Health Care/Joan Retsinas

The Annals of Greed

Perhaps those whom the gods of finance have blessed the gods of compassion have slighted. The Annals of Greed spotlight the champions of greed as they scheme for more wealth.

Winner Number one: university-based nonprofit hospital systems, like Methodist LeBonheur Healthcare (Memphis), the University of Virginia Medical Center and Johns Hopkins that bill the poor, even though the poor are entitled to “charity care.” These hospitals are supposed to give “charity care” to poor patients, in return for their exemption from taxes. Some states, like Maryland, add to the pot.

How profitable to ignore those provisions and dun patients! By one estimate, Maryland hospitals collected $600 million from people poor enough to qualify for free care — and, at the same time, those hospitals were collecting money from the state for “charity care.” (Maryland just passed the Medical Debt Protection Act to let people off the hook for bills they should never have received.)

First Runner up: GS Labs (owned by City+Ventures). They turned COVID tests into the fiscal mother lode. We need the tests to staunch this frighteningly infectious virus. Until most of us get vaccinated, the test identifies people who should self-isolate. The nation’s theaters, businesses, schools, hotels, airlines rely on the tests.

Congress, eager to expand testing, allowed laboratories to charge insurers a “cash price” for processing the tests — a squishy term that has allowed labs to charge from $41 (the Medicare rate) to hundreds of dollars. GS Labs won the prize: they charge $380 per test. Several insurers are suing GS Labs, but GS Labs, pointing to the CARES Act, argues that its egregious billing, aka “disaster profiteering” is legal.

Second Runner up: McKinsey. For this consulting firm, the word was “opioids.” From the start, Purdue Pharm knew oxycontin would alleviate pain. It hired McKinsey to make oxycontin truly profitable. McKinsey advised on ways to bolster demand, including incentives to pharmacies, even though soaring profits were predicated on users turning into addicts. The strategy worked: the spin-misters of oxycontin jump-started an epidemic.

One McKinsey tactic: help Purdue ward off FDA regulations. Here the gods of finance smiled again upon McKinsey. Fortuitously, while one arm of McKinsey was pumping up demand, another was advising the FDA, guiding it to soften regulations on oxycontin.

Of course, the good times ended. The addicts clog the judicial system, take up hospital beds, and leave families not just bereft, but impoverished. States sued, successfully. Purdue Pharm declared bankruptcy, and McKinsey has paid states more than $600 million dollars to settle. Yet, for McKinsey, the setback is minor: it now advises governments at all levels on the COVID epidemic.

Third Runner-Up: Philip Morris. The protean beauty of capitalism run amok is not new. Philip Morris, who gave us cigarettes, just bought Ventura, who gives us ventilators — a handy confluence of interests.

Final Entry: the 18 retired professional basketball players who defrauded their insurers. The players earned respectable salaries, including health insurance. That wasn’t enough for a cadre of players. Why not bill for root canals? One player billed for 17; another billed for an assortment of root canals and caps, all on the same day — a feat since he was playing in Taiwan at the time. This is not a victimless scam, if any scam is victim-less. The scams increase the costs of insurance for the rest of the pool. Maybe the only people who benefit, now that the media has broadcast it, are the lawyers who jump onboard as defense.

We need an antidote for greed. How about shame? Just as US Army Counsel Joseph Welch shamed Senator Joe McCarthy in 1954 during the Senate Permanent Subcommittee on Investigations (“Have you no sense of decency”), we might shame the greed-champions.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, November 15, 2021

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