Former Senator Bill Frist, interviewed on public radio (July 29), reminded listeners of his solemn commitment to universal health care while explaining its implausibility, at this juncture, due to “affordability” issues. He would know.
The retired Rightist leader, who put aside his career as a heart-lung transplant surgeon to represent his family interests in the US Senate, is part of a health care clan that pioneered for-profit hospitals in the US back in 1968. That was just three years after Medicare was born, with the Frist family, undoubtedly seeing Bolshevism at the gates of Nashville, doing its part to blunt America’s only successful national health program, then in its infancy. Talk about visionaries.
Frist’s dad, also a medical doctor, turned the Hippocratic Oath into another, less humanitarian, commitment: turning sickness into a gangbuster business. It was a sure thing. Old man Frist and family made themselves billionaires. Some of that money helped grease the wheels of democracy in bringing Mr. Bill to Washington.
Bill Frist likes to say, and underscored this modest notion for his public radio audience, that first and foremost the American health care system stands for innovation. Any reform, he warned, would alter the key ratio – termed P&L – at the very heart of that innovation.
HCA, Inc. – the Frist money machine – acquired a couple of hundred hospitals and merged in the late 80s with Columbia Hospitals, Inc., another for-profit hospital company, headed by Richard Scott, who got in via the Bass Gang of Dallas. Scott, who has recently appeared in an extensive ad campaign in behalf of, yes, innovation and health care, took his P&L expertise to hospitals and, together with the Frists, added hundreds of more health care institutions, making more billions. The combined company, Columbia/HCA, Inc., however, got carried away. While it was within the bounds of “innovation” to staff with non-certified doctors, cut the number of RNs, inject duller needles, have fewer supplies and less maintenance – in short, cut the quality of care – it was not ok to cook the books too blatantly. In 1996 the FBI raided Columbia/HCA in what was then the biggest government raid ever. Medicare fraud was proved, hefty fines were paid and the company broken up. Little fish were put in jail, the big fish got away—only , as in the case of Richard Scott, to reappear in a miraculous comeback: think Mussolini reenters Rome.
HCA survived just fine, with the help of the Bush’s compassionate Department of Justice. And Bill Frist managed to move his political career along just fine . In a final act of statesmanship, Frist helped push through Medicare Reform Act of 2003, nothing short of a giveaway of Medicare money to hospitals, accomplishing in the end what the book-cookers couldn’t.
With top White House lieutenants David Axelrod and Rahm Emanuel leading the charge to reform health care today , health reform now comes down to some trivial consumer protections coupled with an untenable shift of Medicaid costs to the states, most of which are in a fiscal vice. Medicaid in some locales has already abandoned the provision of dental services for the poor. Less to chew with.
Innovation wins out: The pillar of the US health care system: fee-for-service — the more you do the more you make – is solid. Preventive care has no place in fee for service medicine. Nor do tens of millions of Americans, as it turns out.
“Consumer protections are a lot more tenable,” is the pathetic Axelrod spin. Emanuel, we are told, won’t accept anything short of success in anything, at any time, etc., etc. Which raises the question: why are these two still on the job?
CARL GINSBURG is a tv producer and journalist based in New York. He can be reached at email@example.com