Usually, however, politicians are much less concerned about the costs of private enterprise transactions. Tax payers are always looking for value, especially in public services. Even when tax payers want health care -- and they usually do for seniors -- they still consider cost control to be an important aspect of that care.

Board members are oriented towards controlling the cost of health care, because when costs are controlled, profits are increased.

Staff members usually have little cost orientation, because they are not involved in the financial aspects of their jobs.

Quality of care within an organized hospital system:

Administrators usually are concerned about the quality of care, in balance with cost. Most organized systems like to offer a high standard of care, as this is a key point of competitive advantage.

Most patients want the highest quality of care possible, because it relates to their health and the quality of life that they will live. Only when cost makes the care prohibitive are patients going to be willing to sacrifice quality.

Physicians typically have no interest in sacrificing the quality of care that they give. They prefer to work without constraints on quality. Given the choice, physicians would maximize quality of care and not worry about the other aspects, aligning their interests closely...

Physicians are concerned about malpractice risk, so prefer to eliminate that.
For all their differences, politicians almost universally seem less concerned about the quality level of the care. They are not in the medical profession usually, so have little knowledge of quality issues, and ultimately the standard of care is not as important a voting issue as the cost of it, or its availability.

Tax payers are likewise not as interested in the quality of care. When the program provides care for free, the tax payer is not as fussy about the care. Tax payers generally prefer there to be a balance with respect to quality and cost, such that paying for the highest-levels of service can only be done when it does not unduly affect their tax bill.

Board members see quality of service as a point of competitive advantage, something to emphasize. They are concerned with profit, so few organized systems want to offer the highest standard of care because they will not be reimbursed to that level. Private clinics usually occupy that part of the market. The Board members of organized systems usually want to offer a high standard of quality, but only when the cost is reasonable. The major quality issue for Board members is with respect to malpractice, which should always be minimized as it can be a major expense for the organization. After minimizing malpractice risk, quality is usually less a concern.

Staff members typically want to offer a high standard of care. Quality is important, and they work hard to achieve high standards of quality in their work. They are less concerned about malpractice, and more concerned about patient outcomes.