Investors Extracted $400M from a Hospital Chain
propublica.org
propublica.org
Trying to get everyone insurance involves paying for it, which people often don't want to do.
Trying to lower the cost of health care involves working against well-funded companies willing to do anything and everything they can to preserve their profits, even if it requires destroying a few politicians along the way.
All nedical malpractice costs combined, insurance, actual payments, and legal combined, amount to 0.3% of the total cost of health care[0]. That's one-third of one percent. So its not nothing, but it's not the highest priority, either.
That is not quite true. I used to do a lot of shopping at Sears and also Toys"R"Us but the investors pulled the same shit there as well.
It seems that we have an investor class that no longer cares to wait for a day for the golden goose to lay the proverbial golden egg; they will financial engineer that shit to extract maximum value right now.
By the plain language of this, it would apply to privately insured patients as well. No matter how pricey the plan, it's the insurer that controls how much is paid, not the patient -- and their incentives are to promise a lot, and then pay too little to cover it.
So, is a private insurance+hospital system likewise doomed to "go downhill"?
I've witnessed a P/E firm gut a pretty big firm, ship all the tech work to India, layoff most of the SV employees for quick "value extraction".
Something like a time bound window were the principle beneficiaries have to repay their profits extracted, with actual federal prison time as a likely possibility. Wouldn't take too many examples of prosecuting the most egregious folks before the entire sector cooled.
The counter argument is that this action accelerated the 'creative destruction' that capitalism is known for - where weak companies are harvested by the an apex predator for profits before being committed to bones. But I think that ignores the real societal impact of some of these, specifically in this example where marginalized groups have lower access to health care and standards. If we can eminent domain private property to give to private groups (because the extra taxes and jobs are a public good), couldn't we also take a stronger hand in regulating some of these private equity actions because of the destruction of public good (and taxes and jobs, etc?)
Oh, then there's the milk-as-much-as-you-can-from-govt playbook. An example, SL Green, which advertises itself as NY's largest commercial real estate firm, applied for the federal aid package as a "small business".
If a company is truly growing well investors won't mind them taking on debt to grow and not paying dividends. If it's not growing why should it be taking on debt? I would grandfather existing debt, however, to avoid disrupting the market too much.
I would also like to see dividends only able to be paid from profits, period, no grandfather. You didn't make money, you can't pay out dividends.
There’s a reason they never show up in top quality of care lists.
The fact that most for profits ravage safety net hospitals is even more disgusting.
When she worked at the hospital she made them 500k revenue per year as she treated multiple patients at a time. Her clinic is 1 on 1.
Or are you talking about 150-250k in profit?
The next question becomes, does she turn away patients or start to become the hospital system she left and treat for 37 minutes or multiple patients.
She's highly recommend in our area and has started to believe only she can help these kids.
Money is not really a huge topic, but rather time and quality.
Does she have somewhat unlimited PTO? What’s it like having no boss?
Medicare will pay 50$/hr and that's how much a "pick up" Physical Therapist.
The boss thing is a double edged sword.
Cleaning supplies are trivial.
I can't think of anything else. We are considering getting someone to call insurance companies in the future. 40k/yr, but currently she does it.
Part of the blame here lies with the governance of those institutions to continue paying claims to this provider.
No matter what else the hospital leadership did, if they had had those dollars pulled, this problem would have been corrected much sooner.
Being Non-profit does not insulate hospitals from predatory practices.
For-profit hospitals with price transparency may be a better solution than we have now with extreme price gouging.
https://www.opensecrets.org/federal-lobbying/top-spenders?cy...
The healthcare industry protects it's employees and owners at the expense of the customer.
There's nothing capitalistic here, there's nothing scientific about having monopoly control over healthcare services (Physicians, pharmacists).
As a note, I am shooting myself in the foot discussing this, my wife makes 200k/yr as a doctor of Physical Therapy running her own clinic. And her cartel isn't even on that list.
Really? The process of using capital to erode regulatory inhibitions and thus facilitate the accumulation of even more capital and so on in a feedback loop seems to me to be exhibiting the very essence of capitalism.
Albeit not in a good way.
CONs are what are really backing the loans that would otherwise be very unlikely to be available and are what made hospital acquisitions of the type discussed "profitable".
I was involved as representing a large vendor and investor in the hospital that was stiffed by a smaller version of one of these hospital pillagings and got a terrifying inside look at how these deals go down.
I've read there are positive effects of CONs and realize my experience was very limited.
You can read about the positive effects of ingesting mercury if you want to.
What we get is corrupted politicians stealing money from everyone and imposing regulations under the threat of violence and incarceration.
I understand where you're coming from, anti-capitalist often conflate capitalism with government control - but they're completely different things.
The problem is that people with capital inevitably find it more efficient to leverage their capital to eliminate competition, capture markets, and extract value for value's sake.
It takes a lot of government regulation to ensure free markets.
When any organization starts to bleed a large complex human embedded asset, it is gentle at first as they wait for being caught with their destructive life altering behavior. As they continue unexposed they get more bold and sloppy. Today, in American society, it is a free for all raping of any exposed asset servicing any income pool less than the 2%'s protected assets.
I believe this is class warfare, and would be very interested in joining with like minded individuals with peer legal abilities to my advanced technology skills. Let's expose some financial abuse.
Hospitals want to grow and want to stay solvent (regardless if they're for or non-profit). $400 Ibuprofen it is!
Price transparency is one solution for this.
"Hey, we noticed you pay your executives $25 million a year. We decided to cut the executive pay allowance this year."
"Hey, we noticed you're paying your shareholders 50% of your revenue. You seem pretty profitable, so we're cutting your reimbursement rates for all procedures this year."
Such a system is eminently practical. What's not practical is the current US system.
https://en.wikipedia.org/wiki/Aneurin_Bevan
NB I'm not claiming that the NHS is perfect but I suspect most of its problems actually stem from management consultants and politicians rather than medics or patients.
Having experienced healthcare in a few European countries (including the NHS), and having several doctor relatives, I don't think it's a good deal. The cost of healthcare is really high, you pay a lot of taxes, the hospitals are subpar quality, you have to queue / wait for hours / days / weeks / months and the service provided is rationed. The government decide which tests you get to do according to their playbook. Basically if you want something done quickly you need to pay - but you're already paying for public health in taxes. My doctor relatives are often skeptical of the the government provided guidelines on how to treat people, but they still follow them because if you don't you'll be liable for whatever happens.
The most recent and incredible case is the use of corticosteroids for covid patients. My doctor relative and colleagues wanted to use them in some cases but they were told not to and to follow the guidelines. Now that corticosteroids are being recommended, they've been told to don't talk to the newspapers, because they fear people thinking it was a state sanctioned mass murder.
Some more examples of how public health care sucks in everyday life:
- I had an unbearable stomach pain and after self diagnosing myself a range of potential issues (some of which needed tests to be proven) I went to the hospital. At the time I was switching jobs so I didn't have private insurance setup. After waiting for 4hrs the doctor told me that because I was under 40 I wouldn't get any tests done and she told me to go and buy some stomach medicines. The pain was unbearable, so I setup my private insurance, did some test and I ended up having a stomach ulcer which needed surgical treatment. So much for public health care, I could have died.
- My wife replaced teeth fillings via NHS (it's "free" for new moms), we thought it was something simple enough that we wouldn't have problems. So we waited for months for an appointment and got it done. After a couple of weeks the filling fell off - and the same thing repeated three times. Eventually we went back to our usual dentist and she didn't have problems with her new filling.
As for everything else - I literally have no complaints about the treatment anyone in our family has had from the NHS. Of course, other people will have had bad experiences - that is inevitable with something the size of the NHS but I don't.
NB We have neighbours who are NHS doctors who complain about the costs of the German healthcare system - everybody has some problems!
Edit: About a month ago, on a Sunday, my wife got what appeared to be an insect bite that had become infected. She phoned NHS 24, spoke to someone and had to wait for an hour for a nurse to phone back. The nurse said it was best to play safe and arranged a hospital appointment for about 7pm. I drove her to the appointment and she was in, examined by a doctor and out again in about 30 minutes with a pack of antibiotics to take.
Cost: £0 (prescriptions are free in Scotland).
That is pretty typical of my experience of the NHS.
Here you basically have to ask your insurer if they will pay for damn near everything and record the interaction ID otherwise you're getting a supprise bill which are supposedly banned.
Had to deal with this in the last week it is infuriating wasting so much time on hold or navigating through a phone tree.
We should really be making a yellow vest style movement against this just and burn the whole healthcare system down. Unless you work for a select few companies or have the medicaid it's a nightmare to deal with.
Also the problem is we don't give a damn about preventative care and nutrition so you end up with a majority overweight/obese population that you could have prevented with a fraction of the cost in preventative care.