An unhealthy situation
Submitted by Doug Thompson on January 4, 2009 - 11:02pm.
A survey of Floyd County residents a few years ago showed more than 60 percent do not have any form of health insurance.
That's not surprising in a county where, according to the U.S. Census Bureau, the per capita annual income is $16,345. Basic health insurance for two people through Anthem Blue Cross costs more than $12,000 a year. That doesn't leave much for basics like food or rent.
Even those with health insurance find themselves strapped to pay for the things that aren't covered. We've contributed to two fundraisers in recent months for a county employee battling colon cancer.
Carilion Health Care Systems, the "non-profit" company that holds a virtual monopoly on the area's medical providers, banked more than $100 million in profits in 2007. Yet the costs of medical care provided by Carilion far exceeds that of independent operations in Roanoke and other parts of Southwestern Virginia.
The situation gets worse for Seniors Some 15.7 percent of Floyd County's 14,789 residents are 65 or older -- many living on fixed incomes.
Which means too many residents of our county simply can't afford to get sick.
AN ADDITIONAL MEDICAL NOTE: Floyd County framer and blogger David St. Lawrence suffered a heart attack recently and is in the Cardiac Care Unit of Roanoke Memorial Hospital. He's keeping us updated on his condition through his blog -- Ripples. Our best wishes to David for a speedy recovery.
Additional Perspective
Doug,
A little additional perspective on your comments. Carilion's "profit" for 2007 was largely investment income - its gain on actual operations was about 1%. Carilion will not be so fortunate in 2008 with the market down significantly. The gains Carilion made in 2007 are part of the reason Carilion, unlike other health care organizations, has not been forced to cancel projects, curtail services or lay people off.
Carilion does not have a "virtual monopoly". Carilion has 60% of the hospital market in the Roanoke area, with a major HCA hospital just 8 miles away. Carilion employs fewer than half the physicians in the Roanoke area, about a third of the physicians in the region.
I'm not sure what your source is for the statement that "costs of medical care far exceeds independent operations in other areas of the country". Carilion's prices are generally lower than comparable hospitals in Virginia - based on data from the www.vapricepoint.org.
Services provided in hospitals cost more than services provided in independent free-standing centers - everywhere - because hospitals bear the brunt of providing charity care to the community. Carilion provided $43 million last year.
Regarding Floyd County residents who can't afford health insurance and medical care - yes that is a problem. You mentioned the $16,000 per capita annual income - residents should be aware that under Carilion's charity care policy, a family of 2, making up to $28,000 is eligible for a complete write-off of the cost of their hospital care. A family of four making up to $42,000 would be eligible for the same.
No one denies that there are serious problems with the nation's health care system and the rising number of uninsured - problems that need to be addressed. Carilion is working to be part of the solution, while providing a safety net for those who currently fall through the cracks.
Eric
An additional perspective on your perspective
Eric:
The sources for my conclusions include articles in The Wall Street Journal, The Richmond Times Dispatch and information from the Citizens Coalition for Responsible Healthcare.
As Rex Bowman wrote in The Richmond Times-Disptach:
Dr. Geoffrey Harter, a doctor who heads the Coalition for Responsible Healthcare, notes that Carilion could easily lower its costs without impacting the bottom line. As noted by the Times-Disptach:
As The Wall Street Journal reported:
It would have been helpful if you had been upfront and disclosed to my readers that you are employed by Carilion and paid to serve as their spokesman. It's your job to put a positive spin on anything that affects your employer. It's my job to comfort the afflicted and afflict the comfortable.
Doug, I was writing as an
Doug,
I was writing as an individual, however I used my full name, which, in this region, generally identifies my employer since I have served as the spokesperson for Carilion for nearly 10 years. It was not my intention to conceal anything.
Regarding your sources - they still do not support your original contention that Carilion's "cost of medical care far exceeds independent operations in other areas of the country". I note that you have re-written that part of your original post - it now reads "far exceeds that of independent operations in Roanoke and other parts of Southwestern Virginia".
As I mentioned - independent, free-standing operations will always be lower than hospital based services - anywhere. That said, Carilion's prices are still, on balance, lower than it's closest competitor, Lewis Gale, lower than comparable hospitals and lower than the state average for hospitals.
This is not spin, it is fact - based on data from the Virginia Hospital and Healthcare Association and Virginia Health Information, published at www.vapricepoint.org.
I'm not going to argue with anyone's opinion about Carilion... but facts are facts. 60% market share does not create a monopoly. Ms. Aldrich doesn't have to travel 100 miles to find a hospital not owned by Carilion - Lewis Gale Medical Center is a 12 minute drive from the front door of Carilion Roanoke Memorial Hospital. Whatever Carilion makes, on operations or investment - goes back into the healthcare operation. The amount of money (at cost) that Carilion gives back to the community was $83 million last year, one and a half times the value of its tax exemption.
Yes the cost for immunoglobulin to treat rabies is high - that reflects the cost the drug manufacturer charges for the vaccine itself, not Carilion's charges - the cost is high no matter where you go. That said, if any of those 23 people came to a Carilion hospital and qualified under Carilion's charity care guidelines, they paid nothing, and Carilion absorbed the cost of the vaccine.
A family of 5 making almost $50,000 can qualify for a 100% discount.
These are facts, not spin. People are free to like or dislike Carilion, and hold the opinions they choose to hold - but facts are facts, regardless. Inaccurate information, frequently repeated, makes it difficult for anyone to make an informed decision, and that is what I attempted to address in my response.
Sorry Mr. Earnhart but you are in full spin cycle
You state that Carilion is not a monopoly. That's not what the U.S. Department of Justice says. I refer you to the opening of the article in The Wall Street Journal:
In 1989, the U.S. Department of Justice tried but failed to prevent a merger between nonprofit Carilion Health System and this former railroad town's other hospital. The merger, it warned in an unsuccessful antitrust lawsuit, would create a monopoly over medical care in the area.
Nearly two decades later, the cost of health care in the Roanoke Valley -- a region in southwestern Virginia with a population of 300,000 -- is soaring. Health-insurance rates in Roanoke have gone from being the lowest in the state to the highest.
That's partly a reflection of Carilion's prices. Carilion charges $4,727 for a colonoscopy, four to 10 times what a local endoscopy center charges for the procedure. Carilion bills $1,606 for a neck CT scan, compared with the $675 charged by a local imaging center.
Carilion's market clout is manifest in other ways. With eight hospitals, 11,000 employees and $1 billion in assets, the tax-exempt hospital system has become one of the dominant players in the Roanoke Valley's economy. Its dozens of subsidiaries include businesses ranging from athletic clubs to a venture-capital fund.
I suggest to you that the Department of Justice is a better source on what is or is not a monopoly than a paid shill for the very monopoly they feared would be created by the merger.
I would also refer you to the judgment of the doctor who heads up the Citizens Coalition for Responsible Healthcare:
"They've inflated the cost of health care by creating a monopoly," said Dr. Geoffrey Harter, head of the Coalition for Responsible Healthcare, a group of physicians that organized to bring attention to what it calls Carilion's "exclusionary anti-competitive behavior."
You are paid to lie if necessary. You are paid to represent the position of Carilion and truth is not an absolute in public relations. I know. I was in the business for 33 years. I know spin when I see it.
response
Mr. Ralston,
With all due respect, I am not paid to lie, nor would I do so, for money or any other reason.
Your reprint of an excerpt from the Wall Street Journal article still does not address the facts, and provides no data to support your allegations.
The Justice Department warned in 1989 that a monopoly would be created. It lost the case, and it was wrong - a 60/40 market split is not a monopoly. I am not aware of any current information from the DOJ accusing Carilion of being a monopoly. If such an accusation exists, please provide that documentation.
Health insurance rates in Roanoke are not the highest in the state, according to the President of Cigna. I am not aware of any data that supports that allegation - if you are, please provide it.
Carilion's hospital based prices for a colonoscopy and neck CT are not out of line in comparison with independent free-standing centers. The Wall Street Journal itself reported on colonoscopy charges in the Northern Virginia/DC area of $6,000, without indicating that those charges were out of line.
The VHHA Virginia Price Point website clearly shows that Carilion's prices are lower that the state average and lower than comparable hospitals state-wide. If you have data indicating that this information, collected by Virginia Health Information, is inaccurate, please provide it.
Nothing will be gained by name-calling and personal attacks and I will not participate in either. I am happy to engage in a discussion about the facts.
A PR man who doesn't lie? Yeah, right
H.L. Mencken once said that if a public relations man tells you we live on a planet called Earth you would do well to confirm it with a second source.
I don't need "due respect" Mr. Earnhart. I was in the public relations business. Respect isn't part of the game. You would not have lasted 10 years as the mouthpiece for Carilion by telling the truth. Frankly, I'm surprised you've stayed in the job that long because you don't lie that well either.
Just because the Justice Department lost its argument doesn't make it wrong.
Comparing your prices to Northern Virginia is outright spin. Everything is more expensive there. Your facilities are located in Southwestern Virginia and that's what the Wall Street Journal and Richmond Times Dispatch used for comparison.
Citing stats from organizations where Carilion is a member and a major contributor is hardly convincing.
Better bone up son. Your employer is under the microscope and the dirt is showing. Carilion better bring in the pros if they want to polish their image. I hear Fleishman-Hillard is taking on new clients.
Of course Carillion could always do the right thing and clean up their act but that's too much to ask of a monopoly that thrives on the pain of others.
Health Care Costs
Yep, and if you're uninsured, don't suffer from a rabies exposure either. Carilion's gouging cost for the rabies vaccine...around $10,000, believe it or not. In one local county 23 people were exposed to rabies this summer. That's a windfall profit of $230,000 for Carilion from that one event alone. In my estimation, some of the hottest places in Hell should be reserved for those who profit outrageously from life and death medical treatments.
Thank you for exposing the PR flak
I see it didn't take long for Carilion to unleash its public relations man to try and steer your article away from the truth. I'll bet they pay him a lot more than the average income of a Floyd County resident.
Carilion is a fraud and a gouger, preying on those who can barely afford health insurance costs they are responsible for sending through the ceiling. I would rather travel 100 miles to a hospital not owned by Carilion than ever let them get their hands on me or my money.
Not a monopoly? LOL!
Eric Earnhardt says Carilion is not a monopoly? That's not spin, it's an outright lie!
As the news articles point out, Carilion is gobbling up everything in sight. They want the imaging center in Roanoke. They want thier name on the Wachovia Tower. They want it all and they expect us to pay through the nose for their excess.
A word of advice Doug. If you need to go to the hospital you might want to try out of town. I doubt you would make it out of a Carilion facility alive.
Seriously...
...Doug would get out of a Carilion hospital alive...and broke!!!
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