By Donna Smith–
Many know by now that a single payer healthcare system is the type of reform most widely supported by the American people and a majority of nurses, doctors and healthcare professionals. Many also know that Congress has so far deftly and purposely shunned most expert witnesses who would offer evidence in favor of that publicly funded, privately delivered system. The media has also done its part to keep the message targeted away from single payer as recent independent studies showed how the mainstream media did its level best to keep big insurance and pharmaceutical advertisers happy by not reporting fairly on the topic.
Congress isn’t alone in its shading the discussion nor is the media. Both followed President Obama’s lead as he locked out the single payer voice from the first White House forum on health reform until the phone lines jammed with reports of planned protests by nurses in scrubs and white-coated docs marching outside the gates of the executive mansion while the industry “stakeholders” and the elected officials they support so mightily met inside at the invitation of Mr. Obama.
We might expect the fawning and fainting with glee over the cooperation between the usual suspects in this health reform period. With the most power-challenging and boat-rocking alternative kept out of the picture for now, those who profit most under a for-profit insurance based reform would be expected to act as if they have previously been enemies but are now ever so generously working together.
This is political theater staged by those with lots and lots of money in the game, and it is a fight for human rights being waged outside that political theater by those of us with lots and lots of real skin in the game. Millions of Americans have lost loved ones and homes and careers and good health and credit ratings to this travesty of a system, and none of the plans currently being “vetted” by this Congress or this President do much to mitigate that at all. It is a classic struggle of epic proportions.
But some of what is being offered and accepted as expert Congressional testimony is shocking even within this skewed and staged arena. There are some real rotten apples now in this Congressional record. And those rotten apples will spoil the whole process unless we all demand better. This fight for healthcare justice demands that we call for our best experts, our finest minds and not simply the most well-connected ones.
One example of the terribly biased testimonies being taken is that of the testimony submitted by Richard Scott to the U.S. House of Representatives Energy and Commerce Committee, subcommittee on health, on March 24, 2009. Mr. Scott reports that he was asked to submit his testimony to the committee. On his website, Conservatives for Patient Rights, Scott touts his own experience in the delivery of healthcare in this nation as reason enough to consider him an expert. And Scott is also launching some very inaccurate advertising on behalf of his “organization” in the effort to keep himself and his closet allies in the insurance and private provider industry in a very preferred position in the U.S. healthcare system.
Here’s a bit of this Congressional expert witness’s biography: Scott founded the Columbia Hospital Corporation in 1987, but dumped by the company’s board of directors in 1997 in the midst of the nation’s biggest healthcare (Medicare and Medicaid) fraud scandal. In 2001, Scott co-founded the Solantic Corporation, which operates walk-in medical care centers.
We need to know more about who is influencing Congress and the media now in the discussion. So, here’s more about witness Scott: In July 1997, when Scott was then the chairman and CEO of Columbia/Hospital Corporation of America and was forced out by the company’s board of directors, he left with a $10 million severance deal and 10 million shares of stock. At that time, the shares were worth more than $300 million. Scott was replaced by Dr. Thomas Frist, Jr., the co-founder of HCA and the brother of Senator Bill Frist, then Majority Leader in the U.S. Senate.
It’s all just a little incestuous, don’t you think?
But wait, our 2009 expert witness on healthcare reform in the U.S. left a little more than history behind at his company that speaks to how he views what is most important to him: making a buck in this system.
In 2001, HCA reached a plea agreement to pay $95 million in fines to the federal government to avoid criminal charges against the company. In late 2002, HCA agreed to pay the government $631 million, plus interest, and paid another $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims. In all, civil law suits cost HCA more than $1.7 billion to settle, including more than $500 million paid in 2003 to two whistleblowers.
$1.7 billion with a great big “B” was paid by HCA to resolve the Medicare and Medicaid fraud mess orchestrated under Mr. Scott’s watch who walked away with his own sweet deal. The largest Medicare and Medicaid fraud case in U.S. history, an investigation of over 10 years and he walks away with hundreds of millions of dollars only to return as one of our current expert witnesses on health reform? Whew. That’s an epic award and an epic injustice.
I worked for a Columbia-owned hospital in 1990. I was the billing manager. I was asked to do some very creative bookkeeping and went to the Medicare law and read that I would be risking prosecution if “I knew or should have known” what I was doing was illegal under federal law. As I read the law, it broadly imposed appropriate sanctions upon those who might consider bilking the taxpayer-funded system. My bosses told me if I wouldn’t do the transactions, they would hire someone who would.
As a consequence of what I read about the law, I packed up my belongings, walked to my car and drove away from that hospital rather than break the law. My husband was three weeks away from having his first open-heart surgery, and it was two weeks before Christmas. We had no other source of income.
What I had been asked to do in order to keep my job – my $35,000 a year job – was not right and I knew it even as a relatively “green” billing manager. How in the world am I to believe that Richard Scott knew less than I did about what was right and what was wrong under the Medicare program? And why was my life’s course forever altered in ways so very much different? He walked away with hundreds of millions. I certainly was not rewarded in any way for my honesty. I reported what I saw by way of letters to the government, but never heard anything back from my letters, save one response from a Senator who said they’d look into it.
And the fraud cases that were settled didn’t even touch on all the ways companies headed up by some of 2009’s “expert witnesses” like Richard Scott came up with to skirt the rules and bump up the bottom line. What I saw related to how Medicare bad debt is reimbursed – and it’s still an area where rules are broken today. Scott never went to jail. He took his hundreds of millions and now returns to say what’s needed in healthcare reform.
It’s all about the money folks. It’s all about the money.
We must demand that our Congress and our president hear from experts that are not of this ilk. We are better people than this. And our healthcare system must reflect our values of justice, decency and compassion. Dr. David Himmelstein of Physicians for a National Health Program testified finally a couple of weeks ago – but so far he has been the only expert from outside the corporate fold allowed to utter a word on the Congressional record on behalf of single payer. The Senate has invited no witness who strays from the canned agenda that will force us all to buy the defective product that is for-profit health insurance.
Mr. Scott didn’t care one bit about ripping off you and ripping off me and ripping off any other patient or taxpayer in this nation. He should not be an expert now advising Congress or anyone else on healthcare reform. His commercials and his organization’s communications should have to carry a disclaimer fully disclosing his involvement in the Columbia/HCA fraud case.
In fact, every witness ought to have to disclose their current source of any income as well as their conflicts of interest. Otherwise, we’ll end up with a system crafted in large part by those whose interests are not shared by hard-working Americans who don’t get rewarded if they break the law. How could Congress – our lawmakers – do less than demand full disclosure?
And, I would sure like to hear from a few witnesses whose salaries are not paid by the largest corporate interests in healthcare insurance, big Pharma or for-profit provider corporations. Congress needs to reverse this right now and invite real expert testimony from the broadest spectrum of law-abiding true stakeholders – not liars and cheats and gamers who would pretend they have conservative values at their core and as their reasons for opposing a single payer system.
Look at all the truths. Look at the evidence not the scare tactics. Listen to economic and social policy experts and clinical professionals and patients. But for God’s sake, stop taking testimony from solely the big-money interests – else you’ll get just the long-term results people like Scott would embrace.
Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.