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On the Cost of the Profit Motive in Human Services

cost of the profit motive in human services
“Blue Iris in St. Tammany Parish” by Rick Wheat
Have you wondered about the cost of the profit motive in human services? What is the impact of profit? This week’s suggested readings include essential reports about the influence of healthcare organizations’ profit orientation on the quality of care they deliver. Generally, the bottom line in the for-profit world is profit. Nonprofit organizations’ bottom line is improved lives, not dollar signs. The ultimate lesson here is that an organization’s mission and fundamental motives do matter.

AARP: For-Profit Status Correlates to More Nursing Home Deaths, by Ruth McCambridge, should surprise no one who pays attention to the influence of healthcare organizations’ ultimate motives. Prioritizing profits over lives in human services work leads provider organizations toward a “minimum standards” perspective. Doing more than the minimum costs extra.

A Sign the ESG Movement Is Too Big to Ignore: There’s Backlash, describes the recently growing debate over the “environmental, social, and governance” movement in corporate America. Not specifically related to nonprofits, this comprehensive article tells of the corporate tensions between those who believe in the primacy of the shareholder’s profits and those who hold corporations have a responsibility (perhaps, like all citizens) to the needs of the environment, society, and ethical leadership.

Profit and pain: How California’s largest nursing home chain amassed millions as scrutiny mounted, in the Washington Post is subtitled, “As advocacy groups call for transparency, documents help trace the flow of public money to a complex network of related companies .”Simply put, this is a fascinating article.

This Is Why Nursing Homes Failed So Badly, by E. Tammy Kim, in The New York Times Sunday Review tells of the growing gap between the increasing medical needs of nursing home residents and the level of care generally available in nursing homes.

As “aging in place” becomes an option for more seniors, residents of the 15,400 nursing homes in the U.S., which are certified by U.S. Centers for Medicaid and Medicare, are becoming older, more impoverished, and sicker. This transition is steadily changing the intensity of care residents of nursing homes require.

This New York Times Sunday Review article reports that as nursing homes become “little hospitals,” profits have increased while expenditures on care and staffing are not keeping pace with the increased intensity of care.

The tension between profit for owners and quality of care is not new. Against the background described by these articles, the COVID-19 crisis makes the dynamic between priorities more obvious. As always, mission and primary motives matter.

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