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"Hospitals ...........spend and waste money profligately.
Hospital
boards are supposed to provide oversight, but in reality the members are either well meaning but naive community leaders,
or doctors whom the hospital can play like a violin because it tosses them some special perks...paid directorships, etc. There
is little if any real oversight, and anyone who believes the 990's provide an accurate accounting of hospital revenue and
spending is naive. There is some value in the 990...but only if you sit down and read several consecutive 990's from a single
institution and start looking for patterns.
The real name for all these euphemistic slogans is...corporate medical
practice. The hospitals deploy the line that they provide all this charity care and who will provide it if they are gone.
If you actually look at the so called charity care, you will discover that what they claim is not the actual cost of providing
the care, but is the retail, marked up chargemaster price...meaning, if it actually costs $20 to take a chest XRay they will
claim $100 or more dollars. Sort of like marking up the value of underwear donated to goodwill for the tax deduction.
Also,
the dirty secret is, with few exceptions, there is not so much genuine charity care these days. Pretty much anyone has access
to something...generally medicaid...and the hospitals pay from the government is figured on a formula for each hospital which
makes allowances for non payment........ . the hospitals never mention the care doctors provide in hospital and out of hospital
to these same people, but we don't get any credit or tax deduction.
The observation hospitals are also reimbursed
more is correct. In my state, BC/BS pays 94% of Billed hospital charges! Doctors take a 45% hit on our fee schedule from BC/BS
relative to other private payers with less market share. However, who is called greedy.....?Hospitals are biggest threat ...The
government is creating Accountable Care Organizations...which will pay the hospital the money for the care doctors provide,
and then doctors will be paid by the hospital. This is about as bad a model as one could construct, yet the AMA seems to be
pushing it.................It will take public comment and education but that is long term. Short term, the state boards of
medicine should start looking at the implications of having hospitals employ all doctors, or having doctor's economic livelihoods
dependent on hospital administrators who...hate us................virtually
no talk of the conflict of interest inherent in employed physicians and hospitals. Sham
peer review has already been used to get rid of doctors who express concerns about patient care, and since the doctors
who will be judging those who speak out, or dare to economically complete with a hospital and have sham charges brought before
the employed doctors...whose paycheck is being signed by the hospital CEO...what chance are you going to have?"
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How Did Doctors Become Serfs?
WASHINGTON -- There is no better key to a culture than language. The lilting poetry of everything uttered in Ireland, for instance, shows a depth of spirit that punishing hardship never could obliterate. The directness of New Yorkers places a high premium on honesty, and the indirectness of the French on privacy. The elaborate courtesy of the American South indicates a sense of form and consideration that sometimes overrides the true intention underneath. Also, it's possible to make extravagant offers in the South, because people can be counted on not to accept. They, too, are governed by what Thomas Mann called "the discipline and energy of good manners."
But something disturbing is happening in the way Americans talk about each other. They seem determined to drain the language of its essential juices and to rob people of importance. The most egregious example is in the field of medicine. How did doctors come to be called "health-care providers"? It's a shocking and insulting dismissal of years of training and reservoirs of authority that patients need to confer upon their physicians. It all grew out of the managed-care movement and a deliberate effort to undermine doctors in order to pay them less and impose upon them more. Patients were denied the dignity of the medical practice they had known, and doctors were hounded into other lines of work because that's what their profession, once respected, had become -- a line of work.
The same thing is happening now to writers. When Time-Warner merged with AOL, suddenly the scribes became not authors, journalists or playwrights, but "content providers."
Universities have become so obsessed with paying their bills and pleasing their benefactors that many of them now refer to their students as "customers."
The oddest of all is the designation of prostitutes as "sex workers." This vocabulary flows from the wish of feminists to treat all women with courtesy and to point out that many sell their bodies out of sheer desperation to support children and keep themselves alive. It's a worthy sentiment, but should language really try to change the degradation of such circumstances? What is happening in all these cases (except, of course, the last) is an ascendancy of corporate/entrepreneurial culture that is rendering everything else secondary and subject to revision. Especially under attack are the professions. Lawyers are among the few to be spared, but they may well be next. Too many are surrendering too quickly, not understanding that their expertise, their creativity, their insight, clear and undiluted, are critical to the success of the whole -- business included.
By Jack Anderson and Douglas Cohn with correspondent-at-large Lee Cullum
United Feature Syndicate 2000 Deseret News Publishing Co.