Hospital Bed? Certainly. The Credit Card Reader’s Built Into The Headboard…

Since I came to America ten years ago the cost of healthcare has appalled me. Every doctor visit, every hospital outpatient appointment, not to leave out the horrendous bills for in-patient procedures, results in insurance co-pays amounting to thousands of dollars a year, even for those “well insured”.

US Healthcare

You wait with dread for the insurance company’s form to arrive stating the total cost of the medical bill, the amount the company will pay, and the amount outstanding (the co-pay) that is your responsibility. Inevitably, this is closely followed by the hospital/doctor bill demanding payment forthwith.

It’s always been my habit to check the medical bill with the insurance form to ensure the figures coincide, before stapling both together and instructing our bank to pay the outstanding amount.

The Marquette General Health Service, our local provider, has always given good service. Then it sold out. Duke Lifepoint was a relatively small operator when it bought MGHS in September 2012 for $132.7 million. Not a bad bargain for a 276 bed hospital with a host of ancillary departments, including a number of doctor’s offices and a pristine medical center.[1]

At that time the Tennessee-based Duke Lifepoint, financed by hedge funds, had purchased three other hospitals: the 102-bed Maria Parham Medical Center in Henderson, N.C., an even smaller 50-bed Person Memorial Hospital in Roxboro, N.C., and the 86-bed Twin County Regional Healthcare in Galax, Va..

But it was, according to ‘Modern Healthcare’:

…the July deal for 276-bed Marquette General that was a turning point for the joint venture—signaling its intention to be not only a regional health network, but also a national one, where potentially every region of the country is ripe with targets.

Leif Murphy, executive vice president and chief development officer at LifePoint, said the joint venture has a list of 50 “perfect candidates” to pursue, which he described as having a reputation for quality but in need of additional capital to meet the demands for technology and clinical upgrades. Duke LifePoint, he said, is focusing on hospitals in the southeast region stretching as far as eastern Tennessee and South Carolina, but also major acute-care hospitals that could be located anywhere…”[2]

That was twelve months ago. Shortly after the takeover my wife developed a serious condition in her right eye. It was the weekend. We rushed to the emergency room. Eventually, she was seen by a doctor, given treatment, and we went to leave. Our passage was blocked by a woman behind a desk in the foyer.

“You have a co-pay of $250,” she rasped, somewhat abruptly.

Rather taken aback, I responded, “We’ll pay it when the bill arrives.”

“You have to pay it now!” she snapped, “It’s expected that you pay before you leave.”

To be brief, I told the good lady we wouldn’t be paying ‘now’, and that we’d await confirmation of the co-pay from the insurance company before handing over a penny. With that, we left.

When the insurance documents eventually arrived, the co-pay was $175, not $250 as she’d stipulated.

Some months later I made a routine visit to our doctor’s office. As I was about to leave, the receptionist informed me I was expected to pay a $20 co-pay. On querying this, she told me “they” wanted co-pays to be paid before the patient left the office.

“Then ‘THEY’ need to learn a hard lesson,” I said, “that ‘THEY’ don’t always get what they want in life.” I left, keeping my credit card in my pocket.

Since this incident I’ve spoken to some of the staff at the Marquette General Hospital. While Duke Lifepoint’s website is smothered in images of ecstatically happy doctors and nurses, on balance, I found those at Marquette were somewhat unhappy. It seems Duke Lifepoint is cutting lots of corners to save money. Equipment is being replaced with inferior quality products; staff morale is sinking fast.

Perhaps the most disturbing comment I heard was that credit card readers were being taken around the wards and sick patients coerced into paying co-pays even before they were discharged.

Of course, its only hearsay. But I doubt nurses and medical professionals would have any reason to state this if it were not true. Duke Lifepoint, it seems, despite the sickly sweet rhetoric of its website, has only one thing on its mind: money. Not that Lifepoint’s CEO has to worry too much on that score. His annual income last year was just under $9,000,000.[3]

Patients; caring quality healthcare; basic humanity, are all way down Duke Lifepoint’s list, if they’re on it at all.

‘Modern Healthcare’, again:

Durham, N.C.-based Duke [University Medical Center] launched its joint venture with publicly traded LifePoint Hospitals, Brentwood, Tenn., in January 2011 with the acquisition of 102-bed Maria Parham Medical Center, Henderson, N.C…Duke LifePoint marked the start of an aggressive, nationwide expansion strategy for the two-year-old joint venture when it clinched a deal to acquire a hospital on Michigan’s Upper Peninsula.

The addition of Marquette (Mich.) General Health System, 1,100 miles from Duke University Medical Center— which holds a small stake and brings its name and clinical expertise to the venture — also will test whether a university health system could play on the same turf as its investor-owned peers.

Partnerships among for-profit and not-for-profit systems are nothing new — nor is it unusual for an academic medical center to forge clinical affiliations with hospitals hundreds of miles away. But groups such as the Mayo Clinic Care Network, which was launched in 2011 and now has 12 members, are about extending expertise on clinical matters, not ownership…

…LifePoint CEO Bill Carpenter declined to quantify how many deals he expects to pursue this year, but noted that LifePoint has acquired $500 million in new revenue from the joint venture’s four buys with the potential to continue on that scale…”

Is this the bleak future for US healthcare? How long before the doctor’s office receptionist is replaced by a card reader and computer screen on the waiting room wall? Insert your credit card, pay your money, or, sorry, the doctor won’t be available to you this morning.

My last post dealt with the corporate takeover of government. What we, in Marquette, are seeing is the early result of that takeover.

Believe me, it will get worse.

[1] “Duke Lifepoint” (For more of the sickly sweet rhetoric)

[2] “Modern Healthcare” January 12th 2013

[3] “Salary.Com” Mister William F Carpenter the Third’s tidy little stash for 2012.