Hyppocrates v Hypocrite

NOTE:  
      Charging the North Broward Hospital District was guilty of over-paying its physician employees, the U.S. Justice Department filled suit against the public health care system under provisions of the Federal Stark Law in 2010.
      Six years later, Broward Health's governing Board of Commissioners agreed to pay nearly $70 million to the Federal government in response to the suit.
      So...
      How did all this impact the level of compensation the District paid to its physician-employees?
                   North Broward Hospital District
                    District Employed Physician Program
    Fiscal Year                     2010                 2015
    Total Physician
    Office Visits                    227,901            311,476
    Gross Charges               $55,800,692      $85,227,315    
    Surplus (Loss)               ($20,763,236)    ($28,794,096)             Per Visit                            ($91)                  ($92)
    Employed
        Physicians                  50 physicians   70 physicians
    Physician
        Salaries                       $23,274,475      $32,066,873
    Per Physician                 $465,590           $458,098*
    Regular  FTEs                163                    248 
      Total Salaries               $8,338,046         $11,854,243
    Per FTE                          $51,443              $47,799 
                     
                   *Average Physician Salary
              SE United States - $269,000
                       Source - Medscape magazine
            $ Trends - North Broward Hospital District

Adam Smith's Invisible Hand - NOT

 NOTE: 
           Each hospital programs a "Chargemaster" to establish the amount it will charge its patients.          
           Theory is, this should provide a certain degree of control over the amounts Florida Hospitals charge their patient - and thus combat the historic increase in health care costs.        
           Following are the trends in Broward County hospital patient care charges for certain specific "Chronic Diseases" tracked by the state's Agency for Health Care Administration.
           So, does monitoring hospital patient care costs appear to be working in this case - or do hospitals charges appear to involve the dynamics of a Persian Market as opposed to Adam Smith's "Invisible Hand" allegedly at work in a "Free Market"?
           Oh yes.
           The amouunts below are gross charges for which uninsured patients are legally responsible!    
                       
Chronic Illness - Diabetes
Hospitals                      2008              2014
Broward Medical           $52,108           $55,357
Coral Springs                  $35,205           $34,258
Imperial Point                 $30,610           $27,516
North Broward               $35,478           $42,572
Memorial Miramar        $33,503          $59,374
Memorial Pembroke       $41,183           $63,723
Memorial Regional         $49,145          $78,962
Memorial South               $33,948         $46,515
Memorial West                 $39,224         $71,867
Cleveland Clinic               $35,750          $47,371
Florida Medical               $66,580          $82,482
Holy Cross                        $61,441           $56,373
Northwest*                       $46,755          $85,120 
Plantation*                       $50,280         $70,401    
University*                        $39,917          $62,885
Westside*                           $53,523          $77,742

Chronic Disease - Congestive Heart Failure
Hospitals                      2008              2014
Broward Medical            $79,280          $83.645
Coral Springs                   $52,494          $39,753
Imperial Point                  $37,682          $31,657
North Broward                $39,242          $48,920
Memorial Miramar        $32,173            $55,673
Memorial Pembroke       $34,950          $51,150
Memorial Regional         $45,085          $75,090
Memorial South               $32,198          $43,394
Memorial West                 $35,333          $67,625
Cleveland Clinic               $43,648          $52,442
Florida Medical               $90,418          $103,908
Holy Cross                        $70,460         $65,475
Northwest*                       $58,882         $105,247
Plantation*                       $86,009        $120,293
University*                       $51,416          $73,186
Westside*                          $83,095         $101,638

*HCA Hospital - A for profit chain where Florida Governor Rick Scott once served as CEO.  JKdeG

Facts v Opinion & Hearsay

               Two Broward Hospital Systems
            (Gross Revenue per Adjusted Admission)
                      Public                                Private
                Tax Supported                      For Profit
              North Broward                Hospital Corporation
              Hospital District                     of America*
              Broward Health                         HCA        
              Broward Medical                  Plantation General
                    $39,000                               $63,389
                Coral Springs                           Northwest
                        $25,258                               $69,049
                Imperial Point                          University
                    $23,635                               $49,116
               North Broward                     Westside Regional
                    $42,425                               $71,005
            Source - Agency for Health Care  Administration
                                      Question:
                    Which private hospital chain was
         founded by Rick Scott, current Florida Governor

Confession

      If the old theology holds true. I'm sure there's a place reserved front row center for me to roast in the fires of hell.
     How so?
     Well, at 78, I'm too old for the more mundane sins  like adultery or idolatry.  
     But as for the shameless pleasure I take from wallowing in the sin of Pride...?
     Especially the obscene sense of self-righteous superiority I enjoy while exploring America's greed-driven healthcare system.
     Anyhow, here I go again:
     As custodians of one of the nation's ten largest public healthcare systems, the folks at the tax-funded North Broward Hospital District take great pleasure in tinkling all over their mission of service to the sick and needy.
     And certainly no District program takes greater pride in serving the less fortunate in the northern two-thirds of the county than Broward Health's Division of Community Health Services (CHS).
      Now, according to CHS officials, their "mission is to provide a network of family primary health services that offer affordable, comprehensive, quality primary, home health and hospice services in neighborhood community locations, primarily serving indigent, uncompensated care patients and the working poor."    
         So let's look at the District's CHS Primary Care Centers' service to northern Broward's - uh, well - "less fortunate".
        Broward CHS Primary Care Centers*
               Fiscal Years         2000              2016
               Visits                    204,122         126,487  (38%)    
               Cost per visit       ($149)            ($362)
               In 2016 $             ($206)            ($362)      78%      
               FTEs                     262                360          37%
               Visits per FTE       779                 351        (55%)
               Salary
               Per FTE                $58,631         $78,842
               In 2016 $               $80,910         $78,842    (2%)                
   *NOTE - A major justification for the District's Primary Care Centers was to reduce the "load" of non-emergent patients visiting the system's Emergency Rooms.
   However, in comparing the "load" pf patients visiting the District's Emergency Rooms to the its Primary Care Centers we find:
                 District Visits                 
           Emergency Rooms       186,397      298,223     60% 
           Primary Care Centers    204,122     126,487    (38%) 
  
       Okay.
       So shame on me for having fun with these numbers at the District officials' expense.
       Mea maxima culpa!
       As well as a craven sinner!

The question....

   In his attempt to regain control of the North Broward Hospital District, has the Governor of Florida fucked over two  highly principled and intelligent men who are "true believers"....? 

    Not that Rick Scott, as an obvious Borderline,  would know what a "true believer" is - or what motivates them.
   Stay tuned!

Healthcare and Bobbleheads

This Seriously Stinks

     Florida Governor Rick Scott has (3/14/2016) just removed the only two* District Commissioners with the knowledge and ability to  fathom the current chaos at the tax-supported North Broward Hospital District - one of the  ten largest public hospital systems in the nation.
    Not sure what this means.
    Although I'm deeply troubled by Scott's history as a man who earned his millions (and ability to self-finance his campaign for the Governor's office) as the puppet master founder of the Hospital Corporation of America (HCA) - from which he bailed shortly before the Feds slammed his creation with the biggest health care fraud conviction in the nation's history.
    Anyhow..
    Now Scott's political bobbleheads are running the show at the $1.9 billion public health care system 
    Oh yes.
    Dig deep enough and I'm sure you'll find Scott's long-standing Broward-based HCA Lobbyist Billy Rubin and political sidekick Ken Jenne (of convicted Broward Sheriff jail time fame) involved in all this.
    And  Broward State Attorney Mike Satz says there's no need for a local Grand Jury to look into this local health care train wreck.
    Which is why Courthouse folk call him Mike Sitz.   
    

   *David Di Pietro 
    Chair of the Board of Commissioners
    Chair of Commission Executive Committee
    Chairr Risk Management/Claims Review Committee
    Member of Commission Fiance Committee
    Member of Commission Audit Committee
    Member of Commission Governance Committee
    Member of Commission Compliance Committee
    Member of Commission Legal Affairs and Government                Relations Committee
    Member of Commission Marketing Committee 
   *Darryl Wright
    Chair of Commission Audit Committee
    Chair of Commission Investment and Pension Committee
    Member of Commission Finance Committee
    Member of the Commission Compliance Committee
    Member Commission Legal Affairs and Government                    Relations Committee 
    Member Community Relations Council

Broward Stealth!

    

Populary known as Florida's

Sunshine Law   

 Chapter 119 of the Florida Statutes

requires public officials to

conduct their meetings
in public.

However,

uncomfortable with scrutiny,

the tax-funded 

North Broward Hospital District

Board of Commissioners

has hired a law firm to 

assist them in holding additional

board meetings behind closed doors

and in the "shade".

So much for

accountability.

And in a move filled with irony,

the District Board hired the

lawyer to facilitate more 

closed door meetings  in "shade"

during the state's annual

"Sunshine Law" Week.