Here’s a wish for 2015: Let’s save our community hospitals.
I know that’s much easier said than done. If the recent drama revolving around Tenet’s effort to acquire Waterbury and several other hospitals teaches us anything, however, it’s the need for adult conversation — and an action plan that respects the concerns of all stakeholders, not just hospitals and other corporations more focused on profits than care.
The collapse of the Tenet deal generated a lot of finger pointing, much of it unfairly directed at the Office of Health Care Access and Attorney General George Jepsen, as well as at unions and community groups that raised concerns in public hearings. The naysayers complained that Connecticut was displaying hostility to business and corporate investors.
It would be helpful to tamp down the hyperventilating and remember that state regulators simply recommended some common-sense conditions as part of any Tenet acquisition, such as:
• Maintaining skilled, quality staffing at the hospitals in question.
• Creating restraints against price gouging.
• Establishing reporting provisions to provide transparency and allow for an independent monitor.
• Designating a community advisory and accountability board.
• Requiring a community benefit agreement.
The notion that any agreement converting non-profit hospitals into profit-making enterprises should protect patients, workers and the community at large is neither radical nor obstructionist. The state’s recommendations for Tenet mirror those required when Sharon Hospital was sold to a for-profit entity a decade ago. If establishing standards for quality care and financial transparency have worked in Sharon, they should work when a wealthy conglomerate comes to town seeking looser protections for patients, payers and workers.
Tenet’s abrupt cancellation of its Connecticut joint ventures says more about corporate America’s and Wall Street’s preoccupation with profit than it does about Connecticut’s so-called “business unfriendly” environment.
A recent report from U.S. Sen. Chris Murphy shows that states where for-profit hospitals dominate spend around three percent more per Medicare beneficiary than states where not-for-profit hospitals dominate. By cherry-picking the kind of care being delivered to patients, investor-owned hospitals ultimately drive up Medicare costs while pressuring non-profits to follow that same dangerous model of prioritizing revenues over patient care.
Further, if per-Medicare enrollee spending took place at the same rate in the top non-profit states as in the top for-profit states, the Medicare program would have spent nearly $2 billion more in 2009. If Connecticut’s per-enrollee spending was the same as for-profit spending, Medicare would have spent $173 million more in that same year for Connecticut beneficiaries.
The Senator’s report is worth reading if we’re going to have a serious discussion about the future of our local hospitals. Those of us who expressed concern about a potential Tenet takeover publicly acknowledged that our community hospitals are struggling and in need of additional operating capital — and in the specific case of Waterbury Hospital, better, smarter management. We acknowledged, too, that for-profit ventures could very well become part of the hospital landscape.
I was disappointed, but hardly surprised, that Tenet’s decision to back out of Connecticut triggered a wave of finger pointing as well as warnings of “cost-cutting measures” (translation: layoffs) from the head of Waterbury Hospital. It’s easy to threaten layoffs, but threats won’t solve the problems faced by hospitals in Waterbury and throughout the state. The hard question for the community — for patients, hospital workers, lawmakers, the Governor — is where do we go from here?
Tenet’s decision to pursue opportunities elsewhere is not a signal for the status quo to remain in effect. St. Francis Hospital just announced it was partnering with Michigan’s Trinity Health; Yale-New Haven Hospital, meanwhile, continues to gobble up private physician practices. The situation demands an orderly process for reorganizing our healthcare delivery system that takes care of patients and payers, not just out-of-state hospital chains and corporate profiteers.
We need a blue ribbon-style commission that’s reflective of the community at large to recommend a path forward that will ensure quality care for patients, control costs and protect decent middle-class jobs at our local hospitals. There should be plenty of seats at this table so all the stakeholders can be heard: workers and their unions; hospital administrators; business leaders; health care policy experts; regulators; citizen and community advocates; elected leaders.
Let the Tenet saga serve as a galvanizing opportunity for a healthy, constructive and solution-oriented dialogue about the future of health care in Connecticut. There is no better time, and no more resourceful state than ours, to get it done the right way.
Sal Luciano is Executive Director of Council 4, a union representing 32,000 workers.
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