Another reason health care costs are through the roof
Two years ago, a nurse working for HCA, the largest for-profit hospital chain in the United States, sent a letter to the company’s ethics office claiming that physicians at one of the company’s hospitals in Fort Pierce, Fla., were performing unnecessary heart procedures in the catheritization lab, putting patients’ lives at risk.
The nurse, C.T. Tomlinson, did not get his contract renewed, most likely in retaliation for his whistle-blowing.
Tomlinson’s charges proved true, not just at the small Fort Pierce hospital, but at several of the company’s hospitals in Florida and a few in other states. According to an article in the New York Times ( http://www.nytimes.com/2012/08/07/business/hospital-chain-internal-reports-found-dubious-cardiac-work.html?_r=1&pagewanted=all), the civil division of the United States attorney’s office in Miami asked information in July concerning reviews of the medical necessity of interventional cardiology services provided at 10 of its hospitals.
Doing interventional cardiology procedures (most often the placing of stents in narrowed arteries) on people who don’t need it increases profits, and although it is less invasive than bypass surgery, it poses risks to patients. Arteries can be nicked or burst and patients can bleed out or go into cardiac arrest. The Times article recounts the misadventures of several such patients in HCA hospitals who very nearly died.
The motivator, of course, is greed: for each stent procedure, Medicare reimburses hospitals about $10,000; diagnostic catheterizations bring about $3,000.
The Times reviewed thousands of pages of memos, e-mails and other communications surrounding the investigation and found that the company’s concern was more about how this might affect the bottom line than on whether regulators needed to be notified or how patients’ health was affected.
HCA, by the way, is the company once headed by now-Gov. Rick Scott in Florida. Under his leadership in 2000, HCA reached one of a series of settlements involving a huge Medicare fraud case with the US Justice Department that would eventually come to $1.7 billion in fines and repayments. The accusations primarily involved over-billing, and Rick Scott wasdismissed by the board of HCA.
As part of the settlement with the federal regulators, HCA signed a 97-page agreement that extended through late 2008. It detailed what had to be reported to the government and provided for stiffer penalties if the company failed to report properly, which they appear to have done as early as 2002, according to the Times.
In 2003, the HCA hospital in Bayonet Point, Fla., was performing far more stent procedures than its population demographics would suggest. An investigation by an outside agency, completed in late 2004, found that nearly half — 43 percent — of stent procedures were “outside reasonable and expected medical practice,” according to the Times article.
Even worse, doctors were found to have falsified records to say patients’ conditions were far more serious than they actually were.
The Obama Administration is cracking down on Medicare and Medicaid fraud, and raking in millions of dollars in fines. It’s about time we all stopped turning our backs on this kind of fraud because, in the end, we all pay the price.
Tags: Patient Pals & Family Friends
Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.
We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.
Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.
Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.
Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.
Family Friends are there to help caregivers and other family members grow into their new role.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
Life o’ Mike honors Joe Eblen
Life o' Mike presented its first Michael T. Danforth Community Service Award to Joe Eblen at a luncheon on June 8, in the Friendship Hall of First Congregational Church, 20 Oak St., Asheville.
Joe, seen here with Leslie Boyd, left, and his wife, Bobbie, has spent his life helping children and families, both as a coach and game official for more than 60 years, and as founder of Eblen Charities.
Start From Seed
Life o' Mike has a new program- Start from Seed (SFS).
SFS is a volunteer doula program aimed at providing non-medical, comprehensive support to low income, high-risk women and families of Buncombe County focusing on three areas:
1. We help new doulas with certification and training in return for their participation as a volunteer doula for SFS
2. We mentor volunteer doulas with their first few clients
3. Our volunteer doulas provide birth and postpartum doula services to low income, high risk moms, providing support and tools to empower them as a new parent.
A birth doula is a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; a postpartum doula provides emotional and practical support during the postpartum period.
Start from Seed clients are referred to us from the Buncombe County Department of Health’s Nurse-Family Partnership Program, Western North Carolina Community Health Services, and Mission Hospital. The Program is intended and designed for growing clients’ inner strength and helping them gain empowerment to help them cope with the emotional, physical and mental challenges of childbirth, labor, and motherhood.
Our new moms and their infants have many needs. If you would like to help them get off to a good start, please visit our Start from Seed web site: Start from Seed, or call Program Director Chelsea Kouns at 804-814-9946.