Cracking Open Chests for Profit

How would you like to wake up from major surgery only to discover later that your operation was entirely unnecessary?  That unpleasant experience has happened to a lot of people in this country and hardly anyone seems sufficiently outraged about it.

The most shocking instances recently would seem to have taken place at the Redding Medical Center, a hospital in Redding, California. Lawsuits leveled against that hospital charge that unnecessary surgery and other procedures were done on 366 patients. The plaintiffs have accused the doctors of elder abuse and contend that some patients died because of such treatment.

In 2002, the federal government sent FBI agents to Redding on a raid to investigate charges of Medicare fraud, among other things. Kickbacks to doctors and excessive charges to Medicaid patients are also under investigation.

The hospital in Redding is owned by Tenet Healthcare, a company with a highly dubious past. In 1999, this corporation owned 129 hospitals, making it the second largest hospital chain in the United States. Now it owns some 100 including two hospitals in Massachusetts: Metro West Medical Center in Framingham and Saint Vincent Hospital in Worcester, neither involved in the scandals.

Tenet Healthcare is the second incarnation of a company called National Medical Enterprises which was convicted of Medicare fraud in 1994. This embarrassment that led to the resignation of its founder and CEO, Richard Eamer.

Last month, in response to government findings, Tenet Healthcare agreed to pay the federal government $54 million dollars. As is frequent in such cases, however, the company did not have to admit wrongdoing. The company called the payment “a business decision.”

More problems lie ahead; last week the government notified Tenet of proceedings to bar Redding Medical Center from participation in federal health care programs.

Under both its names, the company has been widely esteemed for its money making prowess. In fact, it has been called “the darling of the marketplace” as its profits have soared. However, some people have seen this as a threat to good medical practice. One of its shareholders, M. Lee Pearce, M.D., in a letter to board members, spoke of the problems at the hospital in Redding as “DIRECTLY related to a philosophy of Wall Street Medicine” (his capitals).

After its recent problems with the law, the company’s stock plunged from $70 to $14 in three weeks, a sign of public alarm about its actions. This spring Tenet announced its intention to sell 14 of its hospitals, instead of expanding as it had planned.

Many, if not most, of the patients who suffered the ravages of this kind of medicine were presumably over age 65. They and others were victims of what was tantamount to assault; their situation should inspire outrage about a national health care system based on profits rather than human need.

Larry Polivka, a Tampa-based gerontologist who cares strongly about the medical needs of older people, feels concern about what he calls the “loss of soul in contemporary health care.”

He is especially critical about “Tenet’s policy of routinely cracking open chests when there was no medical reason to do so – – another breathtaking sign of the moral bankruptcy of U.S. healthcare and the business that runs it. Only money and profits matter.”

What worries me is how vulnerable we elders are to this kind of manipulation. Especially do I feel concern about those of us who may be isolated from other people. According to the U.S. Census Bureau, the proportion of Americans over 65 who live alone has risen steadily over the past 45 years. By 1995, the number of us living by ourselves has reached 32 percent, up from only 10 percent in 1950.

These statistics about living alone mean that, when things get difficult many more of us are likely to lack an advocate. A sudden health crisis may send us to the hospital by ourselves, without a family member or friend committed to argue for our best interest.

This situation can make us vulnerable to unscrupulous professionals who may not have our interests at heart. Certainly had we been transported by ambulance to the Medical Center Hospital in Redding, we would have been easy prey for doctors who wanted to get extra pay for surgery we did not need.

Ideally, we would have asked for a second opinion. But in an emergency, that would almost surely have been impossible. Even with an advocate at our side we might not have had the presence of mind to insist on seeing a doctor entirely focused on our wellbeing.

We older people have good reason to push for the reform of the health care system. Yes, Medicare preserves us from being entirely uncovered by insurance, the way more than 40 million of our fellow Americans are. But all of us desperately need a system that will provide for people of all ages and make scandals like the Redding abuses much more difficult to inflict on us.

Richard Griffin