Saturday, June 15, 2013

Episode 26: Down the Rabbit Hole Yet Again aka Health Care Due Diligence

Health care due diligence.

Has a nice ring to it.

We patients, the so-called "consumers" of health care, expect due diligence when we entrust our bodies and minds to that system.

But that's not what the term refers to.  No, "due diligence" is an accounting term, a requirement to investigate a potential investment before recommending it to clients.  If you are an investment banker, that is.  And you know how concerned they have been about our welfare over the past, say, oh, twenty years. These shills for the megarich are selling our flesh on the open market, while the megarich buy personal physicians and specialists who come to their homes or live there, sort of like modern-day Rasputins.

And the rest of us are relegated to a system built on corruption. I don't mean the health professionals and researchers and all of those who, with integrity, are working to make lives better for their fellow human beings.

I'm talking about the ones who are exercising their due diligence.  You know, them.

"'The best sort of due diligence process begins with a game plan [or strategy], and it proceeds along that game plan, only changing as dynamics of the due diligence changes or as [new issues] are discovered,' says Mr. Van Demark," one of the principals in the investment firm quoted in an article online (URL below).

I'm glad to know our physical and mental anguish is bandied about on the market as a game. Gives me extreme confidence in the system, let me tell you.


Unknowingly tonight I typed the words "health care" and "diligence" in the Google search bar.  I'd wanted a quotation to add to a PowerPoint presentation I am making for a research seminar for high school students interested in health careers. Instead of getting peppy stories of the diligence required to educate oneself to work or the diligence required to continue working in health care when it has become so inequitable, so overblown with arbitrary forms and rules at the behest of stingy Ebeneezers holding those CEO bonuses unless they can bring home bacon sliced from each and every claimant's hide, I learned that the term is used in investment banking, as in these words from one such firm's Web site:

"Our panel discusses what might cause a private equity general partner to back away from a health care investment."

Oh, yes, that certainly deserves due diligence--one must be sure to make as much money as possible on the suffering of others. This is the extent to which our bodies, minds, futures (pun intended?), and very lives are commodities traded on the open market. These purveyors of due diligence, consulting firms that no doubt charge exorbitant rates beyond any measure of common sense or decency to advise corporate-owned health care investors--and the super rich whose portfolios contain our hospitals, our clinics, our pharmacies, our pharmaceuticals, our insurance companies, our politicians, and, in a very real sense, our bodies on capitalizing (there's that word again) on money-making opportunities. Consider this blurb:  
Possible deal breakers could include problems in manufacturing, in management, in quality of earnings, clinical compliance, referral sources, or reimbursement. The health care space is so perilous today that due diligence has become more important than ever in understanding the industry’s many risks. http://mcgladrey.com/Private-Equity-Groups/Health-care-due-diligence-and-deal-breakers


Really?

Doesn't it bother anyone else that our hospital stays and emergencies and family tragedies play out like this in a for-profit environment?  How are "profits" secured by an institution whose purpose is to provide healing services to persons in distress? They think the health care environment is perilous? They don't have to use it--they've got private doctors and/or carte blanche, thanks to their own companies, to go to any specialist and have any procedure they want--how many of us would have made it through five or six heart attacks and still be able to manipulate the world to my selfish will a la Lionel Barrymore's Mr. Potter.  I'm a major shareholder in an insurance company!  Why the hell should I have to pay premiums or co-pays or 20 percents or anything else for what I already own?

They don't mind the $18 or so a hospital charges for a box of crappy, scratchy fake Kleenex (a very small box, of course).  Why should they?  They don't ever have to pay that, or any portion of it.  Their family's claims against insurance companies they own add to the profits of their healthcare system investments with nothing out of their own pockets, of course, and the capital for all that comes from you and me, friends. YOur employer pays for your insurance?  Well, lucky you. And who pays the premium? Your state government?  And who funds your state government?  

That's right. If you have any kind of public job, you are paying for your own premiums even if you don't see the money coming out of your paycheck, and most of us also have to make greater and greater contributions to our premiums even if covered and then have fewer and fewer services and facilities and physicians available to us for no logical reason except to make the owners or shareholders bloated with wealth while we waste away watching our bodies and lives fail because we are paying so damned in dollars, energy, and general wellness just to stay alive while often getting less than adequate results, while we are led ever deeper into that Rabbit Hole, paying at every turn in the warren, even those of us lucky enough to have insurance, and pity the poor bastards without it.

One hand greases the other, as has happened since time immemorial until those of us getting the shaft stand up and refuse to let it happen anymore.  (I'm not going to explore that metaphor--I'm getting very tired . . . )

And the insurance companies do pay, the insurance companies whose owners and CEOs are the investors in the above-quoted firm:  Vestar Capital Services--

My god, there is no shame.

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