Healthcare Contradictions

Health Care
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Pearl River      The coronavirus pandemic continues unabated as it rises and falls from state to state and country to country.  Healthcare institutions have been bent, but largely not broken in the United States.  Meanwhile experts are divided on whether by the end of the year we will have 180,000 or 200,000 deaths with the only sure thing being that we have already had too many, and that we will have way more to come. The more we read about how hospitals, nursing home chains, and most other healthcare institutions have handled some of this, it’s hard not to believe we have only been saved by a combination of luck, miracles, and the heroic sacrifices of frontline healthcare workers.

This was a point was driven home repeatedly in talking recently to Phil Mattera, the researcher director for Good Jobs First and a regular columnist for Social Policy, on Wade’s WorldThe Times referenced one of their tracker reports showing that the top twenty hospital chains had received several billion dollars in stimulus money from the CARES Act to support their finances, despite, or perhaps because of, the fact that they were holding more than $100 billion reserves.  The formula for assistance supports the big outfits as well, because it is based on revenues not client base or need.  The federal Department of Health and Human Services has given hospitals in the top 10% based on share of private insurance revenue $44,321 per hospital bed, more than double the $20,710 per hospital bed for those facilities in the bottom 10% of private insurance payments with lower income patient populations.

Nursing homes have also been huge hot spots for infection, and, worse, death.  The huge chain Genesis has seen a lot of this, but also managed to cash in hugely from the CARES Act.  Other reports have noted that nursing homes were unprepared in many cases for this pandemic because of private equity.   Real estate investment trusts or REITs had purchased a number of chains or particularly the real estate underneath them and contracted out the management.  The cost expenditure for care and the staffing ratios then were reduced markedly under equity control.  Patients are hard to manage as profit centers, and they are dying because of it.

Mattera also noted the fact that the federal Occupational Safety & Health Administration (OSHA) has become such a toothless, sleeping dog put both workers and patients at risk because working and client conditions had been allowed to deteriorate without enforcement.  Additionally, he noted that when it came to CARES Act stimulus money the government made no effort to screen out scofflaw corporations with long records of violations from OSHA and a handful of other tax and regulatory agencies, still allowing them to collect millions.  It’s no wonder that Treasury Secretary Mnuchin recently reneged on his promise to Congress of transparency and now says they will not disclose the corporations or amounts been given in federal aid.

When it comes to healthcare, as a society we need to resolve the contradictions over whether the mission of health operations is patients first or profits first.  That confusion left us flatfooted in facing the pandemic and there are thousands of head stones that should always remind us that we have to get this right both now and in the future.

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Please enjoy How I Weep by Norah Jones.

Thanks to WAMF,