We need better for-profit health care

Mr. Janowski, the author of the Viewpoint piece, “Connecticut shouldn’t fear for-profit hospitals” (March 24), must live in an alternative universe if he thinks speaking with Sharon Hospital’s management gives him a correct view of what the true state of health care is at Sharon Hospital. So I was pleased when a few weeks later, The Lakeville Journal published an article, “New team wants old-fashioned values back at Sharon Hospital.” Sharon Hospital’s management fessed up and acknowledged that hospital services have suffered since the conversion from a not-for-profit status to a for-profit hospital, which has been very “rocky at times,” and local residents have gone elsewhere for their medical needs. The management states it now wants to build new relationships and services and get residents to use their hospital again.

First, there is a reason why Sharon Hospital, since its conversion in 2002 to a for-profit hospital, is still the only for-profit hospital in Connecticut. Tenet Healthcare tried to buy five Connecticut hospitals last year but retreated when the state forced it to accept staffing and other restrictions. People generally know that a for-profit cuts corners, cuts staff and cuts some services, which while essential, might not be as profitable as other services. Governor Malloy has now placed a moratorium on all Connecticut hospital ownership conversions, pending a review of the certificate of need (CON) process. Unfortunately, the current CON law has some critical weaknesses. For instance, it prevented Sharon Hospital’s last two sales to buy-out/private equity firms from having CON reviews because the lawyers structured the purchases so as to avoid the state review, public input and hearings. This loophole must be changed in a revised CON law.

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Health experts Drs. Steffie Woolhandler and David Himmelstein have consistently highlighted the dismal record of for-profit hospitals. The for-profits have higher death rates and employ fewer clinical personnel like nurses than their non-profit counterparts. Care at for-profits actually costs more, and they spend much more on their bureaucracy, a reflection of the high cost of implementing shrewd financial strategies. 

In a recent study in Health Affairs (reported in The Washington Post, June 8, 2015), it was found that 50 hospitals in the United States are charging uninsured consumers more than 10 times the actual cost of patient care. All but one of the facilities are owned by for-profit entities, and the largest number of hospitals (20) is in Florida. For the most part, researchers said, the hospitals with the highest markups are not in pricey neighborhoods or big cities, where the market might explain the higher prices. Topping the list is North Okaloosa Medical Center, a 110-bed facility in the Florida panhandle, about an hour outside of Pensacola. Uninsured patients are charged 12.6 times the actual cost of patient care. Community Health Systems operates 25 of the hospitals on the list. Hospital Corporation of America operates 14 others.

“They are price-gouging because they can,” said Gerard Anderson, a professor at Johns Hopkins and co-author of the study in Health Affairs. “They are marking up the prices because no one is telling them they can’t.” Interestingly enough, one of the 50 hospitals on the list is owned by Capella Healthcare (National Park Medical Center, which marked up its prices by 1,030 percent). Capella is merging with RegionalCare — Sharon Hospital’s owners.

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We have had three ownership changes at Sharon Hospital, with many changes of senior management, since 2002. This led to a major deterioration of the Sharon Hospital service culture that we previously knew. Sharon Hospital has, over the years, terminated several key services because the hospital could apparently improve its profit margins. In 2015, we saw that Sharon Hospital closed its oncology center (the Smilow Center), and now cancer patients have had to travel to other Smilow Centers in other towns, several times a week. A good friend, who was being treated at Sharon’s Smilow Center, told me he was moving his home to the Torrington area so he didn’t have to travel there several times a week. The long-established and well-liked Sharon Hospital emergency room doctors who had worked there for many years under the name Sharon Emergency Medicine had to leave, and were replaced with a company called EmCare, which is headquartered in Waterbury. 

The community has also suffered the loss of several long-time well-liked and respected doctors who left for other hospitals. These doctors were being asked to work longer hours for the same pay, with the result that they were leaving. There have been at least two major staff layoffs. As a result, we now have many ‘floaters’ – staff that is not permanent but moves around. I have personally witnessed and heard stories of poor nursing and medical service. All of this downgrading has had a major impact on patients using the hospital. In spite of the rebate of sales tax by Connecticut to the hospital (a major gift from the state to these private equity firms) saving the hospital some $500,000 annually — which was made permanent in 2015 — Sharon Hospital still lost $1.4 million in fiscal 2014.

It is clear that Sharon Hospital owners/management must improve its transparency with meaningful communications to the community while extending and upgrading the quality of their services if it is to survive as a viable entity. Public relations is good, but even better are meaningful changes, and not focusing on the bottom line to the exclusion of excellent patient health care.

Victor Germack lives in Salisbury and New York.