NEWS CLIPPINGS 1997
Largely but not exclusively Columbia/HCA
Samples from many recent newspaper
-- illuminating the corporate health care model --
Between March 1997 and November 1997 there was increased media coverage of the misconduct and allegedly fraudulent conduct of US corporate medicine. This intensified after the raids on Columbia/HCA facilities in July 1997. Reporting and analysis of Columbia/HCA's practices dominated the media but other operators also received attention. Large numbers of press reports including the articles listed here were soon in the hands of relevant politicians and medical associations. Because I realised that large volumes of material would not be read it was my practice to write a covering overreview indicating the content and the significance of the press clippings which I sent. This is simply a copy of that overview. The exercise was in order to show the extent of corporate fraudulent practices, the concerns being raised in the USA and the analyses being performed in the USA.
Introductory remarks -- a front page -
some considerations regarding this material
Hospital giant plans Australian network (Weekend Australian 8/2/97)
US health giant gets out of our hospitals (SMH 3/4/97)
These two articles describe the arrival of
Columbia/HCA in Australia on 8 February 1997 and its departure only 8
weeks later. During this time large
numbers of documents became widely
available in Australia. A group of doctors visited the USA and
Big move on to uncover health care fraud Modern Healthcare August 20th 1997
Columbia/HCA Probe Chronology August 7, 1997 New York Times
Changes at Columbia-HCA Have Wide Ramifications August 8, 1997 New York Times
3 States Probing Columbia/HCA By The Associated Press Aug 97
Hospital Giant, Under Attack, Plans a Shake-Up of Practices August 7, 1997 New York Times
PATIENTS VS. PROFITS Houston Chronicle Interactive 19/8/97
Columbia/HCA Profit Pressure Blamed The New York Times Business September 7, 1997
THE RISE AND FALL: DESPITE YEARS OF WARNINGS FROM COLLEAGUES, THE AGGRESSIVE AND OFTEN ARROGANT LEADERSHIP OF RICHARD SCOTT WOULD LEAD TO COLUMBIA'S TURMOIL Modern Healthcare Sep. 8, 1997
Columbia/HCA Ponders Hospital Sales October 10, 1997 By The Associated Press
COMMENTARY: PHOENIX OR BUZZARD?: WILL COLUMBIA REALLY END ITS PREDATORY WAYS? IF SO, WHAT WILL WALL STREET THINK? Modern Healthcare Sep. 8, 1997
EX-CEO SUES COLUMBIA: WOMAN CHARGES SHE WAS FIRED FOR REFUSAL TO BREAK LAW Modern Healthcare Nov. 10, 1997
TWO STATE REPORTS HIT STAFFING AT COLUMBIA HOSPITALS Modern Healthcare Sep. 15, 1997
Columbia Plan Would Recast Health Care [The New York Times Business] November 18, 1997
Columbia/HCA Said to Settle Tax Case for $71 Million December 3, 1997 New York Times
These are sets of 1997 newspaper reports
describing the FBI's massive fraud investigation and the practices
which gave rise to them. This initially targeted Columbia/HCA, the
largest health corporation in the world. The investigation is now
moving to target other fraudulent corporations. The revelations
follow massive raids by the FBI on Columbia/HCA's facilities across
the USA. They confiscated truck loads of documents.
$100 Million Settlement Seen in Tenet Suits July 30, 1997 The New York Times
For-Profit Care's Human Cost August 8, 1997 The New York Times
A Canadian province has sued Tenet Healthcare May 9 edition of the Contra Costa Times
These articles describe Tenet/NME's recent US
$100 million settlement of actions taken against it by patients. Past
patients describe the way they were mistreated in corporate
hospitals, confirming accounts given by doctors to inquiries in 1992.
The Canadian action relates to paying bounty for patient referrals to
Canadian bounty hunters.
Hospital firm to pay $12.6 million UPI Spotlight) 23 July 1997
SmithKline faces suit. Modern Healthcare Aug. 25, 1997
I have many articles documenting fraud and
related settlements by other large health care corporations in the
USA. I include only two. The first relates to the third largest US
corporation, OrNda Healthcare and involved kickbacks to doctors. It
was paid by Tenet/NME which merged with OrNda in 1997. SmithKline
Beecham which paid $325 million to the US government in a "no
wrongdoing proven" settlement operates in Australia.
COMMENTARY: MONEY, MEDICINE AND ETHICS: THE DOCTOR-PATIENT RELATIONSHIP MUST BE SHIELDED FROM INFLUENCE OF MARKET FORCES Modern Healthcare July 28, 1997 Page 24 - Opinion
An invited commentary in this corporate
journal sets out the obvious, but corporations have never taken any
notice of comments like these.
Columbia/HCA Profit Pressure Blamed New York Times 7/9/97
An analysis of the conflict between profits
Comparison of Florida Community not-for profit hospitals and Columbia Facilities Dec 1996
These are not newspaper reports. They are the
summaries of one of the few reliable comparisons between leading for
profit hospitals as represented by Columbia/HCA and community not for
profit hospitals. The for profit hospitals compare very poorly. They
are made by an independent group of lawyers experienced in this and
are based on information gathered by the government.
Health fraud costs billions in US Brit. Med J. vol 130 p 823 1/4/95
This describes the 1994/5 US senate inquiry
into aged and nursing care chaired by Senator Cohen. Sun Healthcare
which recently became the major shareholder in Alpha Healthcare in
NSW is a major provider of aged and nursing care. I do not know if it
was mentioned in the senate report. Sun is the only large US
corporation operating in health care in Australia.
Texas Department of Insurance report on Kaiser - March 1997 -- two pages only
The report recommended a $3 million fine (for denying care) but I understand Kaiser paid only $1 million. Kaiser tried to suppress publication of this damning report on a technicality but the court rejected this.
HCFA Report Criticizes Kaiser Hospitals - I think this is reprinted from Modern Healthcare
This describes the state investigation which
followed patient deaths. The poor standards revealed caused the
closure of two hospitals in California. The investigation has now
been extended to other hospitals in California. These things have all
occurred in spite of hospital accreditation procedures. A US
investigation has found that many of the accrediting bodies are owned
or funded by corporate medicine. Even the JCAHO, the world role model
was found to be in the corporate pocket. The main role of
accreditation was found to be for corporate marketing and not for
patients. Sadly this is the reality of health care controlled by
corporate might. Representative Stark is pushing legislation through
the US congress to terminate the control of accreditation bodies by
Bankrupt psych chain settles fraud charges Modern Healthcare 10/11/97
Snippet from www
Doc group blasts Aetna Modern Healthcare 5/12/97
Smith Kine Pays millions to settle charges of fraudulent Medicare billing - Nurseweek 23/8/97
Note the companies which are listed Vendell Healthcare, Community Psychiatric Centers, Charter Medical Corp., Hospital Corp of America, SmithKline Beecham and National Health laboratories. Add to these Tenet/NME, Columbia/HCA, OrNda and a number of others whose names I don't have at hand. The government and the FBI's prime concern is defrauding medicare, but a constant theme in most of these allegations is the attempt by corporate businessmen to pay kickbacks to doctors, or alternately provide other illegal and unethical inducements. These are in return for patient referrals, pathology requests and other "team player" activities. What is clear is that a very large number of doctors in the USA have been willing participants in these practices. The evidence emerging indicates the adverse consequences for patients.
It is not productive for us in Australia to be critical of our colleagues. Corporate practices are presented in a very plausible way by corporate executives who all receive incentives themselves. The public is generally unaware that this is the way business operates. My accountant whom I believe gives me independent advice gets a kickback for referring me to a financial consultant. At least they disclosed this to their customer. Health corporations don't. Doctors increasingly live and think in a corporate business world. Large numbers are doing MBA's and management courses. Once a few accept creeping incentives, the whole process becomes "normalised". We are already happy with expensive pens, wines, dinners etc. I have no doubt that, had we been in the same position as our US colleagues most of us would have behaved similarly.
Aetna is one of the largest insurance company
in the USA. It is a major provider of managed care. Its contracts
with doctors are criticised.
Which is the Real Kaiser?: Is the nations largest HMO a model of cost-effective, quality care or a greedy medical factory that endangers its patients? Modern Healthcare 25/8/97 Cover Story page 6
This business journal for corporate medicine
attempts to confront the actual consequences of managed care as
revealed by Kaiser in Texas and California. It tries to steer a
middle course and will not seriously challenge the whole concept of
managed care and the "for profit" pressures behind it. My point about
social Darwinism in the corporate marketplace is reinforced.
Corporations which are prepared to disadvantage patients in their
search for profits are the ones which succeed and become the
"largest". See the three largest providers Columbia/HCA, Tenet/NME
and OrNda (until recently 3rd largest), the two largest laboratory
services National Health Laboratories, SmithKline Beecham, and the
largest managed care group Kaiser. Sun Healthcare one of the largest
aged care and subacute care provider is still under investigation.
These are all the largest and most successful in their areas in the
USA. If we are to look for early evidence of similar dysfunctional
conduct in Australia we need to watch the most financially successful
shareholder owned and profit driven companies. Mayne Nickless and the
Alpha/Sun group are doing well. Both follow some US style practices
Governments who welcomed Columbia/HCA into Australia were well informed.
Some comments and articles which reveal that
politicians who were well informed in regard to the problems with
corporate medicine in the USA negotiated with Columbia/HCA and
welcomed them without asking any questions.
Snippets from the US Health Scene These are sets of some documents I have handy. There is information about some of the US contracts. Dr Peeno who worked as a gatekeeper for a managed care company resigned when she was rewarded for refusing care to a patient who died as a result. The USA is alive with horror managed care stories. In one report an NME hospital executive is convicted of threatening to kill someone to stop him speaking out. David Dahm is an Australian accountant who has looked at the implication of US style managed care in Australia. His article is included.