[Congressional Record Volume 142, Number 123 (Tuesday, September 10, 1996)]
[Extensions of Remarks]
[Page E1549]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




[[Page E1549]]



       THE RAIDERS ARE COMING--AND I DON'T MEAN THE FOOTBALL TEAM

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                      Tuesday, September 10, 1996

  Mr. STARK. Mr. Speaker, the raiders I am referring to do not wear 
football helmets and they do not throw a ball. They are profiteering 
health care entrepreneurs, and they are quickly moving into our 
community.
  The move toward investor-owned health care, particularly where 
doctors are sharing in the financial risk and have incentives to deny 
care, means that patients could be denied access to critical medical 
resources. Significant health care dollars are being siphoned off to 
pay shareholders, soaring executives salaries and exorbitant marketing 
costs. Meanwhile, the number of Americans who are uninsured and 
underinsured is growing.
  The explosion of profit-sharing health care companies is leading the 
current transformation of the U.S. health care market, and they have 
arrived in our district. Watch out. The move toward monopolistic, for-
profit health care requires a legislative response to protect patients 
and consumers.


            the move to for-profit health care: columbia-hca

  The largest, most aggressive for-profit health care company is 
Columbia-HCA Healthcare Corporation [Columbia]. Columbia has 
aggressively pursued the acquisition of nonprofit hospitals. As a 
result, Columbia now owns 355 hospitals making it the wealthiest for-
profit chain with $18 billion in annual revenue.
  Columbia owns the San Leandro Hospital; the San Leandro Surgery and 
Outpatient Center; Estudillo Surgery Center; and the San Jose Hospital 
as well as Diablo Valley Surgery Center in Concord. Elsewhere in the 
bay area, Columbia owns Healdsburg General Hospital and Palm Drive 
Hospital in Sebastopol; Columbia Los Gatos Surgical Center; Mammography 
Plus Medical Group; and Sereno Surgicenter in Los Gatos in addition to 
the four facilities in the south bay that comprise the Good Samaritan 
chain. They have reportedly offered to negotiate deals with almost 
every hospital in the bay area including Sequoia, Eden, and St. Rose.
  I have asked Medicare to investigate whether Columbia's merger mania 
is bad for the patients and for our community.
  Will quality patient care be provided?
  As a for-profit hospital, Columbia's primary obligation is to its 
out-of-town shareholders. Their focus is on the bottom line, not 
quality care.
  We will see a reduction in care provided to the poor in our 
community!
  Columbia offers physicians up to 20 percent ownership interest to 
encourage physicians to direct paying patients to their hospital, and 
charity cases away from the Columbia hospital. Study after study shows 
that for-profit hospitals provide a lower level of charity care than do 
nonprofit hospitals.
  Will services be eliminated that are vital to our community?
  It is likely that programs such as trauma centers and neonatal 
intensive care units will be eliminated.
  Will Columbia close local hospitals?
  It has a history of buying many local hospitals and closing them to 
increase bed occupancy and profits in other units.
  Will existing labor contracts be ignored?
  Columbia is reportedly reneging on labor contracts at Good Samaritan 
Hospital and has an antilabor record.
  Capitalism is great but should patients be put at risk?
  I do not believe health care is a commodity. Joseph Cardinal Bernadin 
said it best:

       Health care is fundamentally different from most other 
     goods and services. It is about the most human and intimate 
     needs of people, their families, and communities. It is 
     because of this crucial difference that each of us should 
     work to preserve the predominately non-profit character of 
     our health care delivery system.

  The goal is not health care anymore--it is care of the stockholder 
interest. I am preparing legislation to make sure: First, for-profit do 
not skim off the healthiest patients and dump the sickest, money-losing 
patients in public hospitals; and second, the public's investment in 
nonprofit hospitals is not lost through phony sales prices. You can 
count on me to fight the takeover of our community's hospital system 
and keep the ``care'' in health care.

                          ____________________