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During the 2012 presidential campaign, Mitt Romney like many of his GOP colleagues insisted that Americans without health insurance can always go to an emergency room. But for some with health coverage—especially Medicare—the ER is the "front door" to an unnecessary hospital admission. And as it turns out, while those filled beds and needless tests may do nothing for patient health, they are a boon to the bottom lines of America's burgeoning for-profit hospital chains.

That's the word from CBS' 60 Minutes, which on Sunday spotlighted that disturbing practice:

For more than a year, we have been looking into the admission and billing practices of Health Management Associates. It's the fourth largest for-profit hospital chain in the country with revenues of $5.8 billion last year, nearly half of that coming from Medicare and Medicaid programs. We talked to more than 100 current and former employees and we heard a similar story over and over: that HMA relentlessly pressured its doctors to admit more and more patients -- regardless of medical need -- in order to increase revenues.
According to the former employees interviewed and documents obtained by CBS, HMA pressured ER physicians at newly acquired facilities push ER admissions to the hospital to 20 percent from past rates often half that frequent:
[Graphic: "Only 14 admits so far!!!!!!! Act accordingly...."]

And this email from an ER director at an HMA hospital in South Carolina to a new emergency room doctor.

[Graphic: "Every time a 65 year old or older comes in, I am already thinking, do they have some condition I can admit them for?"]

[Graphic: "We are under constant scutiny[sic]]."

[Graphic: "I will be blunt... I have been told to replace you if your numbers do not improve."]

Among patients over age 65, Dr. Cliff Coonan reported, the admission target was 50 percent. That doesn't just tax hospital staff, but can put patients at risk. "If you are put into the hospital for reasons other than a good, justifiable medical reason," Coonan warned, "It puts you at significant risk for hospital-acquired infections and what we would refer to as medical misadventures."

For its part, HMA disputed the 60 Minutes report, providing its own data on the hospital chain's admission statistics and portraying those interviewed by CBS as "disgruntled former employees." Nevertheless, HMA shares by the close of business Tuesday dropped to 7.37 from 7.95 two days earlier (7.3 percent):

CRT Capital Group analyst Sheryl Skolnick cut her rating on HMA shares to "sell" from "fair value", citing the Medicare fraud allegations in the 60 Minutes report.

"We believe there is significantly greater risk of a deeper/wider (government) investigation and a substantially higher risk that HMA may have to pay bigger fines to settle it," Skolnick wrote in a note to clients.

Those government investigations were highlighted in a New York Times report Friday about the rapid acquisition of physician practices by hospitals and insurers around the country.

(Continue reading below the fold.)

As the Times explained, HMA and its emergency room contractor EmCare aren't just facing civil suits from executives, physicians and nurses warning about the risks to patient safety from the firms' admissions policies:

Health Management Associates, a for-profit hospital chain; EmCare, a Dallas-based emergency room staffing company for hospitals; and other hospitals have disclosed that they are the subjects of federal investigations. Regulators are looking into whether the hospitals improperly pressured physicians to admit patients...

Health Management, which operates 70 hospitals, said United States attorneys' offices in seven states were investigating physician referrals, including financial arrangements and the "medical necessity of emergency room tests and patient admissions."

EmCare said in an e-mailed statement that it could not comment on continuing legal matters involving it or its clients, but that its "first concern is the well-being of the patient."

As the New York Times detailed, the acquisition and consolidation of private physician practices is part of a trend towards unified patient care advocated by many health policy experts.

But for for-profit hospital chains and private equity firms, the physicians groups can help supply a pipeline of patient referrals and provide higher payments from programs like Medicare:

By one estimate, under its current reimbursement system, Medicare is paying in excess of a billion dollars a year more for the same services because hospitals, citing higher overall costs, can charge more when the doctors work for them. Laser eye surgery, for example, can cost $738 when performed by a hospital-employed doctor, compared with $389 when done by an unaffiliated doctor, according to national estimates by the independent Congressional panel that oversees Medicare. An echocardiogram can cost about twice as much in a hospital: $319, versus $143 in a doctor's office.
Health Management Associates has denied any wrong-doing. But in an October presentation to the Deutsche Bank Leveraged Finance Conference, HMA executives were candid about the financial incentives that fuel the bottom line of their Fortune 500 firm. As Treasurer Joe Meek explained, "As most of you know, we focus on non-urban markets, primarily in the Southeast, the United States. This is an area where there is a higher amount of retirees, again 70 facilities in 15 states." And while net revenue grew in the recent quarter, Meek told the investor audience not to worry about the recent decline in EBITDA (Earnings Before Interest, Taxes, Depreciation and Amortization):
As you can see, net revenue has benefited substantially by the impact of acquisitions. Adjusted EBITDA and adjusted EBITDA margins while growing, EBITDA, the margin has declined somewhat because of the ramp-up involved with the acquisition of new hospitals. Typically we acquire not-for-profit hospitals that are marginally profitable. We've then use our skill and experience to increase those margins, getting them up to the Company average in three to four years. So this margin will increase over time absent additional acquisitions.
Later in the same discussion, Senior Vice President of Finance Bob Farnham offered this nugget about his firm's emergency room operations:
For emergency room operations, if you don't know, I will tell you that -- this is true of any hospital -- about 60% of a hospital's admissions comes through the emergency room. So in all respects, the emergency room is really the front door to the hospital.
And, apparently, the key to the bottom line.
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Comment Preferences

  •  My experience working in private clinics & (19+ / 0-)

    hospitals as a med lab tech has been that there is a large portion fo admissions that are more related to income stream then medical necessity. Sometimes even the patients know it but they get lots of attention, someone to make thier bed, serve them food and family members swarming to be by thier bedside. We had one Dr like clockwork when the rumor mill said he was planning a vacation, admitted patients and ordered lots of unneccessary tests that he could then charge for reading. I knew all his money generators because I did EKGs on them daily and since I was doing them so often, up to and including having 2 patients die while the EKG was running I could see a normal EKG easily...Didn't matter daily EKGs were the Drs order. Anyway this is probably why I seldom see a Dr any more.

    This profit crap has been going on a long time and is a unfair burden decent docs have to share with those who will do whatever is necessary to earn the bucks. But who has the nerve to question a Dr? Today I returned my O2 I've been carrying around like a miserable lump...  Months ago I got a O2 sat meter and found that during the day walking around I might drop to 83% instead of 95%+. So what, as my lung Dr said in a moment of honesty... climbers of the Himalayas drop to the 50%s and stay there nearly constantly. Instead I am going to quit sitting around worrying whether the Drs were right to put me on it all the time or whether it was for fear of  lawsuits if they didn't do the standard or if it was the profit he earned by buying the testing machine that cost me nearly $800 for tests he ran every year while I was on it. I am going to start my treadmill and work up to 2 hours a day until I am aerobically fit again. But I can see why those who are in pain or have some serious issue completely yield to to the Drs orders without thinking why those orders.

    Get the damn 'for profit' crap out of medicine...It contaminates it all. I worked for a group of 4 Drs and I know how they talked about profits and how to improve thier margins... Shouldn't they be able to concentrate on what is really best for thier patients? Now it seems tha tthe wall street investors and equity firms are lining up the patients to milk them. When I turned 60 I did not suddenly turn into a cash cow.

    I am not going to just let them set me up for the big spend.

    Fear is the Mind Killer...

    by boophus on Tue Dec 04, 2012 at 09:07:09 PM PST

    •  You're scaring me (3+ / 0-)
      Recommended by:
      kurt, peachcreek, SmileySam
      Months ago I got a O2 sat meter and found that during the day walking around I might drop to 83% instead of 95%+.
      http://en.wikipedia.org/...
      One simple rule is that hypoxemia becomes very serious when the decreased partial pressure of oxygen in blood is less than 60 mm Hg, because that point is the beginning of the steep portion of the hemoglobin dissociation curve, where a small decrease in the partial pressure of oxygen results in a large decrease in the oxygen content of the blood.[3] or when hemoglobin oxygen saturation is less than 90%.
      http://en.wikipedia.org/..._(medical)
      An SaO2 (arterial oxygen saturation) value below 90% causes hypoxemia (which can also be caused by anemia). Hypoxemia due to low SaO2 is indicated by cyanosis.
      anemia?
      carbon monoxide?

      Others have simply gotten old. I prefer to think I've been tempered by time.

      by Just Bob on Tue Dec 04, 2012 at 09:46:02 PM PST

      [ Parent ]

      •  Sounds scary but I have been living with this for (6+ / 0-)

        decades. It was only when my hematocrit clinbed to 61 (when 45 was the highest for my sex) that anyone noticed and stuck me on O2. At first they assumed it was because I smoked... But after over ten thousand dollars in tests including a bone marrow aspiration they were ready to do even more tests but had to admit that the smoking had no part in it... By this time I quit because of the surprise of blowing flames from the end of a lit cigarette... Stopped the next day.  Oxygen will do that.

        What finally happened is that I asked the Oygen delivery guy if I could use his recording O2 meter. After leaving it on all night the meter recorded me dropping to low 60s at night... Surprise the Dr never thought of that... So off to the races and another 10K+. We have a 20% copay so we ran our credit cards to the max after a period of 4 months from Dec of one year to Mar of the next (both years cost us thier own deductible). Result bipap... Result from Dr, shrug and more tests every year. Result  thousands more spent each year.

        I will keep the bipap and keep the night time O2 generator and have my hematocrit checked every 6 months at a walk-in clinic. If they don't want to do it I will. But the burden of the carry around tank led me to do less and less physical activity which is far more harmful. If I sit still my O2 sats are as high as 99% without O2 during the day. If I walk around they drop but quickly rebound. Even my lung Dr said that a drop is not a death sentence and that reaction in the form of blood cell creation does not happen quickly. So I drop to the 80s for short periods as I walk into the store isn't going to kill me. Once I have a cart to hold onto my O sats go back into 90s (handy meter tells me so)for the most part unless a sale on pineapple gets me excited. Actually excitement does nothing lol. Anyway it is the night time drop that is really the worst problem.

        To me there is being alive and there is living. I choose living. Especially living on my own terms and trusting my own knowledge of my body which led me to go to a Dr because of changes I noticed and which led me to show the Dr the data to make a turn in his assumptions.  I am on this really...

        Fear is the Mind Killer...

        by boophus on Tue Dec 04, 2012 at 11:27:43 PM PST

        [ Parent ]

        •  Below 90 ? hope you use a Walker (1+ / 0-)
          Recommended by:
          ER Doc

          the ones with their own seat are best. When my wifes O2 drops into the 80s I can place and win bets on how long it will be before she collapses. MediCal pays for her O2 but only if it is below 90 when walking.
           You are playing with fire. You may not feel weak but one fall can cost way more than most think about. A broken hip or arm, broken nose or wrist ? Who knows how or when you will passout, maybe while behind the wheel with your grandkids in the car ?

          "the government's role should be to uplift, enlighten, educate and ennoble the citizen, not oppress them with taxation and intrusive laws," Gatewood Galbraith, Historic Marijuana Advocate, aka "The Last Free Man In America," RIP 1-3-12

          by SmileySam on Wed Dec 05, 2012 at 04:14:03 AM PST

          [ Parent ]

        •  Damn straight! (0+ / 0-)
          To me there is being alive and there is living. I choose living. Especially living on my own terms and trusting my own knowledge of my body
          So after all this testing what do you think is causing this?
          •  oh now I get it (0+ / 0-)

            You have some combination of primary polycythemia and sleep apnea, or maybe just the latter.  This results in "thick" blood that does not get through your lungs very well causing the limited capacity and the pulmonary hypertenstion.

          •  I have read some articles that say there may be (1+ / 0-)
            Recommended by:
            wilderness voice

            a relationship to being a premie. I was a twin who my mother did not carry to term due to my father throwing her across the room. Who knows, but I believe this has been going on for a very long time. I became less aerobically active  for a period of time after I quit working in labs where I stood most of the day at lab benches. When I was healthiest I swam at least a half hour every day. I have started a treadmill program where I monitor  O2 and stop when it drops below 80. That is happening less already.

            As for falling, I never did before they put me on O2. (well once at 12 I fell off a garage roof but my bro was hosing me down at the time) Since then the tubing has tripped me over a dozen times or snagged on door handles or even the arm of the couch yanking me suddenly to a painful stop. I damaged my shoulder on one of those falls from the tubing. I am fixing that with exercise too.

            Actually have been eying microscopes so I can do Differentials on my own blood so I can alter behavior in the right direction. LOL I especially like the one that does digital pictures to a computer. I could do biologist stuff for fun while having another reason to go out hiking to get fitter. Maybe I'll discover some thing new.

            Fear is the Mind Killer...

            by boophus on Thu Dec 06, 2012 at 06:52:48 PM PST

            [ Parent ]

    •  I agree that the profit motive has been (5+ / 0-)

      a corrupting influence in medicine. What else can we expect from the "health care industry"? We're all just cogs in a money-making machine.

      "The object of persecution is persecution. The object of torture is torture. The object of power is power. Now do you begin to understand me?" ~Orwell, "1984"

      by Lily O Lady on Tue Dec 04, 2012 at 10:05:17 PM PST

      [ Parent ]

    •  Doing it for profit is a choice. When I began my (0+ / 0-)

      career I had the choice of Wall Street or academia and I chose academia fully aware that my income would probably be 20% or less of what I could have earned on Wall Street.

      Those doctors knew in medical school that different specialties carried different remuneration. How they chose their specialty was their choice, not a necessity.



      Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

      by Wee Mama on Wed Dec 05, 2012 at 06:10:31 AM PST

      [ Parent ]

      •  No, its not, Wee Mama, not for those in the (2+ / 0-)
        Recommended by:
        Wee Mama, wilderness voice

        medical profession.  Working in these 'for profit' mills is often a necessity NOT A CHOICE.

        If you research articles and talk to those who have had long training to serve as a medical professional, you will consistently find that solo or group practices are being RUN OUT OF BUSINESS by the FOR PROFIT MONOPOLIES that are run by Big Pharma/Big Insurance/BigMed (hospital chains, etc.).  So, there are many valiant souls and practices trying to survive, that see their bottom line in a continual state of decline and wonder how they are going to survive when costs just keep escalating.  Many doctors throw their hands up in despair and join 'The Borg.'  (I do not sit in judgement of them; it is a very harsh reality out there today.)

        Most people have no clue the extent of the inroads that have been made by the monopolistic, for profit regardless of patient health, capitalists that right now have a stranglehold on all parts of the medical field.

        Today I would strongly discourage ANY one from going into the medical field, without understanding the dreadful conditions they would be working under  As far as finding a relatively decent practitioner, look for those who were there before the vulture capitalists came into to extract as much profit out of the the system as possible.  A system that rewards the sociopathic who are willing to extract as much $ out of a person, regardless of whether what they are recommending is necessary for their health.  And then, we have seen the soaring bankruptcies the chief cause of which is medical bills.  This is not a crime against humanity?

        So, your comparison to the choices you had of Wall Street or academia does not correlate one bit.  The gutting of our medical system is a NATIONAL TRAGEDY that has been happening under the radar for some time now.  Wide spread devastation has happened to patient care already.  

        The other part not mentioned often is that unless a medical practitioner is at the top of the food chain (and not all doctors, etc. are,) they are being crushed by inhumane working hours and as the article describes, demands for behavior that is contrary to their medical training: making judgements that results in higher profits for the hospitals, for example.  Privately the vast majority of practiioners are getting sick themselves from incredible overwork, stress and pressure and working in a very toxic environment.

        This is an unmitigated disaster.

        So, my point, is that many medical professionals have no choice.  Be glad if you have a half way decent medical practitioner.

        The seriousness of this situation must be seen and acknowledged.

        It is enough that the people know there was an election. The people who cast the votes decide nothing. The people who count the votes decide everything. ~~Joseph Stalin

        by SeaTurtle on Wed Dec 05, 2012 at 07:42:52 AM PST

        [ Parent ]

  •  Way Back in the Mid 80's I Was Mined By a Small (12+ / 0-)

    local hospital, over skipping heartbeats, because I had great insurance. 4-5 interns who visited me during triage all made the correct diagnosis which was not delivered by the hospital till after 4 days of me lying in cardiac intensive care under The Death Clock. 1 simple test they should've ordered when I rolled in but delayed 4 days would've avoided it all.

    This con goes back a ways!

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Tue Dec 04, 2012 at 09:10:41 PM PST

    •  Fear and having to rely on experts leaves us (3+ / 0-)

      vulnerable. And it is an expensive vulnerability. Not only that but many of the standard treaments have side effects that are not discussed so that in effect patients are not allowed to make truly informed decisions based on what is best for them and what they are willing to spend both in money, life altering regimens and activities that are curtailed by the treatments.

      After my lung Dr finally told me I had high blood pressure in the small arteries surrounding my lungs I went and looked it up online. What I read scared the crap out of me. I have learned after living with diagnosed pulmonary hypertension several things. Number one it is no the worsening kind that kills many young women as net articles described. I have probably had the problem since I was at least 10 but diagnosis was always for something else more fitting with assumptions made. Bronchitis, Pneumonia, anemia ( frequently had that one- earliest 10), tachycardia (caused I believe by a heart laboring for O2 which has completely stopped after nearly 50 years despite happening at least  once a month), psychosomatic, and on and on. Until my hematocrit of 61 shocked them out of thier assumptions...after draining 8 units of blood from me and thousands of dollars in tests ... I am sceptical of any diagnosis...and resistant to any further spending for unsure results. So now I am on a mission to get control of my stupid frigging  lungs don't control my life all of a sudden. I amde it for 40 years without dragging an O2 tank around like a parasite.

      Fear is the Mind Killer...

      by boophus on Tue Dec 04, 2012 at 11:47:07 PM PST

      [ Parent ]

      •  The tachycardia ceased after I got the Bipap. (2+ / 0-)
        Recommended by:
        Vatexia, wilderness voice

        Fear is the Mind Killer...

        by boophus on Tue Dec 04, 2012 at 11:48:20 PM PST

        [ Parent ]

        •  boophus, I am with you (0+ / 0-)

          knowing what I do re. the entire medical profession, I have taken control over my own health, study a lot about it and am determined to do all the self care things I can do.

          Eastern approaches have worked miracles for me; qigong and acupuncture, and Chinese balancing w/herbs.  I have studied some herbalism and more extensively the therapeutic use of essential oils.  I have constructed a lifestyle in which I continually work on balance and addressing my own particular issues.  I would much rather spend the time I do improving all my functions than blindly taking a pill.  I research everything.

          Also, an alternative doctor taught me a tool that has been invaluable.  Simply I do a daily health journal. It keeps me on track with my goals and tasks as well as helps me identify what went wrong when I have a problem.  I identified a food allergy through this.

          Every morning I do a qigong exercise of some sort and meditation and then journalling.  This takes time but the rewards are enormous.  Thare are still adjustment issues in my health and I am continually working on trying to get in balance.  Through study  of the Chinese medical approach, I have really learned the enormous impact of the mind/emotions on the body and so my healing and health approach is a wholistic one.

          All this takes discipline and commitment and consciousness.  But when I consider the alternative, there is no choice.

          It is enough that the people know there was an election. The people who cast the votes decide nothing. The people who count the votes decide everything. ~~Joseph Stalin

          by SeaTurtle on Wed Dec 05, 2012 at 07:51:50 AM PST

          [ Parent ]

  •  I added a Rec tag (6+ / 0-)

    This is sickening.  Not surprising, but sickening.  

    So it turns out for-profit healthcare is as grotesque in practice as it is in theory.  The idea that doctors, nurses, and assistants should be laboring but a separate non-working cadre of "investors" should be compensated for doing absolutely nothing.  What a scam.  

  •  Keep in mind too: (7+ / 0-)

    That good non-emergency healthcare should not be dispensed at the fucking ER! Properly, most of these folks are, or should be, trauma specialists. Got that? TRAUMA.

    Unfortunately, what they see and what they have to deal with is both traumatic and mundane.

    Car and motorcycle accidents. Gunshots. Domestic violence. Heart attacks.
    Aaand...Diabetes complications and drug-seeking behavior.
    Over and over.

    Every ER person I know seems to think that most all motorcyclists are crazed people with death wishes and almost everyone exhibits drug-seeking behavior.

    It is not surprising. That is their reality. That is who comes through the door.

    The fact that Mitt suggested that this was the place to go for primary care shows his ignorance. The ER is for emergencies.  The fact that these good folks, trained for years in dealing with trauma, instead find themselves being asked to admit patients unnecessarily, in order to increase the bottom line?

    Fuck that.

    Take business out of medicine. Let doctors be the best healers their training allows. It's pretty simple.

  •  The number of for-profit general hospitals in NY (3+ / 0-)
    Recommended by:
    Vatexia, LI Mike, ER Doc

    remains zero. And I'm not objecting.

  •  As a former hospital administrator (5+ / 0-)

    this is what I would do:

    Send a letter to the Centers for Medicare and Medicaid and inform them that it appears that the Utilization Review requirements contained in Medicare regulations are being compromised at certain for profit hospitals. Admissions found not to be "medically necessary" should be downgraded to outpatient level services...and paid accordingly.

    If that doesn't happen after this story made it to 60 Minutes, then this system is corrupted beyond repair.

    •  The down side to that is once a mistake is (0+ / 0-)

      made and somebody was denied admission who should have been admitted - a spate of "murder by spreadsheet" diaries are bound to pop up here at DailyKos.

      My point being that a tweak to the system as you propose will do very little, compared to what needs to be done (e.g., get profit out of the system entirely - or have it strictly regulated like electrical utilities were decades ago - and change from a fee for service model to reimbursements made for keeping somebody healthy . . .. ).

  •  Utilization Review at HMA (2+ / 0-)
    Recommended by:
    LI Mike, ER Doc

      When UR is rigged by the for-profits hospitals and CMS pays, then Seniors on Medicare don't know or care that they are being over-treated.
        It is a vicious cycle.  For example:  People demand antibiotic therapy for viral infections.  The attending physician knows that it will not work, but some still write the prescriptions - because it is easier than educating the patient.
         Yes, that is a simple example - but it holds true for many other treatments.  

         Alarm bells went off when I read that someone was walking around with a HCT of 61%.   I would hope that they received the immediately treatment of a theraputic phlebotomy.  

         Over the course of my 40 yr career in healthcare,  medical therapy becomes more complicated, perhaps more than is actually required for good health.   Admitting patient's became less popular when DRG's were instituted, but since then, companies have learned how to play the game for profits.  
         

  •  DRGs are not a reason not to admit (0+ / 0-)

    anymore than admitting them is.

  •  The profit motive is what is driving up the cost (1+ / 0-)
    Recommended by:
    SeaTurtle

    of health care in America at every level, from health insurance companies to hospitals to clinics to imaging centers. Sure, you can get an MRI almost instantly in America. Just find a doctor who's an owner or stockholder of an imaging center. I believe that everyone in the health care system and Congress completely understands this, yet too many are willling to sell us out for a buck. Capitalism has eaten our souls.

    “Social Security has nothing to do with balancing a budget or erasing or lowering the deficit.” -- Ronald Reagan, 1984 debate with Walter Mondale

    by RJDixon74135 on Wed Dec 05, 2012 at 06:13:21 AM PST

    •  God, RFD, your comment should be burned in stone (0+ / 0-)

      every, every word is 100% UNDENIABLE TRUTH.

      Rage, rage is all I feel.

      It is enough that the people know there was an election. The people who cast the votes decide nothing. The people who count the votes decide everything. ~~Joseph Stalin

      by SeaTurtle on Wed Dec 05, 2012 at 07:55:00 AM PST

      [ Parent ]

  •  EmCare is & always has been an exploiter of its (3+ / 0-)
    Recommended by:
    SeaTurtle, arlene, wilderness voice

    physicians. It's a publicly-traded corporation that skims a substantial percentage off the top of the fees it charges client hospitals for physician staffing in the emergency departments. It's illegal in many states for non-physicians to profit from the work of individual physicians, but the laws are routinely ignored in the name of expediency.

    -7.25, -6.26

    We are men of action; lies do not become us.

    by ER Doc on Wed Dec 05, 2012 at 06:23:43 AM PST

  •  Admission to hospital is dangerous (2+ / 0-)
    Recommended by:
    SeaTurtle, wilderness voice

    One thing not mentioned is just how dangerous being a patient in a hospital can be.  The fact that people are being admitted for unnecessary reasons actually endangers their lives.  More people are injured inside hospitals per year than in car accidents!  Until people realize that hospitals are only for the very ill or for surgery, they won't resist these types of practices. Keeping a focus on keeping people OUT of hospitals should be a major focus.  I am not a kook...I work for the sixth largest hospital system in America.

  •  BIG Medicine, as BigPharma and BigInsurance (0+ / 0-)

    are hugely driving up medical costs and not many people are aware of the incredibly powerful lobby they have and how they have influenced many medical standards and laws directly (ALEC like.)

    The summary statement is: This is a huge POLITICAL problem and must be seen as such.  This trio (Big-Pharma/Insurance/Med) are one of the UNREGULATED monsters of vulture capitalism that must be regulated as far as their costs, illegal/unethical practices, and monopolistic practices.

    Below is a comment I had in a previous diary American Psychiatric Association approves vast numbers of changes to the new DSM-5
     which applies to this subject.

    I am totally convinced that there is an equivalent "Alex" w/regards to the medical profession who works with insurance companies, BigPharma, Big 'for profit' Hospital complexes to influence the content of professional group's standards (such as the APA,) in such a way as to provide a segue into making money, more money than we can imagine, from those standards.  And then if legislation is needed, they have 'bought and paid for' politicians who are only to willing to bury in bills language which either remove s liability (flu vaccine,) or allows non-competitiveness (Medicare and prescriptions,) or whatever else they consider in the best interests of their bottom line.  It has been widely reported that Big 'for profit' Medicine is driving out individual or group medical practices viewing them as competitors in their one and only goal: making money.  Once again, monopolies are being constructed and the public is forced into a my way or the highway product.

    Right now there exists a very, very strong push to CREATE MEDICAL/PHARMACEUTICAL NEEDS BY SCARING THE SHIT OUT OF YOU BY PATHOLOGIZING NORMAL OR NOT ABNORMAL EVENTS.  Most people can see the evidence of the trillions of dollars BigPharma and Big Medicine is spending on tv ads:  ("If you bruise yourself when playing football, you could have a serious condition called 'bruisetoomuchitis' and it can lead to premature death, not to mention premature ejaculation.  Our professionals at ScamHospital will be only too happy to evaluate your condition and prevent further damage from occurring.  We have the latest techniques, a silicon formula patented in China, which we will inject into your blood stream to prevent the veins from being damaged.  Serious side effects may be immediate heart attack, secondary death from poisoning and early aging if you live longer than three days after the procedure.)  Have you ever listened to the side effects that their lawyers demand they list after touting a 'miracle cure.'

    Let me see?  These insurance/medical companies are spending trillions of dollars on advertising to create new, unnecessary needs for the products they are pushing, yet are refusing to provide for the genuine needs of people.  They scream they cannot afford to pay for treatment for someone who is seriously ill  because they view their advertising and pr as a higher priority than the health and life of their patienets.  And besides they need their patients to live, so they can continue to suck them dry.

    Oh Kay.... I may have feelings about this.

    One really good concrete first step would be to identify the "Alec" behind the insurance/BigPharma/BigMedicine industries and educate the public about what is really going on behind the scenes.  It seems to me that a lot of good was done by exposing Alec; hopefully benefit can be brought here if we can find the wizards behind the screen.  We need to find them and tell everyone about them.  

    And live to tell about it.

    Oh kay,  Rant over.  I'll go and take my blue pills.................

    And the next step, is to BREAK UP THE MONOPOLIES.  How have monopolies ever worked for us in the past?  As an example, where has BIG BANKING taken us?

    It is enough that the people know there was an election. The people who cast the votes decide nothing. The people who count the votes decide everything. ~~Joseph Stalin

    by SeaTurtle on Wed Dec 05, 2012 at 08:11:40 AM PST

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