Think Government Should Be Run Like a Business? Think Again!

The business of business can be quite lucrative for those who play that game, but there is a case to be made that Mitt Romney’s profit-seeking mentality could be bad for normal Americans. 

A New York Times story ran this week about a hospital company called HCA, which has instituted policies including rejecting some emergency-room patients whose conditions aren’t considered urgent enough for care. Through this and other means, HCA has managed to stay profitable over the past few years while other health-care companies have floundered. 

I’m working on a piece comparing HCA to St. Vincent Regional Medical Center in Santa Fe, because the NYT story includes interviews with doctors and nurses who say care has suffered because HCA cut staffing levels to increase nurses’ caseloads, just like we’ve seen at St. Vincent’s. 

That’ll come out later, though. What I’d like to talk about today is Bain Capital, the private equity firm co-founded by Republican presidential nominee Mitt Romney. Bain, it turns out, is one of three companies who took over HCA in 2006 and instituted changes that resulted in its profitability. 

Romney is running for president on the notion that his acumen as a businessman is what America needs to recover fully from the economic crash that began in 2008. “Mitt is not a career politician,” his campaign website says. “He has spent most of his life in the private sector, giving him intimate knowledge of how our economy works.”

People who plan to vote for Romney on the basis of his business skills should look at this piece on HCA. Bain bought into HCA in 2006. From the Times: “HCA’s robust profit growth has raised the value of the firms’ holdings to nearly three and a half times their initial investment in the $33 billion deal.”

Bain buys into a business and turns it around – bada bing, bada boom. Capitalism. Except this is a hospital chain, with 163 facilities in several states, and some of the ways it makes money now is by increasing the number of patients per nurse and nurses’ aid, and by screening emergency-room visits to weed out people who aren’t actually in an emergency, who may be simply looking for flu medicine but don’t have the insurance to see a primary care physician. 

Screw with staffing levels and you get bedsores in patients who can’t get the attention they need from their nurses. One man wound up disabled because he languished, unattended, for too long in his bed after an operation. You can blame the nurses for this, but it’s a direct result of staffing levels, which is a direct result of a costs-first mentality. 

And turning away emergency-room patients, predictably, has resulted in people getting dismissed without care from the ER only to return later in worse condition because they’d been misdiagnosed. A man died from the flu and severe respiratory problems within a few days of being turned away at an NCA ER in Florida, according to the Times piece. 

Which is all to say that Mitt Romney is a particular kind of businessman, who buys up other companies and either closes them or institutes changes to increase profits. HCA also started making larger profits because it billed “much more aggressively,” the story says, from insurance companies and patients and Medicare. That’s a three-way hit: Nail consumers directly, nail the private insurance companies who bill those consumers, and nail the consumer again by more roughly milking Medicare, which is paid for with our tax money. 

I can’t help but think of this as pure profiteering, with no regard for a greater American good. No one begrudges success, no matter what Fox News says, but it’s fair to wonder whether spinning all facets of this country to maximize profit is best for us. Restructuring HCA hospitals to make them more lucrative certainly helps the businessmen who bought in, but the details of this story appear to demonstrate that care has suffered and individuals have been hurt. 

If Romney wants to sell himself as a businessman, so be it. But people should know that his business doesn’t provide any product or service; it turns a lot of money into a lot more money, whether that’s the right thing to do for consumers or not. Good for him, I guess, but why would we want that mentality in the Oval Office? 

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