Rumors rumors rumors...
Mission Hospital is buying the assets of South Coast Medical Center.
Interesting ain't it?
Tuesday, March 3, 2009
Concerns about the stability of the health care delivery system in California and USA
Can someone in gov't actually do the math?
Let me get this straight, we have unemployment doubling and therefore more demand for gov't provided healthcare by unemployed people.
Then, we're supposed to be confident that the private insurers are paying doctors and hospitals?
HUH?
How are the private insurers supposed to be paid if there are fewer covered lives?
So, no wonder the doctors and hospitals can't balance their budgets. The insurers are insolvent!
Let me get this straight, we have unemployment doubling and therefore more demand for gov't provided healthcare by unemployed people.
Then, we're supposed to be confident that the private insurers are paying doctors and hospitals?
HUH?
How are the private insurers supposed to be paid if there are fewer covered lives?
So, no wonder the doctors and hospitals can't balance their budgets. The insurers are insolvent!
State fines three O.C. hospitals for safety problems
State fines three O.C. hospitals for safety problems
Anaheim General, Western Medical and Fountain Valley broke rules that put patients at risk.
By JENNIFER MUIR
The Orange County Register
Comments 2 Recommend 0
Three Orange County hospitals are being fined for breaking hospital licensing rules that put patients at risk of injury or death, the California Department of Health reported Tuesday.
For Anaheim General Hospital, which treats many of the county's poorest residents, it's the latest blow in a string of safety concerns that include losing a national quality accreditation and two other administrative penalties by the state health department. Anaheim General was cited for poor food handling practices that could have sickened patients throughout the hospital's campuses, including preparing food with dirty equipment and storing it at unsafe temperatures, according to a state report.
Fountain Valley Regional Hospital received its second health department penalty because a nurse administered oral medicine intravenously, causing a patient's heart to stop beating and brain to swell. And Western Medical Center in Santa Ana received its first-ever state penalty for failing to appropriately investigate a report that a staff member assaulted a psychiatric patient, causing a black eye.
Fountain Valley and Western Medical plan to appeal, spokespeople said.
The hospitals are among 10 in the state sanctioned today by the California Department of Health, which started issuing administrative penalties in 2007 to medical facilities that are out of compliance with state licensing requirements, potentially causing patients injury or death. Since then, the agency has given out 71 administrative penalties to 49 hospitals across the state.
Each of the hospitals was fined $25,000 for violations that occurred in 2007 and 2008, and each has taken steps to correct the problems.
"As consumers, we have to be aware of the fact that there are medical errors that take place in hospitals," said Kathleen Billingsley, deputy director of the California health department's Center for Health Care Quality. "One of the important things, for me, is to realize that if I went to one of these particular facilities, I would feel very confident that the hospital had addressed the issue."
Here's what happened at each hospital:
Fountain Valley Regional Hospital and Medical Center
In May of 2008, a nurse mistakenly gave oral anti-seizure medication through an IV. The errors caused the patient to go into cardiopulmonary arrest, which caused brain swelling, ultimately leaving the patient "obtunded," or mentally dull, according to a state report.
The hospital immediately reported the issue to the state, the California Board of Registered Nurses and the staffing agency through which the nurse was employed, hospital spokesman Ben Russo said in a prepared statement.
"The hospital notified the staffing agency that the nurse is not permitted to return to work at Fountain Valley Regional Hospital and Medical Center," the statement said. "We take seriously our responsibility to deliver quality, safe health care services."
The hospital also has required training for nursing staff, created new procedures and done self auditing.
It was the second such sanction given to Fountain Valley Regional. In June, the hospital was cited for leaving a sponge inside a patient during surgery.
Western Medical Center Santa Ana
In November 2007, a psychiatric patient complained that a staff member slapped her across the face, causing her to bruise under her right eye. The patient later told a therapist that a staff member "punched my face then he tried to get me to eat my fist."
Family members were not immediately notified and the hospital didn't properly investigate the allegation, according to the report. Hospital staffers didn't report the case to police for 16 days, and a director said that because of the patient's psychological presentation, he did not know if the patient's story was "delusional or not."
The staff member involved in the alleged attack never was identified, spokeswoman Shelle Malm said. Since then, the hospital has set up a process to immediately notify the appropriate people when something like this happens and has done extensive staff training, Malm said
"We take all of these allegations seriously," she said. "We failed to report the allegations in a timely manner."
Anaheim General Hospital
The hospital was cited in February 2008 for several food violations that "had the potential to expose patients to a hospital-acquired food borne illness, which may result in nausea and vomiting, thereby further compromising the medical status of inpatients."
Inspectors described pre-cooked turkey breast being stored in a broken refrigerator, left-over sausages sitting in a tray of congealed fat, moldy bagels and a rubber blender gasket being covered in "a green, slime-like substance," according to the state report.
The hospital was cited for lacking a fulltime person responsible for managing dietary services at the hospital's Anaheim and Buena Park campuses, storing food at unsafe temperatures in Buena Park and failing to properly monitor the cooling down of potentially hazardous food.
Since being cited, the hospital has hired a full time dietician, educated staff on food safety and repaired broken equipment, the report said.
"Since then we've had a management change, and the hospital continues to provide excellent care," says James Young, chief executive for Pacific Health, which owns Anaheim General.
Contact the writer: 714-796-7813 or jmuir@ocregister.com
Anaheim General, Western Medical and Fountain Valley broke rules that put patients at risk.
By JENNIFER MUIR
The Orange County Register
Comments 2 Recommend 0
Three Orange County hospitals are being fined for breaking hospital licensing rules that put patients at risk of injury or death, the California Department of Health reported Tuesday.
For Anaheim General Hospital, which treats many of the county's poorest residents, it's the latest blow in a string of safety concerns that include losing a national quality accreditation and two other administrative penalties by the state health department. Anaheim General was cited for poor food handling practices that could have sickened patients throughout the hospital's campuses, including preparing food with dirty equipment and storing it at unsafe temperatures, according to a state report.
Fountain Valley Regional Hospital received its second health department penalty because a nurse administered oral medicine intravenously, causing a patient's heart to stop beating and brain to swell. And Western Medical Center in Santa Ana received its first-ever state penalty for failing to appropriately investigate a report that a staff member assaulted a psychiatric patient, causing a black eye.
Fountain Valley and Western Medical plan to appeal, spokespeople said.
The hospitals are among 10 in the state sanctioned today by the California Department of Health, which started issuing administrative penalties in 2007 to medical facilities that are out of compliance with state licensing requirements, potentially causing patients injury or death. Since then, the agency has given out 71 administrative penalties to 49 hospitals across the state.
Each of the hospitals was fined $25,000 for violations that occurred in 2007 and 2008, and each has taken steps to correct the problems.
"As consumers, we have to be aware of the fact that there are medical errors that take place in hospitals," said Kathleen Billingsley, deputy director of the California health department's Center for Health Care Quality. "One of the important things, for me, is to realize that if I went to one of these particular facilities, I would feel very confident that the hospital had addressed the issue."
Here's what happened at each hospital:
Fountain Valley Regional Hospital and Medical Center
In May of 2008, a nurse mistakenly gave oral anti-seizure medication through an IV. The errors caused the patient to go into cardiopulmonary arrest, which caused brain swelling, ultimately leaving the patient "obtunded," or mentally dull, according to a state report.
The hospital immediately reported the issue to the state, the California Board of Registered Nurses and the staffing agency through which the nurse was employed, hospital spokesman Ben Russo said in a prepared statement.
"The hospital notified the staffing agency that the nurse is not permitted to return to work at Fountain Valley Regional Hospital and Medical Center," the statement said. "We take seriously our responsibility to deliver quality, safe health care services."
The hospital also has required training for nursing staff, created new procedures and done self auditing.
It was the second such sanction given to Fountain Valley Regional. In June, the hospital was cited for leaving a sponge inside a patient during surgery.
Western Medical Center Santa Ana
In November 2007, a psychiatric patient complained that a staff member slapped her across the face, causing her to bruise under her right eye. The patient later told a therapist that a staff member "punched my face then he tried to get me to eat my fist."
Family members were not immediately notified and the hospital didn't properly investigate the allegation, according to the report. Hospital staffers didn't report the case to police for 16 days, and a director said that because of the patient's psychological presentation, he did not know if the patient's story was "delusional or not."
The staff member involved in the alleged attack never was identified, spokeswoman Shelle Malm said. Since then, the hospital has set up a process to immediately notify the appropriate people when something like this happens and has done extensive staff training, Malm said
"We take all of these allegations seriously," she said. "We failed to report the allegations in a timely manner."
Anaheim General Hospital
The hospital was cited in February 2008 for several food violations that "had the potential to expose patients to a hospital-acquired food borne illness, which may result in nausea and vomiting, thereby further compromising the medical status of inpatients."
Inspectors described pre-cooked turkey breast being stored in a broken refrigerator, left-over sausages sitting in a tray of congealed fat, moldy bagels and a rubber blender gasket being covered in "a green, slime-like substance," according to the state report.
The hospital was cited for lacking a fulltime person responsible for managing dietary services at the hospital's Anaheim and Buena Park campuses, storing food at unsafe temperatures in Buena Park and failing to properly monitor the cooling down of potentially hazardous food.
Since being cited, the hospital has hired a full time dietician, educated staff on food safety and repaired broken equipment, the report said.
"Since then we've had a management change, and the hospital continues to provide excellent care," says James Young, chief executive for Pacific Health, which owns Anaheim General.
Contact the writer: 714-796-7813 or jmuir@ocregister.com
Monday, February 16, 2009
Did OctoMom delivery at Kaiser Bellflower influence Senator Lou Correa to vote yes on higher state taxes?
It is my understanding that Senator Lou Correa's wife is an obstetrician/gynecologist at Kaiser.
http://www.ncsl.org/programs/pubs/799fmly.htm
Apparently her name is Dr. Esther Reynoso or Dr. Esther Correa or Dr. Maria Correa or Dr. Maria Reynoso or Dr. Maria Esther Reynoso.
She is a Kaiser Pemanente obstetrician at the Kaiser Permanente facility where Nadya Suleman delivered!
See:http://www.ucomparehealthcare.com/drs/california/obstetrics_and_gynecology/Maria_E_Reynoso.html
Notice that the facility where she is assigned is where....OCTOMOM DELIVERED!!!
We heard earlier in the last week that Kaiser Permanente Bellflower was requesting a special increase in their hospital reimbursement from Medi-Cal for the octuplet delivery.
Now, we hear that Senator Lou Correa was holding out on his vote for the tax increase...then we hear that Lou Correa was voting for the tax hike AFTER he received a concession on "public safety and health funding".... is that health funding for Kaiser where his own wife gets paid her salary???
Was Lou Correa's vote for higher taxes just so that his wife or her group would get paid for the OctoMom delivery???? (MUSIC!)
Check the California State Medical Board web site to confirm the identity and license status of Dr. Maria Esther Reynoso, MD
Physician InformationLicensee Name:MARIA ESTHER REYNOSO, MD
License Type:PHYSICIAN AND SURGEON
License Number:G80949
License Status:LICENSE RENEWED & CURRENT
Public Record Actions:NONE AVAILABLE ON WEB SITE ]
To find out what information is and is not available on the Web site, please click here.)
Original Issue Date:APRIL 05, 1995
Expiration Date:FEBRUARY 28, 2011
Address:9449 E IMPERIAL HWYDOWNEY, CA 90242
County:LOS ANGELES
http://www.ncsl.org/programs/pubs/799fmly.htm
Apparently her name is Dr. Esther Reynoso or Dr. Esther Correa or Dr. Maria Correa or Dr. Maria Reynoso or Dr. Maria Esther Reynoso.
She is a Kaiser Pemanente obstetrician at the Kaiser Permanente facility where Nadya Suleman delivered!
See:http://www.ucomparehealthcare.com/drs/california/obstetrics_and_gynecology/Maria_E_Reynoso.html
Notice that the facility where she is assigned is where....OCTOMOM DELIVERED!!!
We heard earlier in the last week that Kaiser Permanente Bellflower was requesting a special increase in their hospital reimbursement from Medi-Cal for the octuplet delivery.
Now, we hear that Senator Lou Correa was holding out on his vote for the tax increase...then we hear that Lou Correa was voting for the tax hike AFTER he received a concession on "public safety and health funding".... is that health funding for Kaiser where his own wife gets paid her salary???
Was Lou Correa's vote for higher taxes just so that his wife or her group would get paid for the OctoMom delivery???? (MUSIC!)
Check the California State Medical Board web site to confirm the identity and license status of Dr. Maria Esther Reynoso, MD
Physician InformationLicensee Name:MARIA ESTHER REYNOSO, MD
License Type:PHYSICIAN AND SURGEON
License Number:G80949
License Status:LICENSE RENEWED & CURRENT
Public Record Actions:NONE AVAILABLE ON WEB SITE ]
To find out what information is and is not available on the Web site, please click here.)
Original Issue Date:APRIL 05, 1995
Expiration Date:FEBRUARY 28, 2011
Address:9449 E IMPERIAL HWYDOWNEY, CA 90242
County:LOS ANGELES
Friday, February 13, 2009
South Coast Medical Center closures in the wake of Mission Hospital's purchase
Friday, February 13, 2009
Hospital ward's closure forces dire decisions
Patients in subacute unit in Laguna Beach will have to be moved 30 miles from their loved ones.
By COURTNEY PERKES
The Orange County Register
Comments 1 Recommend 1
Richard Thompson, a retired dentist, drives three miles every day to visit his son at South Coast Medical Center, where he sings Lawrence Welk songs with him and brushes his teeth.
His son, Bobby, has the mental capacity of an 8-year-old, breathes with a ventilator and eats through a feeding tube. He asks nurses for his father every morning, and they assure him he'll be coming.
But soon, Richard fears those visits won't be so easy. He was notified last week that the Laguna Beach hospital will close the unprofitable subacute ward, forcing his son and 20 other patients to move to hospitals or nursing homes miles away or in Los Angeles County.
"I'm 81 and not really one who should be driving the freeways everyday, but I will if that's what I have to do," Thompson said. "He really suffers when I'm not around. They tell me at the hospital that he'll say, 'Dad' all morning long."
Thompson and other families received notice shortly before an announcement that Mission Hospital would purchase South Coast for $35.7 million. The sale of the nonprofit hospital must be approved by the state attorney general's office. The families say they plan to fight the closure by lobbying the state as well as Mission, which is owned by St. Joseph Health System.
Officials at both hospitals said the closure of the subacute unit has nothing to do with the sale.
South Coast spokeswoman Alicia Gonzalez said costs of hospital expenses had been under review for a year, long before the hospital was put on the market. She said 80 percent of subacute patients are covered by state Medi-Cal and many hospitals have stopped offering long-term care.
For years, Adventist Health-owned South Coast has been losing money and closed the maternity ward last year.
"This was a unit they've been looking at for awhile," Gonzalez said. "It just did not make sense to continue."
Several relatives of displaced patients said doctors have told them they need more specialized care than a nursing home can provide. The nearest options are Chapman Medical Center, 24 miles away in Orange or Kindred Hospital, 38 miles away in Brea.
Bill Moseley said his 74-year-old father is still alive after a car accident eight years ago because of access to the hospital's operating room and intensive care unit.
"His nurses all say if he wasn't in a hospital, he'd be dead," Moseley said. "Our dad had a couple life-threatening episodes, but because he was in the hospital here he was able to get the right care he needed."
Others are still reeling from the notification.
"It was a total shock because there had been no discussion or indication that anything like that was being considered," said Wally Schminke, 82, who visits his wife, Corinne, twice a day. "It will cut my visits to one a day, for sure. To me, it's just incredible there would be no facility in such a populous area as South Orange County."
Schminke of San Clemente said his wife suffered a stroke three years ago that left her bedridden and breathing with a tracheotomy. He reads her horoscope from the newspaper, articles from fashion magazines and comics. She can't speak, but when her children and grandchildren visit, her face lights up.
"It's going to diminish the amount of visits. Those are important for her morale," he said.
Yvonne Toppses will celebrate her husband Tony's 42nd birthday Saturday at South Coast with cupcakes for nurses, movie rentals and a phone call from his parents in New York. Tony, a former biomedical engineer, has spent two years there because of multiple sclerosis.
Toppses, who lives in Aliso Viejo, quit her job and spends every day keeping her husband company. She hasn't told him yet about the pending move because she doesn't want to depress him.
"They're saying this closure isn't contingent on the sale, but obviously the numbers look much better on paper after a closure," she said. "This is against the mission statements for both Adventist and St. Joe's."
Contact the writer: 714-796-3686 or cperkes@ocregister.com
Hospital ward's closure forces dire decisions
Patients in subacute unit in Laguna Beach will have to be moved 30 miles from their loved ones.
By COURTNEY PERKES
The Orange County Register
Comments 1 Recommend 1
Richard Thompson, a retired dentist, drives three miles every day to visit his son at South Coast Medical Center, where he sings Lawrence Welk songs with him and brushes his teeth.
His son, Bobby, has the mental capacity of an 8-year-old, breathes with a ventilator and eats through a feeding tube. He asks nurses for his father every morning, and they assure him he'll be coming.
But soon, Richard fears those visits won't be so easy. He was notified last week that the Laguna Beach hospital will close the unprofitable subacute ward, forcing his son and 20 other patients to move to hospitals or nursing homes miles away or in Los Angeles County.
"I'm 81 and not really one who should be driving the freeways everyday, but I will if that's what I have to do," Thompson said. "He really suffers when I'm not around. They tell me at the hospital that he'll say, 'Dad' all morning long."
Thompson and other families received notice shortly before an announcement that Mission Hospital would purchase South Coast for $35.7 million. The sale of the nonprofit hospital must be approved by the state attorney general's office. The families say they plan to fight the closure by lobbying the state as well as Mission, which is owned by St. Joseph Health System.
Officials at both hospitals said the closure of the subacute unit has nothing to do with the sale.
South Coast spokeswoman Alicia Gonzalez said costs of hospital expenses had been under review for a year, long before the hospital was put on the market. She said 80 percent of subacute patients are covered by state Medi-Cal and many hospitals have stopped offering long-term care.
For years, Adventist Health-owned South Coast has been losing money and closed the maternity ward last year.
"This was a unit they've been looking at for awhile," Gonzalez said. "It just did not make sense to continue."
Several relatives of displaced patients said doctors have told them they need more specialized care than a nursing home can provide. The nearest options are Chapman Medical Center, 24 miles away in Orange or Kindred Hospital, 38 miles away in Brea.
Bill Moseley said his 74-year-old father is still alive after a car accident eight years ago because of access to the hospital's operating room and intensive care unit.
"His nurses all say if he wasn't in a hospital, he'd be dead," Moseley said. "Our dad had a couple life-threatening episodes, but because he was in the hospital here he was able to get the right care he needed."
Others are still reeling from the notification.
"It was a total shock because there had been no discussion or indication that anything like that was being considered," said Wally Schminke, 82, who visits his wife, Corinne, twice a day. "It will cut my visits to one a day, for sure. To me, it's just incredible there would be no facility in such a populous area as South Orange County."
Schminke of San Clemente said his wife suffered a stroke three years ago that left her bedridden and breathing with a tracheotomy. He reads her horoscope from the newspaper, articles from fashion magazines and comics. She can't speak, but when her children and grandchildren visit, her face lights up.
"It's going to diminish the amount of visits. Those are important for her morale," he said.
Yvonne Toppses will celebrate her husband Tony's 42nd birthday Saturday at South Coast with cupcakes for nurses, movie rentals and a phone call from his parents in New York. Tony, a former biomedical engineer, has spent two years there because of multiple sclerosis.
Toppses, who lives in Aliso Viejo, quit her job and spends every day keeping her husband company. She hasn't told him yet about the pending move because she doesn't want to depress him.
"They're saying this closure isn't contingent on the sale, but obviously the numbers look much better on paper after a closure," she said. "This is against the mission statements for both Adventist and St. Joe's."
Contact the writer: 714-796-3686 or cperkes@ocregister.com
Tuesday, February 10, 2009
Senate Stimulus IS the health care BILL
Read this story from Bloomberg!
Ruin Your Health With the Obama Stimulus Plan: Betsy McCaughey
Email Print A A A
Commentary by Betsy McCaughey
Feb. 9 (Bloomberg) -- Republican Senators are questioning whether President Barack Obama’s stimulus bill contains the right mix of tax breaks and cash infusions to jump-start the economy.
Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.
Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).
The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.
But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”
Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.
New Penalties
Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)
What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.
The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.
Elderly Hardest Hit
Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.
Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).
The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.
In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.
Hidden Provisions
If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later.
The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined (90-92, 174-177, 181).
Hiding health legislation in a stimulus bill is intentional. Daschle supported the Clinton administration’s health-care overhaul in 1994, and attributed its failure to debate and delay. A year ago, Daschle wrote that the next president should act quickly before critics mount an opposition. “If that means attaching a health-care plan to the federal budget, so be it,” he said. “The issue is too important to be stalled by Senate protocol.”
More Scrutiny Needed
On Friday, President Obama called it “inexcusable and irresponsible” for senators to delay passing the stimulus bill. In truth, this bill needs more scrutiny.
The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. Imagine limiting growth and innovation in the electronics or auto industry during this downturn. This stimulus is dangerous to your health and the economy.
(Betsy McCaughey is former lieutenant governor of New York and is an adjunct senior fellow at the Hudson Institute. The opinions expressed are her own.)
To contact the writer of this column: Betsy McCaughey at Betsymross@aol.com Last Updated: February 9, 2009 00:01 EST
Ruin Your Health With the Obama Stimulus Plan: Betsy McCaughey
Email Print A A A
Commentary by Betsy McCaughey
Feb. 9 (Bloomberg) -- Republican Senators are questioning whether President Barack Obama’s stimulus bill contains the right mix of tax breaks and cash infusions to jump-start the economy.
Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.
Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).
The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.
But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”
Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.
New Penalties
Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)
What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.
The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.
Elderly Hardest Hit
Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.
Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).
The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.
In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.
Hidden Provisions
If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later.
The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined (90-92, 174-177, 181).
Hiding health legislation in a stimulus bill is intentional. Daschle supported the Clinton administration’s health-care overhaul in 1994, and attributed its failure to debate and delay. A year ago, Daschle wrote that the next president should act quickly before critics mount an opposition. “If that means attaching a health-care plan to the federal budget, so be it,” he said. “The issue is too important to be stalled by Senate protocol.”
More Scrutiny Needed
On Friday, President Obama called it “inexcusable and irresponsible” for senators to delay passing the stimulus bill. In truth, this bill needs more scrutiny.
The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. Imagine limiting growth and innovation in the electronics or auto industry during this downturn. This stimulus is dangerous to your health and the economy.
(Betsy McCaughey is former lieutenant governor of New York and is an adjunct senior fellow at the Hudson Institute. The opinions expressed are her own.)
To contact the writer of this column: Betsy McCaughey at Betsymross@aol.com Last Updated: February 9, 2009 00:01 EST
Sunday, February 8, 2009
OC Register Op/Ed piece on the Healthcare Scam in our national politic
Sunday, February 8, 2009
Sally Pipes: Stimulus no fix for health insurance
The stimulus package has money for government health programs, but that's not the way to make coverage more affordable
By SALLY C. PIPES
President, CEO of the Pacific Research Institute in San Francisco. Her new book is "The Top Ten Myths of American Health Care: A Citizen's Guide."
Comments 1 Recommended2
Gov. Arnold Schwarzenegger raised the ire of many in California by calling for $1.1 billion in cuts to Medi-Cal, the state health care program for the poor, as part of an effort to head off a projected $42 billion budget deficit over the next 17 months.
The federal government is now throwing him a lifeline. A cool $32 billion from the massive economic stimulus bill winding its way through Congress was designated for California. About a third of that is earmarked for Medi-Cal relief.
But a bailout of Medicaid (the federal version of Medi-Cal) with no checks and balances to ensure funds are spent as specified only kicks health care reform further down the road. It also shows that both state and federal policy-makers are still falling prey to myriad misconceptions on health policy. Until our leaders gain a hold on what is and isn't true in the health care debate, we'll continue to suffer through ineffective – and often harmful – reform efforts.
Among these myths is the notion that tens of millions of Americans don't have access to health care. The U.S. Census Bureau puts the number of uninsured Americans at 46 million; of those, 6.6 million live in California, according to the California HealthCare Foundation.
But there's more to those figures than meets the eye.
•Fourteen million of the 46 million counted as uninsured nationwide are eligible for Medicaid, Medicare, or SCHIP (a children's program) – they just haven't signed up.
•Thirty-one percent of California's uninsured have annual incomes over $50,000. Nationally, 18 million of the uninsured have household incomes above that level. Is it really fair to count as uninsured folks who can afford policies but have elected not to purchase them?
•Further, 44.7 percent of uninsured Californians are not even American citizens. It's unlikely that even a fully nationalized health system would insure noncitizens.
Throwing more money at Medi-Cal won't address the fundamental reason why many Californians are uninsured. As long as insurance is prohibitively expensive because of mandates and regulations on insurers, people will go without it.
Medi-Cal and Medicare are, in fact, largely responsible for skyrocketing private health insurance premiums because the reimbursement rates for government programs are well below market rates. This means that the privately insured must make up the difference, creating higher costs for everyone not on the government dole. In fact, research shows this hidden tax on those with private insurance adds about 10 percent to premiums.
Here in California, private health care providers subsidized Medicare to the tune of $45 billion in 2004. By shifting so many of its costs to the private sector, Medicare is hardly a model of cost-effectiveness.
So how should we lower health care costs? Many policy-makers believe that updated health information technology is a silver bullet for the task. The federal stimulus package contained about $20 billion for improving America's health IT infrastructure. Gov. Schwarzenegger is on record as stating that health IT "can lead to dramatic savings."
The savings from computerizing medical records sound significant. A RAND Corp. study estimated that revamped health IT would save approximately $77 billion a year nationally.
Unfortunately, those savings would only be realized after 15 years and only if the system were properly implemented. Considering that Americans spend around $2.3 trillion a year on health care, the absolute best-case scenario for cost-savings is about 3.3 percent.
Bailing out failing state programs and investing in dubious initiatives will prove a dead end for health care reform. If lawmakers are serious about lowering health costs, expanding access to care and perhaps even stimulating the economy, they'd be well-served to reform the federal tax code.
Currently, only businesses enjoy a tax deduction for health insurance expenses for their employees who get their insurance paid for with pretax dollars. If that deduction were extended to individuals – or if individuals received a refundable tax credit for purchasing their own insurance – many more would be able to obtain coverage. And costs would go down, as consumers would have the power to shop around for a policy that best meets their needs.
Closer to home, California could abolish its "sick tax" on the contributions individuals make to federally exempt Health Savings Accounts. Today, California is one of four states that taxes contributions to an HSA. Since 2004, Californians have paid some $162 million in unjustified taxes on their HSAs. With those funds, Californians could have saved for future health expenses or shopped around for the best deal on medical services. Instead, their money has been plowed back into the inefficient government system.
Both state and national leaders are interested in using the economic crisis to advance health reform. Whether that's wise is debatable. But it's critical that their deliberations heed the facts of the health care debate. If they don't, we'll continue to suffer through ill-gotten policies that waste time, money and lives and lead us down the path to a government-run health care system – "Medicare for All."
Sally Pipes: Stimulus no fix for health insurance
The stimulus package has money for government health programs, but that's not the way to make coverage more affordable
By SALLY C. PIPES
President, CEO of the Pacific Research Institute in San Francisco. Her new book is "The Top Ten Myths of American Health Care: A Citizen's Guide."
Comments 1 Recommended2
Gov. Arnold Schwarzenegger raised the ire of many in California by calling for $1.1 billion in cuts to Medi-Cal, the state health care program for the poor, as part of an effort to head off a projected $42 billion budget deficit over the next 17 months.
The federal government is now throwing him a lifeline. A cool $32 billion from the massive economic stimulus bill winding its way through Congress was designated for California. About a third of that is earmarked for Medi-Cal relief.
But a bailout of Medicaid (the federal version of Medi-Cal) with no checks and balances to ensure funds are spent as specified only kicks health care reform further down the road. It also shows that both state and federal policy-makers are still falling prey to myriad misconceptions on health policy. Until our leaders gain a hold on what is and isn't true in the health care debate, we'll continue to suffer through ineffective – and often harmful – reform efforts.
Among these myths is the notion that tens of millions of Americans don't have access to health care. The U.S. Census Bureau puts the number of uninsured Americans at 46 million; of those, 6.6 million live in California, according to the California HealthCare Foundation.
But there's more to those figures than meets the eye.
•Fourteen million of the 46 million counted as uninsured nationwide are eligible for Medicaid, Medicare, or SCHIP (a children's program) – they just haven't signed up.
•Thirty-one percent of California's uninsured have annual incomes over $50,000. Nationally, 18 million of the uninsured have household incomes above that level. Is it really fair to count as uninsured folks who can afford policies but have elected not to purchase them?
•Further, 44.7 percent of uninsured Californians are not even American citizens. It's unlikely that even a fully nationalized health system would insure noncitizens.
Throwing more money at Medi-Cal won't address the fundamental reason why many Californians are uninsured. As long as insurance is prohibitively expensive because of mandates and regulations on insurers, people will go without it.
Medi-Cal and Medicare are, in fact, largely responsible for skyrocketing private health insurance premiums because the reimbursement rates for government programs are well below market rates. This means that the privately insured must make up the difference, creating higher costs for everyone not on the government dole. In fact, research shows this hidden tax on those with private insurance adds about 10 percent to premiums.
Here in California, private health care providers subsidized Medicare to the tune of $45 billion in 2004. By shifting so many of its costs to the private sector, Medicare is hardly a model of cost-effectiveness.
So how should we lower health care costs? Many policy-makers believe that updated health information technology is a silver bullet for the task. The federal stimulus package contained about $20 billion for improving America's health IT infrastructure. Gov. Schwarzenegger is on record as stating that health IT "can lead to dramatic savings."
The savings from computerizing medical records sound significant. A RAND Corp. study estimated that revamped health IT would save approximately $77 billion a year nationally.
Unfortunately, those savings would only be realized after 15 years and only if the system were properly implemented. Considering that Americans spend around $2.3 trillion a year on health care, the absolute best-case scenario for cost-savings is about 3.3 percent.
Bailing out failing state programs and investing in dubious initiatives will prove a dead end for health care reform. If lawmakers are serious about lowering health costs, expanding access to care and perhaps even stimulating the economy, they'd be well-served to reform the federal tax code.
Currently, only businesses enjoy a tax deduction for health insurance expenses for their employees who get their insurance paid for with pretax dollars. If that deduction were extended to individuals – or if individuals received a refundable tax credit for purchasing their own insurance – many more would be able to obtain coverage. And costs would go down, as consumers would have the power to shop around for a policy that best meets their needs.
Closer to home, California could abolish its "sick tax" on the contributions individuals make to federally exempt Health Savings Accounts. Today, California is one of four states that taxes contributions to an HSA. Since 2004, Californians have paid some $162 million in unjustified taxes on their HSAs. With those funds, Californians could have saved for future health expenses or shopped around for the best deal on medical services. Instead, their money has been plowed back into the inefficient government system.
Both state and national leaders are interested in using the economic crisis to advance health reform. Whether that's wise is debatable. But it's critical that their deliberations heed the facts of the health care debate. If they don't, we'll continue to suffer through ill-gotten policies that waste time, money and lives and lead us down the path to a government-run health care system – "Medicare for All."
Thursday, February 5, 2009
KFI 640 - John and Ken report that Octuplet Mother's IVF doctor under investigation
The delivery of octuplets is a remarkable news story, and the mainstream media guffaws at the "miraculous" event.
But, was this 8 fetus pregnancy really a miracle or was it the result of manipulation by doctors and the single-mother of 6 other kids?
KFI's John and Ken are reporting that the mother in the case is Nadya Suleman. KFI reports that Ms. Suleman was recipient of hundreds of thousands of dollars of workman's compensation claims reports without any "state doctor" inspecting the case.
Remarkable how much tax payer money is subject to theft of the public money.
But, was this 8 fetus pregnancy really a miracle or was it the result of manipulation by doctors and the single-mother of 6 other kids?
KFI's John and Ken are reporting that the mother in the case is Nadya Suleman. KFI reports that Ms. Suleman was recipient of hundreds of thousands of dollars of workman's compensation claims reports without any "state doctor" inspecting the case.
Remarkable how much tax payer money is subject to theft of the public money.
Saturday, December 13, 2008
OC Register makes story on Breen disappear
We have been observing the OCREGISTER.COM webpage for OC Watchdog.
Somehow the story on Dr. Breen has been dropped from the OC Watchdog index page.
Gee, how conveeeenient.
Did we get our blog messages crossed up with the attempt to libel Breen?
Exactly how much money does CHOC advertisement revenue generate for Freedom?
http://www.ocregister.com/articles/breen-medical-uci-2234973-doctors-state
MOST PERTINENT PHRASE OF THIS STORY:"Kain's annual salary is $550,000, a portion of which is paid by Children's Hospital of Orange County, where he is medical director of perioperative research, Murray said."This case against Breen stinks.The case is wretched because it's clearly a set up by political interests.Medical Board of California needs to stop the larceny at CHOC rather than making idiotic accusations against Breen because of political stances regarding ILLEGAL mergers between State/taxpayer funds at a UC medical center and a private not-for-profit like CHOC.It was illegal at Stanford/UCSF. Somehow UCSD/Children's Hospital San Diego side stepped these issues. But, it remains anti-trust and anti-competitive.Someone should tell the management team at CHOC and UCIMC that they are walking a very thin green line towards federal prosecution.MBC should be ashamed.
Somehow the story on Dr. Breen has been dropped from the OC Watchdog index page.
Gee, how conveeeenient.
Did we get our blog messages crossed up with the attempt to libel Breen?
Exactly how much money does CHOC advertisement revenue generate for Freedom?
http://www.ocregister.com/articles/breen-medical-uci-2234973-doctors-state
MOST PERTINENT PHRASE OF THIS STORY:"Kain's annual salary is $550,000, a portion of which is paid by Children's Hospital of Orange County, where he is medical director of perioperative research, Murray said."This case against Breen stinks.The case is wretched because it's clearly a set up by political interests.Medical Board of California needs to stop the larceny at CHOC rather than making idiotic accusations against Breen because of political stances regarding ILLEGAL mergers between State/taxpayer funds at a UC medical center and a private not-for-profit like CHOC.It was illegal at Stanford/UCSF. Somehow UCSD/Children's Hospital San Diego side stepped these issues. But, it remains anti-trust and anti-competitive.Someone should tell the management team at CHOC and UCIMC that they are walking a very thin green line towards federal prosecution.MBC should be ashamed.
Friday, November 28, 2008
UC Irvine Medical Center CEO resigns
Monday, November 10, 2008
UCI Medical Center chief resigns
Maureen Zehntner, who was promoted in March, announced she will step down, effective in March.
By COURTNEY PERKES AND MARLA JO FISHER
The Orange County Register
Comments 22 Recommend 19
ORANGE The head of UCI Medical Center, who was promoted in the wake of scandal, said Monday she will retire in March, the announcement coming at a time when the hospital continues to face problems.
Maureen Zehntner, a registered nurse who spent 13 years on the hospital's executive committee, was named acting chief executive officer in 2005. She was permanently appointed to the top job eight months ago. She replaced Dr. Ralph Cygan, who resigned after the hospital's liver transplant program closed because of mismanagement and poor survival rates.
In a memo to staff, Zehntner, 60, said she had "very mixed emotions," but that both her parents had recently died and another family member has a serious medical condition. She also wrote that her husband was eager for her to join him in retirement.
Zehntner's announcement to leave her $555,000 job comes as the medical center prepares to move patients into its new hospital early next year. The hospital also continues to face problems stemming from the recent disclosure that anesthesiologists were falsifying patient records to save time.
In August, Medicare threatened to pull the hospital's funding after health inspectors found anesthesiologists were filling out patient records in advance of their surgeries. In one case, inspectors found a completed operating-room record that showed the patient left the operating table that day at 10:30 a.m. However, it was 9:30 a.m. at the time and the patient was still in surgery.
The university said anesthesiologists had been ordered to stop.
Last week, Medicare officials said the hospital was still out of compliance after an October follow-up inspection of the hospital. Because the report isn't finished, it's unknown where problems were found. But Dr. David Bailey, vice chancellor for health affairs, said he expected anesthesiology to be in the clear.
The state Medical Board has also filed a disciplinary accusation against UCI anesthesiologist Dr. Peter Breen. The board alleges Breen falsely filled out a surgery form for a cataract patient in advance of surgery, falsely indicating that the patient was stable and comfortable.
Breen, who was a previous chairman of the anesthesiology department, said in a letter to the editor published in the Register last month: "There was no fraud, no malice, no monetary gain, no patient injury and no compromise of care associated with predocumentation."
Contact the writer: 714-796-3686 or cperkes@ocregister.com
UCI Medical Center chief resigns
Maureen Zehntner, who was promoted in March, announced she will step down, effective in March.
By COURTNEY PERKES AND MARLA JO FISHER
The Orange County Register
Comments 22 Recommend 19
ORANGE The head of UCI Medical Center, who was promoted in the wake of scandal, said Monday she will retire in March, the announcement coming at a time when the hospital continues to face problems.
Maureen Zehntner, a registered nurse who spent 13 years on the hospital's executive committee, was named acting chief executive officer in 2005. She was permanently appointed to the top job eight months ago. She replaced Dr. Ralph Cygan, who resigned after the hospital's liver transplant program closed because of mismanagement and poor survival rates.
In a memo to staff, Zehntner, 60, said she had "very mixed emotions," but that both her parents had recently died and another family member has a serious medical condition. She also wrote that her husband was eager for her to join him in retirement.
Zehntner's announcement to leave her $555,000 job comes as the medical center prepares to move patients into its new hospital early next year. The hospital also continues to face problems stemming from the recent disclosure that anesthesiologists were falsifying patient records to save time.
In August, Medicare threatened to pull the hospital's funding after health inspectors found anesthesiologists were filling out patient records in advance of their surgeries. In one case, inspectors found a completed operating-room record that showed the patient left the operating table that day at 10:30 a.m. However, it was 9:30 a.m. at the time and the patient was still in surgery.
The university said anesthesiologists had been ordered to stop.
Last week, Medicare officials said the hospital was still out of compliance after an October follow-up inspection of the hospital. Because the report isn't finished, it's unknown where problems were found. But Dr. David Bailey, vice chancellor for health affairs, said he expected anesthesiology to be in the clear.
The state Medical Board has also filed a disciplinary accusation against UCI anesthesiologist Dr. Peter Breen. The board alleges Breen falsely filled out a surgery form for a cataract patient in advance of surgery, falsely indicating that the patient was stable and comfortable.
Breen, who was a previous chairman of the anesthesiology department, said in a letter to the editor published in the Register last month: "There was no fraud, no malice, no monetary gain, no patient injury and no compromise of care associated with predocumentation."
Contact the writer: 714-796-3686 or cperkes@ocregister.com
Monday, November 3, 2008
PROPOSITION THREE : CALIFORNIA
OK citizens.
Prop 3 is on the ballot tomorrow.
This is the biggest earmark on the California ballot...and my guess is that bleeding heart citizens will fall for this scam again.
You put the words "children" and "Hospital" on the ballot together, and out comes more billions from the state budget.
This is a regular ATM for the no-top-line is too high and no bottom line is too slim crowd.
The fact of the matter is here:
http://taxdollars.freedomblogging.com/2008/09/04/choc-provides-more-detail-on-executives-compensation/308/#comment-2791
Prop 3 is on the ballot tomorrow.
This is the biggest earmark on the California ballot...and my guess is that bleeding heart citizens will fall for this scam again.
You put the words "children" and "Hospital" on the ballot together, and out comes more billions from the state budget.
This is a regular ATM for the no-top-line is too high and no bottom line is too slim crowd.
The fact of the matter is here:
http://taxdollars.freedomblogging.com/2008/09/04/choc-provides-more-detail-on-executives-compensation/308/#comment-2791
Wednesday, September 10, 2008
OC REGISTER - Watchdog still thinks that the hospitals are not on the taxpayer dime
Teri Sforza, Register staff writer Says: September 10th, 2008 at 9:08 pm
I wish I understood where you guys are coming from.
Medical care in this country is paid for largely by private insurance companies.
Where do you get the idea that becasue a hospital is nonprofit, it is taxpayer-funded?! I’m really quite bemused.
We’ll get some more specific breakdowns from the hospitals about revenue flow, but you do NOT get taxpayer money because you are a nonprofit hospital.
________________________________________
HUH????
This is idiotic!
Medi-Cal money IS tax payer money.
Medi-Cal money comes from the state of California. Medi-Cal funds are appropriated funds from US Government healthcare budgets set by the US Congress. The federal government appropriates the money by Congress and issues checks from the agency in DC to the states.
The State of California gets this check and deposits the money in someone's fund. Who knows which bank gets this fund, but someone does.
Apparently, according to Cal Optima, the state of California agency is squatting on this money and not paying them.
However, the Medi-Cal website clearly shows announcements that they are moving checks to the local agencies.
So, someone is lying. Either the Cal Optima position is a lie and they actually do have the money... OR Sacramento is lying and they haven't issued the check... but in BOTH CASES, we know that the HOSPITALS in OC get plenty of Medi-Cal money...because the hospitals REPORT that revenue to OSHPD.
I wish I understood where you guys are coming from.
Medical care in this country is paid for largely by private insurance companies.
Where do you get the idea that becasue a hospital is nonprofit, it is taxpayer-funded?! I’m really quite bemused.
We’ll get some more specific breakdowns from the hospitals about revenue flow, but you do NOT get taxpayer money because you are a nonprofit hospital.
________________________________________
HUH????
This is idiotic!
Medi-Cal money IS tax payer money.
Medi-Cal money comes from the state of California. Medi-Cal funds are appropriated funds from US Government healthcare budgets set by the US Congress. The federal government appropriates the money by Congress and issues checks from the agency in DC to the states.
The State of California gets this check and deposits the money in someone's fund. Who knows which bank gets this fund, but someone does.
Apparently, according to Cal Optima, the state of California agency is squatting on this money and not paying them.
However, the Medi-Cal website clearly shows announcements that they are moving checks to the local agencies.
So, someone is lying. Either the Cal Optima position is a lie and they actually do have the money... OR Sacramento is lying and they haven't issued the check... but in BOTH CASES, we know that the HOSPITALS in OC get plenty of Medi-Cal money...because the hospitals REPORT that revenue to OSHPD.
Tuesday, September 9, 2008
Why does CHOC like MediCal so much?
This OSHPD report tells it all. Look at the revenue CHOC gets for each type of program.
CHOC reported that their NET Inpatient money per patient per day was about $4500 per private PPO or HMO patient. But, under Medi-Cal (state funded programs), CHOC got $9000 per patient per day.
So, the patients at CHOC under a state funded program generated TWICE as much revenue than a patient who actually pays to be in the hospital.
CHOC reported that their NET Inpatient money per patient per day was about $4500 per private PPO or HMO patient. But, under Medi-Cal (state funded programs), CHOC got $9000 per patient per day.
So, the patients at CHOC under a state funded program generated TWICE as much revenue than a patient who actually pays to be in the hospital.
CHOC reports data to OSHPD
The state of California has an Office of Statewide Health Planning and Development (OSHPD).
OSHPD has a website which you can access to see their reported information.
Here's the key information for 2007
CHOC v. All CA Facilities
Number of Total discharges (from the Emergency Department and from being hospitalized) was 10,247 patients.
Number of Total discharges (from the Emergency Department and from being hospitalized) was 10,247 patients.
Inpatient Discharges from the inpatient services at CHOC are 6,449 patients.
(Average of 17.7 per day)
(Average of 17.7 per day)
Now, look at the chart of ER discharges for CHOC. Notice that ER discharges decreased from a peak in 2004. This means that fewer patients are being discharged.
Now, take a look at the total number of inpatient discharges from CHOC in the same time period. It increases. Why? Probably there is a higher likelihood of admission to CHOC if the patient is seen in the Emergency room.
Average Length of Stay is 6.5 Day(s) in CHOC versus 5.3 days average stay for California
Average Charge is $77,081 at CHOC vs. $34,392 average for California (OVER DOUBLE THE STATE AVERAGE CHARGE PER HOSPITALIZATION)
Average Charge per Day is $11,925 at CHOC vs. $6,486 average for California
Median Charge per admission is $51,194 at CHOC vs. $45,769 for California
Sunday, September 7, 2008
OC Watchdog gets the low-down on Cal Optima Executive Pay
CalOptima staff gets raises while cutting fees to doctors
September 7th, 2008, 6:00 am · 3 Comments · posted by Jennifer Muir
We told you last week that CalOptima, the county’s $1 billion health care safety net, was cutting pay to doctors by 10 percent to pass along the expense of expected cuts to the state budget and that the agency was paying doctors from its reserves even though they haven’t been reimbursed from the state in months.
CalOptima just sent over documents this week that show that while cutting pay to doctors, the agency recently gave one top administrator a 10 percent raise and gave their employees $600,000 in pay raises.
The records also show that CalOptima’s CEO didn’t take a raise at all, and that the agency shaved $1.4 million from what it would have paid for administrative costs if the state budget wasn’t in such trouble.
Disagreement over just how much doctors should be paid during all the budget uncertainty erupted last month at a county Board of Supervisors meeting. At the meeting, Michele Revelle, a lobbyist for the doctor’s group Orange County Medical Association, criticized CalOptima for giving its staff raises and other administrative spending while paying out less to hospitals and doctors.
The argument reinforces the tough situation for both CalOptima and doctors trying to plan their futures when they don’t know whether the state will slash their funding and they don’t know when lawmakers will figure out a solution.
“In a time that’s so desperate and doctors are barely surviving, they’re cutting costs to doctors and still getting all these things,” Revelle said last month. “If you’re going to make all these cuts to physicians that are dying on the vine, we want to look at what you’re spending on, and we need proof.”
So we asked for that proof. Read on to find out what they sent.
Cal Optima sent over a list of salaries for its top five administrators for fiscal year 2007-2008. COO Gary Buchert got the biggest raise this year, 10 percent, bringing his salary to $275,000. A spokesman said Buchert took on some new responsibilities this year.
“You’re also dealing with medical doctors here who have an opportunity to go out into the market and have a potential to realize a bigger salary,” said Ben Boyce, vice president of the PR firm Laer Pearce and Associates, who returned calls to CalOptima on Friday. “It’s all part of competing for the best talent, which ultimately benefits the thousands of patients that CalOptima serves.”
CEO Richard Chambers, who earns $312,700 a year, was among the three top administrators that didn’t receive a raise at all. A fourth administrator got a two percent salary increase.
CalOptima also sent over a breakdown of the administrative costs for its 2008-2009 budget. About $600,000 of the agency’s $26,030,504 salary and benefits budget will pay for merit increases. The money for those raises came from a previous budget surplus.
The rest will pay for new employees, who are needed to take on work for a new shared-risk program, and increases to employee health insurance premiums.
Overall, the budget for salaries and benefits increased nearly $1.5 million, or six percent, from $24,536,823.
CalOptima’s board will likely revisit its entire operating budget once the state budget is passed.
“The board’s approach in connection with facing that shortfall was to share the pain of that,” CalOptima spokeswoman Margaret Tatar said. “I can’t underestimate how dire the state situation is. I totally empathize with the providers … “
Revelle explained just how dire it is for doctors, warning that if the cuts continue, up to 44 percent of the group’s 2,700 local physicians could stop taking new patients enrolled CalOptima, according to an informal survey of doctors.
September 7th, 2008, 6:00 am · 3 Comments · posted by Jennifer Muir
We told you last week that CalOptima, the county’s $1 billion health care safety net, was cutting pay to doctors by 10 percent to pass along the expense of expected cuts to the state budget and that the agency was paying doctors from its reserves even though they haven’t been reimbursed from the state in months.
CalOptima just sent over documents this week that show that while cutting pay to doctors, the agency recently gave one top administrator a 10 percent raise and gave their employees $600,000 in pay raises.
The records also show that CalOptima’s CEO didn’t take a raise at all, and that the agency shaved $1.4 million from what it would have paid for administrative costs if the state budget wasn’t in such trouble.
Disagreement over just how much doctors should be paid during all the budget uncertainty erupted last month at a county Board of Supervisors meeting. At the meeting, Michele Revelle, a lobbyist for the doctor’s group Orange County Medical Association, criticized CalOptima for giving its staff raises and other administrative spending while paying out less to hospitals and doctors.
The argument reinforces the tough situation for both CalOptima and doctors trying to plan their futures when they don’t know whether the state will slash their funding and they don’t know when lawmakers will figure out a solution.
“In a time that’s so desperate and doctors are barely surviving, they’re cutting costs to doctors and still getting all these things,” Revelle said last month. “If you’re going to make all these cuts to physicians that are dying on the vine, we want to look at what you’re spending on, and we need proof.”
So we asked for that proof. Read on to find out what they sent.
Cal Optima sent over a list of salaries for its top five administrators for fiscal year 2007-2008. COO Gary Buchert got the biggest raise this year, 10 percent, bringing his salary to $275,000. A spokesman said Buchert took on some new responsibilities this year.
“You’re also dealing with medical doctors here who have an opportunity to go out into the market and have a potential to realize a bigger salary,” said Ben Boyce, vice president of the PR firm Laer Pearce and Associates, who returned calls to CalOptima on Friday. “It’s all part of competing for the best talent, which ultimately benefits the thousands of patients that CalOptima serves.”
CEO Richard Chambers, who earns $312,700 a year, was among the three top administrators that didn’t receive a raise at all. A fourth administrator got a two percent salary increase.
CalOptima also sent over a breakdown of the administrative costs for its 2008-2009 budget. About $600,000 of the agency’s $26,030,504 salary and benefits budget will pay for merit increases. The money for those raises came from a previous budget surplus.
The rest will pay for new employees, who are needed to take on work for a new shared-risk program, and increases to employee health insurance premiums.
Overall, the budget for salaries and benefits increased nearly $1.5 million, or six percent, from $24,536,823.
CalOptima’s board will likely revisit its entire operating budget once the state budget is passed.
“The board’s approach in connection with facing that shortfall was to share the pain of that,” CalOptima spokeswoman Margaret Tatar said. “I can’t underestimate how dire the state situation is. I totally empathize with the providers … “
Revelle explained just how dire it is for doctors, warning that if the cuts continue, up to 44 percent of the group’s 2,700 local physicians could stop taking new patients enrolled CalOptima, according to an informal survey of doctors.
CHOC responds to OC Watchdog
CHOC provides more detail on executive’s compensation
September 4th, 2008, 3:30 pm · 6 Comments · posted by Teri Sforza, Register staff writer
Recently, we highlighted the healthy compensation of OC’s non-profit hospital executives.
Top earners were Hoag Memorial Hospital Presbyterian’s Richard Afable, whose total compensation was $1.2 million, and Children’s Hospital of Orange County’s Kim Cripe, whose total was $1.1 million.
Denise Almazan, director of public relations for CHOC and CHOC at Mission, wanted to provide more detail on Cripe, so we copy her message below:
Kim Cripe oversees a regional tertiary/quaternary pediatric healthcare system that includes two pediatric hospitals, five community clinics, four centers of excellence, a Research Institute, and a residency program that trains tomorrow’s pediatricians. The system serves multiple counties - Los Angeles, Orange, Riverside, San Bernardino and parts of San Diego, and receives patients from more than 70 hospitals. It is the only children’s healthcare system in the region and acts as a safety net for some of the area’s neediest and most critically ill children.
Not all organizations report benefits on their tax returns in the same fashion, and CHOC takes a conservative approach by including in the total benefit column such elements as the employer’s portion of Social Security, state unemployment insurance, group health insurance, worker’s compensation premiums and even severance packages - which CHOC’s CEO has not received given her continued service. Her compensation, based on market data of like organizations (size, complexity, revenue), including other children’s hospitals, is determined by the Compensation Committee of the board of directors, of which she and other hospital executives are not members. This committee employs best practices in non-profit governance and executive compensation and contracts with an external, independent firm whose database includes compensation data reported by approximately 350 health care systems, 1,000 hospitals,and 50 children’s hospitals, covering over 17,000 executives and 130 positions.
September 4th, 2008, 3:30 pm · 6 Comments · posted by Teri Sforza, Register staff writer
Recently, we highlighted the healthy compensation of OC’s non-profit hospital executives.
Top earners were Hoag Memorial Hospital Presbyterian’s Richard Afable, whose total compensation was $1.2 million, and Children’s Hospital of Orange County’s Kim Cripe, whose total was $1.1 million.
Denise Almazan, director of public relations for CHOC and CHOC at Mission, wanted to provide more detail on Cripe, so we copy her message below:
Kim Cripe oversees a regional tertiary/quaternary pediatric healthcare system that includes two pediatric hospitals, five community clinics, four centers of excellence, a Research Institute, and a residency program that trains tomorrow’s pediatricians. The system serves multiple counties - Los Angeles, Orange, Riverside, San Bernardino and parts of San Diego, and receives patients from more than 70 hospitals. It is the only children’s healthcare system in the region and acts as a safety net for some of the area’s neediest and most critically ill children.
Not all organizations report benefits on their tax returns in the same fashion, and CHOC takes a conservative approach by including in the total benefit column such elements as the employer’s portion of Social Security, state unemployment insurance, group health insurance, worker’s compensation premiums and even severance packages - which CHOC’s CEO has not received given her continued service. Her compensation, based on market data of like organizations (size, complexity, revenue), including other children’s hospitals, is determined by the Compensation Committee of the board of directors, of which she and other hospital executives are not members. This committee employs best practices in non-profit governance and executive compensation and contracts with an external, independent firm whose database includes compensation data reported by approximately 350 health care systems, 1,000 hospitals,and 50 children’s hospitals, covering over 17,000 executives and 130 positions.
OC Register - Watchdog writes about Doctors Pay
It is interesting to research where all of our tax payer money goes in healthcare.
With the Presidential election occurring, and increasing evidence of massive debts levelled on us citizens, don't you wonder where your taxes go?
After all, if you are not paying the hospital and doctor directly, you're at the mercy of those who have the checkbook.
If the government is going to hold the checkbook, wouldn't it make more sense that the government be solvent?
Otherwise, you could end up with your life shortened because of fraud in the area.
Well...look at what the OC Register publishes...
OC doctors, paid from ‘piggy bank,’ dislike fee cut
September 5th, 2008, 7:00 am · 2 Comments · posted by Teri Sforza, Register staff writer
News flash: Poor folks don’t stop getting sick just because the state stops paying its bills.
Which puts the folks at CalOptima - the county’s $1 billion health care safety net - in a rather interesting bind:
Stop paying medical bills - which average some $73.4 million per month (or $2.5 million per day) - until the state gets its act together, which would surely harm people?
Or…keep paying out of pocket, by dipping into CalOptima’s reserve funds?
Drum roll, please….
CalOptima is paying. In July, August and so far in September, doctors were paid out of reserve/piggy bank/rainy-day funds to the tune of tens of millions of dollars.
But as the state’s budget paralysis wears on, “We’re depleting our reserves,” said John Moorlach, chairman of the Board of Supervisors (and CalOptima board member).
Said Michele Revelle, executive director of the Orange County Medical Association: “That’s what reserves are for.”
So doctors are happy, then, right?
Er, not quite.
To help plug that gaping hole in California’s budget, the state wants to cut reimbursements to doctors who treat the needy by 10 percent.
So, while CalOptima is paying the bills out of its piggy bank, it’s also treating that 10 percent cut like it’s a done deal.
“We’re pleased that doctors continue to get paid while the state is in this stalemate,” said the Medical Association’s Revelle. “But in our view, (CalOptima) should not have passed on the cuts. In the end, the state may not even make any cuts to doctors.”
Perhaps, Moorlach said. If that 10 percent cut does indeed disappear, CalOptima would “catch everyone up” and repay the money to doctors. Seems to make more sense to assume the cuts are a go, than to pay full fare now and have to cut even deeper later to try to make up the difference, Moorlach said.
Some counties, of course, aren’t paying medical bills at all.
“This is a vulnerable population, and we have to make sure this vulnerable population is taken care of,” Moorlach said. “If there was to be some epidemic, it would hurt everyone.”
With the Presidential election occurring, and increasing evidence of massive debts levelled on us citizens, don't you wonder where your taxes go?
After all, if you are not paying the hospital and doctor directly, you're at the mercy of those who have the checkbook.
If the government is going to hold the checkbook, wouldn't it make more sense that the government be solvent?
Otherwise, you could end up with your life shortened because of fraud in the area.
Well...look at what the OC Register publishes...
OC doctors, paid from ‘piggy bank,’ dislike fee cut
September 5th, 2008, 7:00 am · 2 Comments · posted by Teri Sforza, Register staff writer
News flash: Poor folks don’t stop getting sick just because the state stops paying its bills.
Which puts the folks at CalOptima - the county’s $1 billion health care safety net - in a rather interesting bind:
Stop paying medical bills - which average some $73.4 million per month (or $2.5 million per day) - until the state gets its act together, which would surely harm people?
Or…keep paying out of pocket, by dipping into CalOptima’s reserve funds?
Drum roll, please….
CalOptima is paying. In July, August and so far in September, doctors were paid out of reserve/piggy bank/rainy-day funds to the tune of tens of millions of dollars.
But as the state’s budget paralysis wears on, “We’re depleting our reserves,” said John Moorlach, chairman of the Board of Supervisors (and CalOptima board member).
Said Michele Revelle, executive director of the Orange County Medical Association: “That’s what reserves are for.”
So doctors are happy, then, right?
Er, not quite.
To help plug that gaping hole in California’s budget, the state wants to cut reimbursements to doctors who treat the needy by 10 percent.
So, while CalOptima is paying the bills out of its piggy bank, it’s also treating that 10 percent cut like it’s a done deal.
“We’re pleased that doctors continue to get paid while the state is in this stalemate,” said the Medical Association’s Revelle. “But in our view, (CalOptima) should not have passed on the cuts. In the end, the state may not even make any cuts to doctors.”
Perhaps, Moorlach said. If that 10 percent cut does indeed disappear, CalOptima would “catch everyone up” and repay the money to doctors. Seems to make more sense to assume the cuts are a go, than to pay full fare now and have to cut even deeper later to try to make up the difference, Moorlach said.
Some counties, of course, aren’t paying medical bills at all.
“This is a vulnerable population, and we have to make sure this vulnerable population is taken care of,” Moorlach said. “If there was to be some epidemic, it would hurt everyone.”
Thursday, September 4, 2008
Children's Healthcare of California
CHOC’s 990 tax return seems to list the Executive Compensation of the CEO, Kim Cripe, and the CFO, Kerri Ruppert, as zero.
However, review of the related organization’s Form 990 shows otherwise.
CHOC’s Form 990 lists a related organization called Children’s Healthcare of California with an identical street address, identical executive officers as CHOC, and yet different books.
The CHC 2005 tax return states total program service revenue for CHC as being $1,347,000 in 2005.
They also report the CEO and CFO salaries…which total $1,346,383.00.
It seems that the CEO + CFO salary is 99.954% of the annual program service revenue of the entire non-profit.
Now, can someone at OC Register explain to this citizen why you are bagging on BSA so much when CHC reports a ratio of Program Service Revenue to CEO + CFO salary exceeding 99.9% ????
However, review of the related organization’s Form 990 shows otherwise.
CHOC’s Form 990 lists a related organization called Children’s Healthcare of California with an identical street address, identical executive officers as CHOC, and yet different books.
The CHC 2005 tax return states total program service revenue for CHC as being $1,347,000 in 2005.
They also report the CEO and CFO salaries…which total $1,346,383.00.
It seems that the CEO + CFO salary is 99.954% of the annual program service revenue of the entire non-profit.
Now, can someone at OC Register explain to this citizen why you are bagging on BSA so much when CHC reports a ratio of Program Service Revenue to CEO + CFO salary exceeding 99.9% ????
Response to OC Watchdog on CHOC statement
The statement sent to OC Register today stands in stark contrast to the facts revealed by simple Google searches.
A simple google search identifies a non-profit called the California Children's Hospital Association
Their website identifies Regular and Associate members. They are as follows:
Regular Members
Children's Hospital Central California
Childrens Hospital Los Angeles
Children's Hospital of Orange County
Children's Hospital & Research Center at Oakland
Loma Linda University Children's Hospital (not identified tonight on guidestar)
Lucile Packard Children's Hospital at Stanford
Miller Children's Hospital (not identified tonight on guidestar)
Rady Children's Hospital - San Diego
Associate Members
Mattel Children's Hospital at UCLA
University Children's Hospital at University of California Irvine
University of California, Davis Children's Hospital
University of California, San Diego Children's Hospital
University of California, San Francisco Children's Hospital
Children's Center at Sutter Medical Center, Sacramento
In a written statement to the Orange County Register, a spokesperson for CHOC defends the actions of their Board of Directors by stating:
"The system serves multiple counties - Los Angeles, Orange, Riverside, San Bernardino and parts of San Diego, and receives patients from more than 70 hospitals. It is the only children’s healthcare system in the region and acts as a safety net for some of the area’s neediest and most critically ill children."
Review of the list from the CCHA (of which we note that CHOC is a member and acknowledges) shows that there are seven other children's hospitals in the counties listed by CHOC representatives. We are unclear why CHOC states that they are the "only children's healthcare system in the region" when USC, UC Irvine, UCLA, UC San Diego, and Loma Linda all have university and medical school affiliated pediatric hospitals. Each of those websites list university affiliation as a part of their programs.
We rank list the reported income of some of these hospitals in 2005
They are:
Hospital (ranked in total Revenue)
Kim Cripe - CEO
TOTAL = $1,101,159
Compensation = $846,394
Benefits = $215,965.00
Expense Account = $38,800
3. Lucile Salter Packard Children's Hospital (number 1 in annual 2005 revenue)
Christopher Dawes - CEO/President
TOTAL = $809,386.00
Compensation = $768,668
Benefits = $40,718
Expense Account = $0
4. Children's Hospital of Oakland reports on 2006 tax return
Frank Tiedemann, MD - President & CEO
TOTAL = $673,671
Compensation = $586,142
Benefits = $87,529
Expense account = $0
5. Central California Children's Hospital
William F. Haug CEO
TOTAL: $597,337
Compensation= $571,478
Benefits = $16,259
Expenses = $9,600
6. Children's Hospital of Los Angeles (number 2 in annual 2005 revenue)
Richard Cordova - President and CEO
TOTAL= $570,605
Compensation = $416,062
Benefits = $153,665
Expense account = $878
A simple google search identifies a non-profit called the California Children's Hospital Association
Their website identifies Regular and Associate members. They are as follows:
Regular Members
Children's Hospital Central California
Childrens Hospital Los Angeles
Children's Hospital of Orange County
Children's Hospital & Research Center at Oakland
Loma Linda University Children's Hospital (not identified tonight on guidestar)
Lucile Packard Children's Hospital at Stanford
Miller Children's Hospital (not identified tonight on guidestar)
Rady Children's Hospital - San Diego
Associate Members
Mattel Children's Hospital at UCLA
University Children's Hospital at University of California Irvine
University of California, Davis Children's Hospital
University of California, San Diego Children's Hospital
University of California, San Francisco Children's Hospital
Children's Center at Sutter Medical Center, Sacramento
In a written statement to the Orange County Register, a spokesperson for CHOC defends the actions of their Board of Directors by stating:
"The system serves multiple counties - Los Angeles, Orange, Riverside, San Bernardino and parts of San Diego, and receives patients from more than 70 hospitals. It is the only children’s healthcare system in the region and acts as a safety net for some of the area’s neediest and most critically ill children."
Review of the list from the CCHA (of which we note that CHOC is a member and acknowledges) shows that there are seven other children's hospitals in the counties listed by CHOC representatives. We are unclear why CHOC states that they are the "only children's healthcare system in the region" when USC, UC Irvine, UCLA, UC San Diego, and Loma Linda all have university and medical school affiliated pediatric hospitals. Each of those websites list university affiliation as a part of their programs.
We rank list the reported income of some of these hospitals in 2005
They are:
Hospital (ranked in total Revenue)
- Lucille Packard Children's Hospital, Stanford, California ($556,069,591 in 2005)
- Children's Hospital of Los Angeles ($527,823,635 in 2005)
- Children's Hospital of San Diego ($395,573,634 in 2005)
- Children's Hospital of Orange County ($343,304,390 in 2005)
- Children's Hospital at Oakland ($336,809,036 in 2005)
- Children's Hospital of Central California- Fresno, California ($291,257,219 in 2005)
- Miller Children's Hospital, Long Beach, California (not reported on Guidestar)
- UCLA Children's Hospital, Los Angeles, California (not reported on Guidestar)
Here is the rank list of CEO salaries for the California children's hospitals we identified at Guidestar tonight.
1. Children's Hospital of San Diego (number 3 in annual 2005 revenue)
Blair Sadler
President
TOTAL = $1,195,103
Compensation= $ 921,381
Benefits = $259,232
Expense Account = $14,490
2. Children's Hospital of Orange County (number 4 in annual 2005 revenue)
Kim Cripe - CEO
TOTAL = $1,101,159
Compensation = $846,394
Benefits = $215,965.00
Expense Account = $38,800
3. Lucile Salter Packard Children's Hospital (number 1 in annual 2005 revenue)
Christopher Dawes - CEO/President
TOTAL = $809,386.00
Compensation = $768,668
Benefits = $40,718
Expense Account = $0
4. Children's Hospital of Oakland reports on 2006 tax return
Frank Tiedemann, MD - President & CEO
TOTAL = $673,671
Compensation = $586,142
Benefits = $87,529
Expense account = $0
5. Central California Children's Hospital
William F. Haug CEO
TOTAL: $597,337
Compensation= $571,478
Benefits = $16,259
Expenses = $9,600
6. Children's Hospital of Los Angeles (number 2 in annual 2005 revenue)
Richard Cordova - President and CEO
TOTAL= $570,605
Compensation = $416,062
Benefits = $153,665
Expense account = $878
From OC Register OC Watchdog
Hoag, CHOC hospital execs earn more than $1 million each
September 3rd, 2008, 7:00 am · 35 Comments · posted by Teri Sforza, Register staff writer
In a raging debate on this site about how much the top-paid National Boy Scout exec earned (nearly $900,000), the conversation somewhat inexplicably turned to how much the heads of local non-profit hospitals make.
OK. The Watchdog will bite.
In fact, eight of Orange County’s 10 largest nonprofits (ranked by how much money they bring in) are hospitals, according to the Gianneschi Center for Nonprofit Research at CSU Fullerton.
And two of the executives at said hospitals — Hoag Memorial Hospital Presbyterian and Children’s Hospital Orange County — earn more than $1 million each. Which, we duly note, has caused a few jaws to drop, and exceeds the compensation paid to the Uber Boy Scout.
But the other six hospital executives earned less than the Uber Boy Scout.
It could be argued, of course, that the duties of the Boy Scout execs (building character, running a volunteer organization, etc.) are but a shadow of what a hospital executive deals with (life, death, blood, guts, malpractice insurance, billing, etc.). But we’ll just put forward the facts and let you argue about what it all means.
Here, from the most recent tax returns filed by the nonprofit hospitals with the IRS, are names and numbers:
September 3rd, 2008, 7:00 am · 35 Comments · posted by Teri Sforza, Register staff writer
In a raging debate on this site about how much the top-paid National Boy Scout exec earned (nearly $900,000), the conversation somewhat inexplicably turned to how much the heads of local non-profit hospitals make.
OK. The Watchdog will bite.
In fact, eight of Orange County’s 10 largest nonprofits (ranked by how much money they bring in) are hospitals, according to the Gianneschi Center for Nonprofit Research at CSU Fullerton.
And two of the executives at said hospitals — Hoag Memorial Hospital Presbyterian and Children’s Hospital Orange County — earn more than $1 million each. Which, we duly note, has caused a few jaws to drop, and exceeds the compensation paid to the Uber Boy Scout.
But the other six hospital executives earned less than the Uber Boy Scout.
It could be argued, of course, that the duties of the Boy Scout execs (building character, running a volunteer organization, etc.) are but a shadow of what a hospital executive deals with (life, death, blood, guts, malpractice insurance, billing, etc.). But we’ll just put forward the facts and let you argue about what it all means.
Here, from the most recent tax returns filed by the nonprofit hospitals with the IRS, are names and numbers:
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