Wednesday, August 8, 2012
By the Way The New York Times on HCA: Putting Profits Before Patients
Posted by Jonathan Meador on Wed, Aug 8, 2012 at 5:01 AM
We'd be remiss if we didn't highlight The New York Times' damning expose of unnecessary and dangerous medical practices coming out of Nashville-based Hospital Corporation of America's Florida facilities.
Yesterday, the newspaper published its review of thousands of internal HCA documents that chronicle a disturbing pattern of superfluous heart surgeries that put patients' lives at risk without providing any evidence that the company later reimbursed those patients' insurance providers for those unnecessary operations as required by law. The Times reports that the company didn't notify patients, either, even while it was pocketing the money from the procedures. As a result, the U.S. Attorney's office in Miami is looking into the practices of 10 HCA facilities, most of them located in the Sunshine State.
From the Times:
Questions about the necessity of medical procedures — especially in the realm of cardiology — are not uncommon. None of the internal documents reviewed calculate just how many such procedures there were or how many patients might have died or been injured as a result. But the documents suggest that the problems at HCA went beyond a rogue doctor or two.At Lawnwood, where an invasive diagnostic test known as a cardiac catheterization is performed, about half the procedures, or 1,200, were determined to have been done on patients without significant heart disease, according to a confidential 2010 review. HCA countered recently with a different analysis, saying the percentage of patients without disease was much lower and in keeping with national averages.
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.
Because the Affordable Care Act has yet to kick in with provisions that will help curtail these kinds of abuses, the NYT story underscores why a for-profit health care system doesn't really work for the people who need it most: the patients.
The most recent data (ca. 2008) from the Bureau of Labor & Statistics reveals that 78 percent of American health insurance plans pay doctors on the kind of "fee-for-service" model that makes HCA the big bucks in our glorious free-market, Randian wet dream of private health care.
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