Going public, and private
Collaboration proves effective and can even lead to some lofty results
When it comes to basic research and development, trying to get complex science-based projects off the ground, what’s the most effective and efficient approach to doing business—through the private sector or the public sector? It can be a polarizing question that for some will evoke an ideological response, especially from those who believe it’s always best to get government out of the way (no more Solyndras!) and let free enterprise go to work.
The simplest answer is that “it depends.” But what has proved to be a successful formula, especially in healthcare, is a combination of both sectors in the form of public-private collaborations. And it’s a model all industries will need to employ more often as “public” resources get stretched ever thinner.
One arena for ongoing public-private partnership is the subject of this week’s special report (p. 28) by reporter Jaimy Lee. She discusses private efforts by hospitals, health systems, foundations, insurers and others to draw more attention to prevention/wellness initiatives and public health. They continue to see promise in these efforts to chip away at the healthcare cost spiral, something that seems resistant to remediation.
But the providers certainly aren’t doing all the work on their own. Yes, they are making sizable investments, realizing that their responsibility for population health is only going to grow in this new era of accountable care. Boston-based Partners Healthcare System, for instance, has set a goal of committing just under $1 million to support programs that promote exercise and access to healthier foods.
At the same time, the federal Prevention and Public Health Fund, created under the Patient Protection and Affordable Care Act, has allocated more than $2 billion to help finance such efforts and is slated to provide billions in additional funds over the next 10 years, dedicated to community prevention, clinical prevention, infrastructure improvement and educational programs.
Also in this issue, Modern Healthcare Washington bureau chief Jessica Zigmond reports on another public health challenge where because of diminishing resources, public-private cooperation has become essential: dealing with the increasing incidence of psychiatric cases being handled in the nation’s emergency rooms (p. 32).
As one expert says, “In the mental health arena, we had the public mental health system and the private system—they used to operate individually. But as the public system contracted, it put more pressure on the private system, which shows itself” in the emergency department. Here again there’s an interdependent relationship that’s proving crucial to ensuring that patients get proper treatment in the proper setting.
Finally, last week brought another high-profile example of public-private partnership, this one quite far outside of the healthcare universe—the successful launch of the first privately built and operated rocket designed to ferry cargo to the International Space Station. And if all goes as scripted, the Spacex capsule could eventually transport astronaut crews to the station.
While the achievement was touted as a private-sector milestone, the company certainly benefited from federal seed money through Nasa—about $400 million so far—according to published reports. The company isn’t the only private contractor vying to offer the next shuttle service into space, and its technology still faces plenty of rigorous tests before it’s on a clear trajectory toward commercial success. But the victor in this race stands to land multibillion-dollar contracts. Then the feds can stop writing checks to the Russians every time this nation needs to hitch a ride into orbit.
There should be little doubt that public-private partnerships—by sharing expertise and financial resources, and with the proper fiscal safeguards—can be one of the best ways to achieve liftoff for many worthwhile enterprises.