Another View: Maine should resist the rise of for-profit hospital chains
By PHILIP CAPER
- The recent news about the possibility that nonprofit Mercy Hospital will be acquired by a for-profit chain owned by Cerberus Capital should raise red flags all over Maine.
With the possible exception of Eastern Maine Health System's flirtation over the sale of a few renal dialysis centers to the for-profit Da Vita Dialysis Center chain, Maine has so far escaped the dubious "benefits" of for-profit medicine, and should continue to resist this malignant trend.
If Mercy Hospital goes to for-profit status, its compassionate and healing mission would inevitably be transformed into one with a much different focus -- the creation of wealth for its investors. There is already speculation that this acquisition will simply be the first in a chain of such conversions in Maine of nonprofit institutions into for-profit ones.
Medical care, despite its scientific trappings, is still largely an art. As such, the "business" of medicine is vulnerable to changes in its incentive structure.
An intensified focus on the bottom line will lead to a proliferation of "profitable" services, such as imaging, orthopedics and cancer care -- regardless of their medical benefits -- and a suppression of "unprofitable" services, such as emergency services, maternity services and pediatric and primary care services -- regardless of their medical benefits. The recent spate of news about the sociopathic behavior of the for-profit hospital chain HCA is ample proof of that.
The night Democrats reclaimed “Obamacare”
By Ezra Klein ,
There’s been a major development in health-care politics over the last few months. The Obama administration and the Republicans came to an agreement on health reform. Not the law itself — they’re still at each other’s throats over that. But they finally agree on how to refer to it. Nowadays, both sides are calling it Obamacare. And during the first night of the Democratic National Convention, the Democrats talked about Obamacare. A lot.
That was, in itself, a surprise. Obamacare — or, as it’s officially called, the Patient Protection and Affordable Care Act — doesn’t poll particularly well, and it’s believed to have been a key contributor to the Republican victory in 2010. But Democrats appear to think that the politics have changed. Indeed, if the first night of the Democratic Convention is to be remembered for anything aside from Michelle Obama’s speech, it will probably be remembered as the night that Democrats stood up and began fighting for their health-care law.
“Governor Romney says people like me were the most excited about President Obama the day we voted for him,” said Stacey Lihn, whose daughter was born with a congenital heart defect. “But that’s not true. Not even close. For me, there was the day the Affordable Care Act passed and I no longer had to worry about Zoe getting the care she needed. There was the day the letter arrived from the insurance company, saying that our daughter’s lifetime cap had been lifted.”
Lihn wasn’t shy about the stakes for her family. “Governor Romney repealing health care reform is something we worry about literally every day,” she said. “Zoe’s third open-heart surgery will happen either next year or the year after. If Mitt Romney becomes president and Obamacare is repealed, there’s a good chance she’ll hit her lifetime cap.”
Michelle Obama, in the featured speech of the night, also emphasized the Affordable Care Act. “When it comes to the health of our families, Barack refused to listen to all those folks who told him to leave health reform for another day, another president,” she said. “He didn’t care whether it was the easy thing to do politically – that’s not how he was raised – he cared that it was the right thing to do.”
Fact checking Bill Clinton on Medicare
By Sarah Kliff ,
President Bill Clinton’s lengthy remarks Wednesday night—48 minutes and 5,896 words— included one of the longest, most detailed defenses of the Affordable Care Act’s Medicare cuts that we’ve seen so far in the campaign. Let’s see how that 549-word section checks out.
FALSE: “Both Governor Romney and Congressman Ryan attacked the president for allegedly robbing Medicare of $716 billion. That’s the same attack they leveled against the Congress in 2010, and they got a lot of votes on it. But it’s not true.”
The Affordable Care Act did indeed cut Medicare spending by $716 billion, as the Congressional Budget Office wrote in a July 24 report. It does that by reducing payments to Medicare hospitals and doctors, essentially ratcheting down the amount they receive when they see a patient. Here’s how those cuts break down, in graph form:
Clinton later goes on to discuss where these cuts come from – we’ll get there next – underscoring that yes, these Medicare cuts do indeed exist.
Our View: Suing feds for Medicaid is a political stunt
The state has better uses for its money than trying to speed up a likely negative decision.
Maine's campaign to reverse progress in health reform entered a new phase this week, when state Attorney General William Schneider filed suit in federal court, seeking to speed up the federal decision-making process on a state plan to eliminate health coverage for 33,000 people.
It is a strange spending choice for a state that is supposed to have trouble balancing its budget: Federal law gives the U.S. Department of Health and Human Services 90 days to respond to changes in state Medicaid plans, and Maine just sent in its request on Aug. 1. And the state has little reason to believe it will be the first in the nation to get permission to deny coverage to people from an agency that is trying to extend it
Drug companies, health-care providers primary culprits in MaineCare fraud
Posted Sept. 05, 2012, at 7:34 p.m.
The health care fraud investigators at the Maine attorney general’s office can rattle off the cases of some of the worst offenders from memory.
There’s the former provider convicted in 1995 of fraudulent billing who’s still paying monthly restitution 17 years later, $200 at a time. His debt to the state is now down to $20,000.
Then there’s Dawn Solomon, a Harrison woman who bilked MaineCare out of more than $4 million through her company that provided services for children with intellectual disabilities. She pleaded guilty in 2010 to overbilling for services and creating businesses solely for the purpose of fabricating invoices.
Solomon illustrates the damage one small health care provider can inflict, according to Michael Miller, head of a unit within the attorney general’s office that investigates health care crimes.
“Dawn Solomon will see my face more than once in her lifetime,” Miller said. “I will try to collect that money from her as long as I’m in this position.”
Abuse of public benefit programs in Maine often brings to mind recipients who lie to the state about their income or circumstances to unfairly gain access to services. But the bulk of the financial hit Maine suffers from health care fraud comes from health practitioners and drug companies tied into MaineCare, the state’s Medicaid program.
“A lot of our big numbers come from pharmaceutical companies who are doing what they’re not supposed to do, but even the small provider in Maine can do a significant amount of damage to the program,” Miller said.
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