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Private Sector Watch

By Justin Straughan, VHPI Researcher

A number of serious flaws plague the American healthcare system. I grew up with an insurance policy exemplifying these issues: “Don’t get sick because we can’t afford the doctor bill. When, inevitably, the premium came due after a serious accident my family missed meals in order to make payments to creditors. [This was before the days of the GoFundMe Health Insurance policies.]

It’s no wonder that it frustrates me to hear people knock the Department of Veterans Affairs, the U.S. Government’s public healthcare option afforded to disabled veterans like myself. It is a cognitively dissonant viewpoint to advocate the privatization of the VA while turning a blind eye to the egregious and unethical actions of private healthcare corporations. Veterans like myself, and, I would argue, civilians as well, would do better without a system of ever-consolidating healthcare companies that put profit over people by limiting choice, colluding with insurance companies to deny competition, maintaining a dubious record with investigations, and eschewing rural areas simply because the actuarial bean-counting is not right.

Take Dallas-based Tenet Healthcare, which requested in excess of $2 billion (with a ‘B’) in COVID-19 pandemic assistance. Totally understandable, right? A big hospital chain having to deal with record patient loads, a ludicrous amount of overtime, paying too much for PPE that just isn’t available, a stagnant economy means bills may not be getting paid, and a hospital has to make ends meet somehow. Except if we dig just a smidge deeper, we find that Tenet reported an annual earning of over $3.1 billion and $2.9 billion in credit. Say nothing about the nearly $1 billion in grants and $1.5 billion from Medicare Advance Payments and payroll tax match deferrals, according to the article in Becker’s Hospital Review. What excuse could they possibly use to justify this need for a loan despite being firmly “in the black”? Well, because they want to ‘maximize their cash position’.

That’s just one example in a series of private companies in and out of healthcare taking advantage of a system and then passing the costs on to all of us. Here’s another: “One Brooklyn Health's Kingsbrook Jewish Medical Center closed 200 beds and ended inpatient services July 1 as part of a planned transition.” This happened in an urban area. What concerns me even more – and should concern all of us – is the fact that that the number of rural hospitals across our country has declined since 2010, to the tune of over 170. How many people who live in rural areas are now having to go without or travel even farther for care?

Mental healthcare in this country is even worse, with jails and prisons replacing a humane system. My anger notwithstanding, I have a very personal relationship to mental health and mental health providers due to family circumstances. Yet private companies such as Kaiser Permanente can simply lay off hundreds of workers in Northern California while pocketing billions of dollars and they even have the gall to give the U.S. Senate a lecture on how to streamline the VA. Why do they not hire more mental health staff? (You can expect a deep dive into this particular subject on another post in the near future.)

Companies like Kaiser may testify to the Senate that they know how to generate profits while administering a wide network. But do we really want our VA to adopt lessons from organizations whose goal is to maximize profits? Simply put: administering healthcare to people cannot be about extraction of maximum value if we treat healthcare as a basic human right and it is impossible to say otherwise when you are in need of lifesaving care.

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