When my patients need surgical interventions, they are most often sent to the HCA- HealthOne hospital next door. But now, because of HCA’s and United Healthcare’s failure to sign a contract, my colleagues and I are forced to take patients elsewhere. Folks to whom Parker, Littleton and Westminster are “the end of the world” submissively travel there because their insurers insist they do so. To do otherwise would cost them large out-of-pocket sums in out-of-network hospitals.
My hospital’s medical staff is in the dark. We don’t know when or if a contract will be signed. For now, our patients are inconvenienced and many of our nurses’ finances left in tatters.
HealthOne – owned by HCA – runs seven hospitals and 10 outpatient surgical centers and employs 8,700 people. In 2005, it served 1 million Coloradans. United insures 850,000 people. HCA and United are America’s health-care giants; their corporate decision not to cooperate is a matter of great significance.
My patients want to know why United and HCA couldn’t reconcile their differences. Denver attorney Brad Shefrin believes that United should have gathered signatures from policyholders before making changes to “limit coverage.” In fairness, United directs patients to hospitals with whom it is currently contracted. It’s unfortunately inconvenient for many, especially the elderly and the infirm.
HCA’s employees and physicians who work exclusively in HealthOne hospitals weren’t included in the decisionmaking process to reject the contract, either. They must be considered non-essential by HCA.
Each hospital’s medical staff protects its turf with zeal and unblinking vigilance. One consequence of the dispute is that many of my colleagues, unused to “travel to cure,” can be seen traveling the freeways to other hospitals whose resident medical staff are not particularly welcoming. Newcomers are made aware of their interloper status.
A year ago, despite the public’s and Colorado Medical Society’s objections, United gobbled up PacifiCare and Secure Horizons, both HMOs for seniors. The result is a bit of that cherished American precept – competition and freedom of choice has been strangled for corporate profit. We watch as yet another corporation dictates where to go, what to do, taking on an Orwellian role of “Big Brother.”
I have had to cancel procedures that I could only perform at HCA facilities; United saved my surgical fees, as well as hospital expenses. I suspect with each passing day, it continues to save large amounts of money; United is winning the arm-wrestling match with HCA.
Another result of this conflict is declining patient census and lighter surgical schedules. Nurses in HealthOne hospitals have either been furloughed or laid off, devastating to many families. This corporate fracas has had a personal toll – on patients, nursing staff and physicians.
Health care should be about health; it should involve patients and their health-care providers. In this conflict between for-profit corporate entities, talk of patients, physicians and nurses is a distant echo in the corridors of power.
The present corporate disagreement is not about the quality of care; it’s about the corporate share of our dollars and cents. United is one of the most profitable HMOs in America. (Its CEO, William McGuire, held a $1.6 billion stock option before he resigned.) It wants to squeeze the last dollar from HealthOne facilities after succeeding in getting concessions from other Colorado health care systems.
There’s deep despair that the struggles between corporate giants have left ordinary Americans mere pieces in a chess game. It’s my hope that these giants will remember that they are fighting over our hard-earned dollars.
Pius Kamau of Aurora is a thoracic and general surgeon. He was born and raised in Kenya and immigrated to the U.S. in 1971. His column appears on alternate Thursdays.
