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Show Doctor fells Chamber why hospif! should no? be sold Vernal Area Chamber of Commerce members Tuesday noon listened to the fourth debate concerning selling the Uintah County Hospital to Hospital Corporation of America. Two meetings have been devoted to those favoring the hospital sale and two have responded against the sale. Dr. Dennis J. Winder, general plastic and reconstruction surgeon at the Uintah County Hospital, addressed the Chamber meeting stating, "I am here today to explain to you why we should not sell our hospital to HCA or any other similar company." Dr. Winder continued his address as follows : "First, I would like to address the topic of how hospitals are managed. There are two general systems: free-enterprise free-enterprise and government owned. Most physicians get their training from ' both these systems. The free-enterprise system has two sub-components: nonprofit non-profit and for-profit. The non-profit returns all monies earned into the institution in-stitution itself for continued growth and development. The for-profit system sends its profits to stockholders, many of whom have little to do with health care, thereby taking many needed dollars out of the health care system. Virtually no physician received any training from the for-profit system. The government system (city, county, VA and armed forces and the non-profit sector) have been in existence for well over 100 years. Most of the for-profit systems have existed for only 10-15 years. It is interesting to note that during this relatively short time period, health care costs have risen faster than any other commodity. And so have the profits, 20-30 percent of which are paid out of the tax dollar. Doesn't it seem strange that such profits should be generated at a time when the government has been shouting cost containment and has created the HSA (Health System Agency) in 1974-75 as an attempt to control this. When for-profit systems first began it appeared as though they would emerge the best. Current evidence would tend to show the reverse, that costs have escalated in excess of benefits derived. It is now apparent that health care cannot be delivered more cheaply by the for-profit for-profit system. The Federal legislature is becoming increasingly concerned about this problem. I would like now to turn to some concepts generated by HCA which I believe to be erroneous and misleading. First, a 36 bed hospital can make money. It may not make as much as HCA would like to see, but it can make (Continued on Page 6) Doctor tells - - - (Continued from Page 1) money. Second, everything promised by HCA can be obtained thru the non-profit sector. For example: financial management and planning, added equipment and supply purchases for minimum cost, inservice programs for employees and staff, expertise in government reimbursement (Medicare and Medicaid) quality assurance in nursing care, data processing for more efficient completion of hospital services, ser-vices, projecting future needs and meeting them, department staff in-service in-service training and developing at local level, additional information and programs which advance the skills of personnel in the art of delivering hospital care and services. Third, for-profit companies engage only in those services which make a profit, therefore comprehensive health care such as is known in the non-profit sector is lacking. Fourth, there has been very little derived from HCA during their 2 year management contract. All major expenses ex-penses have still been funded by the county. No large scale recruitment programs have been launched. The status of the hospital has been allowed to continue to deteriorate with the idea we would throw our hands up and beg them to purchase. We, haye spent $167,000 to save $60,000, thru., bulk purchasing. " . I ' . , Fifth, HCA has created the illusion that the old building is not usable as a nursing home. Again, not so. One reputable nursing home firm has recently visited us and has confirmed the fact that the old hospital could be converted to a 45-bed nursing home more cheaply than building a new one. A second opinion will be coming this week. Sixth, the taxes to be paid to the county would be miniscule compared to the money removed from our community. com-munity. Does it make sense to pay $57,000 a year in taxes when money paid to HCA stockholders could exceed $750,000 per year? , Seventh, that prices won't be excessive ex-cessive is a myth. As of this moment it costs the same or more to be a patient in UCH as in Holy Cross Hospital or St. Mark's. The prices in room rates alone have risen 30 percent in the last three months. I believe this is so that HCA can say they did not increase prices after purchase. I have come to realize that this practice is common place, in other HCA communities. Eighth, HCA's financial report does not discuss health care cost. It does not mention monies spent toward education. Disclosure of cost figures have been difficult to obatin from for-profit for-profit companies. They have even sued to protect this information. Yet much of this information is related to public funds. The non-profit sector volunteers this information freely. Ninth, the behavior of HCA employees em-ployees is questionable. For example, the illusion of a nursing strike in Price when there was none; the unethical public misrepresentation of my contractual con-tractual relationship with this county; the intimidation of employees which can be documented, obstruction in obtaining public documents; misrepresentation of qualifications on an administrative level. Tenth, availability of land for expansion. ex-pansion. If one looks closely, there is enough land on the present hospital complex to: a) have a nursing home 45-50 45-50 beds, b) build doctor's office building, c) expand to 100 beds, d) build a parking deck. Eleventh, let's examine a few cost figures. The commissioners complain because they subsidized the hospital $500,000 last year. I would like to say that one-third of that went to management expenses which is non-retrievable, non-retrievable, $90,000 went to operational expense. The monies paid to the two new physicians has already been recovered in terms of patient revenues. Equipment costs will be paid back within theyear, and when our contracts are paid back, the county will have made a clear profit from the new physician's presence in the community. Twelfth, medical education. In spite of stated claims, HCA and related companies do not involve themselves with large scale medical education. They do hot sponsor medical students, they do not support medical schools. Their only major educational endeavor is the Philippines Nursing School. Again, most physicians are a product of non-profit sector and it seems strange ..that so many forget their -heritage. . Thirteen, nursing shortage. There are many areas where there are excesses of nurses such as LA, Minneapolis, Chicago, New York, Idaho, etc. It is my opinion that shortages in HCA hospitals come thru attrition (creation of internal in-ternal stress) thus opening the door for importation of foreign nurses at cheaper wages thus increasing profits and not necessarily improving quality care. Fourteen, HCA will be costly to Uintah County. Let's assume $60,000 per year in taxes. Those taxes will be attached to the patient's bill. It will not come from the coffers in Nashville. Since HCA stands to earn over $750,000 per year, that leaves about $700,000 per year clear profit plus an additional potential $100,000 per year in indigent care bringing the total to $800,000 per year leaving this community. Fifteen, HCA management company exists solely to set hospitals up for purchase. Doesn't it seem a bit absurd to sell to a company who has not yet proven themselves in management. Sixteen, small hospitals are used as training grounds by HCA. To accomplish ac-complish our goals, instability in administration ad-ministration cannot be tolerated. Seventeen, deceptions by County Commission. Until recently, the public has not been adequately informed. HCA had ample opportunity to take over and build this hospital like they have done in other communities. Not so here. They allowed the taxpayers to do it for them. They are taking credit for specialists which the taxpayers have paid for. All newly acquired equipment with exception of some x-ray pieces have been purchased by the taxpayers. So it is obvious the taxpayers do support sup-port the hospital. In summary, it is my impression on " the basis of the above that you good people have been set up by a corporation cor-poration that will stop at nothing to acquire 500 hospitals by 1985, whose behavior patterns would be exceedingly ex-ceedingly distasteful to this community, com-munity, and whose business practices would remove finances in excess of benefit gained." A debate sponsored by Citizens Against Selling the Hospital (CASH) has been scheduled for Tuesday, May 4 at the Vernal Junior High auditorium. On May 7 a formal hearing will be conducted at the Vernal Junior High auditorium by Utah State Health Planning and Development Agency concerning the certificate of need application for selling the county hospital to HCA. Both meetings will start at 7 p.m. |