A strange case of medical ethics is brewing. As an outsider it almost seems like poetic justice, however, the workers of the Service Employees International Union (SEIU) are neither multi-millionaire’s nor heads of philanthropic organizations.
They are the hard-working people who make hospitals and healthcare facilities run. They are the rank-and-file members of unions.
The workers of the SEIU have a strong beef against HCA Healthcare (the healthcare provider and operator in 180 hospital systems, with revenues in excess of $58 billion) for essentially for padding bills to gain more revenues from Medicare.
SEIU claims the excess billing amounts total nearly $2 billion. They issued a 45-page statement detailing what they felt to be unacceptable practices and charges. The report details (according to Joel Stinnett for the Nashville Business Journal):
“SEIU says that HCA ‘appears to routinely admit patients for inpatient hospital stays regardless of medical need.’”
Adamant Denial
HCA adamantly denies this. I will condense the long statement HCA has issued to the media. You will see by the HCA language the two sides are not exactly playing nice.
“It is disappointing, but not surprising that the SEIU labor union is once again resorting to antics like this to gain publicity. Throughout the pandemic, the SEIU continually has chosen to attack hospitals that are focused on providing the best care to their patients during an unprecedented and challenging time. Their document appears to be nothing more than a rehash of a letter sent by one of their affiliates…”
However, SEIU contends:
“This possibly illegal, unethical patient care practice pads HCA’s pockets by costing taxpayers and consumers billions in reimbursement for unnecessary procedures and services, while also exposing patients to unnecessary risk.”
They base their claims on data that shows admissions rates between 2014 to 2019 to be 5 percent above the national average.
“We are thus concerned,” said officials at SEIU, “that this is the result of HCA corporate efforts to boost their profits by increasing their admission volumes without respect to medical need…”
Why Now?
Is this only a matter of wages? Is it the contention that always seems to exist between those who work “with their hands,” for minimum or low wages, and “the suits?” It could be. COVID-19 put a stress on healthcare workers not seen in decades. Many feel they have not been paid enough and hardly appreciated enough.
On the other hand, fraud continues to run rampant throughout healthcare and who knows better than workers in healthcare facilities of the over-billing, unnecessary procedures and other irregularities?
What I do know as an ethics speaker and writer is that the word “ethical” is tossed about with abandon, while ethical training seems to be in short supply. Who is setting ethical standards on both sides? Who is training workers and administrators alike on ethical behavior? As it turns out, no one. If workers (both blue collar and those who work with their hands) get a one-hour training on “ethics” in any given year they are fortunate. The name calling, accusations, bill padding, workplace irregularities, under-staffing, low wages, all of it, have ethical components.
I am not surprised that healthcare is turning back on itself. The system does not lend itself to reason, mindful thinking, discussion or problem solving. The only place to start is where healthcare has always needed to start – good ethics.
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