Some Medicare reality

Context for Phil Kerpen's "Medicare: Putting seniors before bureaucrats," (His View, Aug. 17) is provided by his website, www.americancommitment.org, which suggests he is a political hack of the same ilk as Susan Stamper Brown.

To evaluate proposed dismantling of traditional Medicare in favor of giving individuals vouchers to obtain "free market" health care, one might wish to examine current practices of large, corporate health care providers. One such example is HCA, a giant conglomerate that controls 163 hospitals from New Hampshire to California (see "A Giant Hospital Chain Is Blazing a Profit Trail," www.nytimes.com/2012/08/15/business/hca-giant-hospital-chain-creates-a-windfall-for-private-equity.html?pagewanted=all ).

Ten years ago HCA was a shaky (shady) company plagued by Medicare fraud investigations (which it settled for $1.7 billion). The big turnaround came in late 2006 when three private equity firms, one of which was Mitt Romney's Bain Capital, purchased HCA in a $33 billion "leveraged-buyout" deal in which each invested a "mere" $1.2 billion. In 2008, with the fraud investigation ended, HCA introduced a new coding system for emergency-room billing. Almost immediately, its patients appeared to be "much, much sicker." By 2010, HCA hospital profits had exploded. A California HCA hospital's Medicare reimbursements increased to $949,000 from $48,000 in 2006. Reimbursements at an HCA hospital in Florida jumped to $1.5 million from $69,000.

Suspicions of HCA's billing and ballooning profits has resulted in its pressures on participating doctors and hospitals to allegedly cut costs by reducing staff and providing sub-standard care for patients, these now resulting in a flood of lawsuits. In these few years, Bain's and partners' equity has become two to three times larger than their initial investment.

Anyone who thinks that individuals using the GOP-proposed Medicare voucher system stand a chance of obtaining reliable health care at affordable cost from these corporate sharks may well consider voting for the Romney-Ryan duo.

Doyle McClure

Moscow