abuses. MGH and BWH, the hospitals of MGB, are Harvard hospitals. These people know better. It's not OK, and the fact is that this little consulting gig is a string you can pull on and out tumbles the cupidity-driven rot of the modern supposedly non-profit system.
www.massgeneral.org
