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Health’s ‘Jungle’

It's a jungle out there in health care
It's a jungle out there in health care

You have gone through Triage and are patiently waiting in the emergency room (ER) to be examined. A person disguised as a hospital employee comes up to you and starts demanding that before you can see the doctor you must pay some unpaid medical bills you have.

According to the lead story in Wednesday’s (4/25/12) online New York Times, that is happening today in some U.S. hospitals. Readers are referred to the bottom of this column for headline and link to The Times’ story.

After the initial shock of being treated like, to put it nicely, garbage, who do you get angry at first...those who were conniving enough to contrive the scheme, brash enough to carry it out, or audaciously calloused or stupid enough to permit it?

Accretive Health is one the nation’s largest collection agencies specializing in health care debt. Its web site suggests pride in “...bringing increased discipline to the revenue cycle.” That is, the health care provider’s revenue. That is also today’s “The Jungle” for patients not knowing they are about to be preyed upon by camouflaged bill collectors.

All health care professionals and providers are supposed to comply with the sacred Hippocratic_Oath. Apparently some hospitals in Minnesota (and most likely many other places in the U.S.) are so desperate for back payments that they put their money first without regard to any standard of civility. Or maybe they can't resist the dollar signs in the sales pitch of a collection agency selling itself as a cash manager. In eiher case, the once sacred oath has been replaced by the self-serving hypocritical oath.

The hospital singled out most in the article is Fairview Health Services ( Ms. Lori_Swanson, Minnesota’s attorney general, said it appears Accretive and Fairview violated the Emergency_Medical_Treatment_and_Active_Labor_Act which prohibits hospitals from withholding essential services for many reasons including ability to pay. Swanson also noted they likely violated the privacy provisions of HIPAA or the Health_Insurance_Portability_and_Accountability_Act

Economic and business literature suggests that organizations which engage in this sort of thoroughly reprehensible behavior, do so because they have contempt for those who are the targets of such behavior-—even when the targets are also essential customers. It sounds kind of myopic or stupid or both that the perpetrators think so little of their targets' abilities to “do something.” That is, the downside risk of any backlash will not outweigh the probable dollar benefits. It is up to victims to make such actions extremely cost ineffective.

Essentially that is bullying. The way to stop bullies is to coldcock them. In this case that involves legal processes.

A major class action law suits against Fairview and Accretive plus government action on various charges is a good starting point. The former for very large damage civil charges; the latter for criminal charges. CEOs going to jail like and with common criminals is usually a very good preventive solution.

Any study of the economic and business history of our great nation will show that regardless of industry, it is the behavior of a relatively small number of relatively large organizations in that industry that bring about easily justified regulations. Perhaps Upton_Sinclair’s classic book The_Jungle, is the best known example of this history.

Truly competitive markets don’t put up which such nonsense which is why they work so well. Word quickly gets out and in short order the perpetrators are put out of business because of the choices available. That is what we need in this country, not Obamacare (which doesn't addrress this issue) and more regulations.


Debt Collector Is Faulted for Tough Tactics in Hospitals

One of the United States' largest medical debt-collection

companies is under fire in Minnesota for placing employees

in hospitals and demanding patients pay before receiving

treatment, documents show”


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