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This forum has often
commented on the fact that the rising health care costs and inefficiency in the
health care system is the result of the basic structure of the
system. The United States has a largely private
‘fee for procedure’ system in which the doctors and health care facilities get
paid when they perform procedures and do not get paid when they do not perform
procedures. Does it really take anyone
with more than an 8th grade education to understand why this would
lead to higher costs?
Now a report in the
New York Times illustrates
in very brutal terms just how bad the system is, and how it leads to
billions in wasted money and unnecessary activity.
HCA, the largest
for-profit hospital chain in the United States with 163 facilities, had
uncovered evidence as far back as 2002 and as recently as late 2010 showing
that some cardiologists at several of its hospitals in Florida were unable to
justify many of the procedures they were performing. Those hospitals included
the Cedars Medical
Center in Miami
Were lives put at risk? Absolutely.
At
Bayonet Point, a 44-year-old man who arrived at the emergency room complaining
of chest pain suffered
a punctured blood vessel and a near-fatal irregular
heartbeat after a doctor performed a procedure that an outside expert
later suggested might have been unnecessary, documents show. The man had to be
revived. “They shocked him twice and got him back,” according to the testimony
of Dr. Aaron Kugelmass in a medical hearing on the case.
In
another incident, an outside expert described how a woman with no significant
heart disease went into cardiac arrest after a vessel was cut when a Bayonet
Point cardiologist inserted a stent, a meshlike
device that opens coronary arteries. She remained hospitalized for several days,
according to a person who has reviewed internal reports.
And HCA has a nice
long history of issues like this.
In
2000, the company reached one of a series of settlements involving a huge
Medicare fraud case with the Justice Department that would eventually come to
$1.7 billion in fines and repayments. The accusations, which primarily involved
overbilling, occurred when Rick Scott, now the governor of Florida
And yes, just as you
might expect Bain Capital (without Mitt Romney) plays a role.
In
2006, HCA was taken private by a group of private equityfirms, including
Bain Capital, the firm co-founded by Mitt Romney, the presumptive Republican
presidential nominee. (By that time, Mr. Romney was no longer a partner in
Bain.) By mid-2010, the private equity owners were eager to start cashing out
of their investment. While HCA prepared for an initial public offering of its
stock that took place in 2011, it borrowed to pay the private equity firms $4.3
billion in dividends.
To its credit HCA
uncovered a lot of the problems in an internal investigation.
In
the summer of 2010, a troubling letter reached the chief ethics officer of the
hospital giant HCA, written by a former nurse at one of the company’s hospitals
in Florida
In
less than two months, an internal investigation by HCA concluded the nurse was
right.
“The
allegations related to unnecessary procedures being performed in the cath lab
are substantiated,” according to a confidential memo written by a company
ethics officer, Stephen Johnson, and reviewed by The New York Times.
And the former nurse,
well he got exactly what everyone would think he deserved.
Mr.
Tomlinson’s contract was not renewed, a move that Mr. Johnson said in the memo
was in retaliation for his complaints.
What, you expected
a different outcome!
It Cannot Be Reformed – It Must Be Replaced. I agree. Thanks for sharing. :)
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