Saturday, October 20, 2018
Editorials

Editorial: Stand for patients, not profits

Florida lawmakers should not be tinkering with the state's trauma center rules to benefit a politically active hospital chain before they are sure that the centers and their competitors are not gouging trauma patients. Gov. Rick Scott and the Legislature should stand with vulnerable Floridians and their families, not special interests that engage in exploitative pricing and preach about the public good to gloss over their focus on profit.

Earlier this week, a House committee voted 8-4 to inject the Legislature into a hospital industry fight over trauma centers. It approved a bill that would ensure three controversial trauma centers opened by the Hospital Corporation of America in recent years, including Pasco County's Regional Medical Center Bayonet Point, would remain open even in the face of a legal challenge from competing hospitals. Rather than risk the outcome of litigation, the for-profit HCA is trying to persuade lawmakers to rewrite state law to ensure their trauma centers stay open and pave the way for more.

The committee vote occurred just days after a Tampa Bay Times investigation revealed HCA is the worst offender when it comes to charging extraordinary trauma center response fees that have no relationship to actual costs. Reporters Letitia Stein and Alexandra Zayas discovered that the six HCA trauma centers in Florida have charged an average trauma response fee of $28,000, more than three times higher than the average fee at the state's 19 other trauma centers. No hospital contacted by the Times could justify the cost drivers for the fee. One even lowered its $10,000 fee by $6,000 after being quizzed by the Times. (The Medicare reimbursement rate for the fee is just under $1,000.) HCA's overall average billing was nearly 50 percent higher than the average at other trauma centers.

But instead of quizzing HCA on its pricing policy, House Health Innovation Subcommittee Chairman Jason Brodeur, R-Sanford, urged his colleagues to ignore it and called it a "separate issue." The governor also is in denial, telling reporters he's for transparency and choice in health care — apparently unwilling to consider that a trauma patient may be unconscious and has no say over where he is treated or what services he receives.

HCA has countered that like any hospital, what it collects in fees is very different from what it bills due to negotiated rates with private insurers. It also trumpets improved health care access in communities. But Stein and Zayas found evidence that at least two major insurers were paying HCA more than other hospitals — costs that can mean higher private insurance premiums for all Floridians.

The wisest counsel so far in Tallahassee came from the sole Republican committee member who voted against the HCA bill. Rep. Doc Renuart, a Ponte Vedra Beach physician, said he saw no wisdom in having politics decide trauma center sites.

He's right. Lawmakers should focus on correcting the issues at trauma centers, not finding ways to circumvent state rules and the courts to benefit one hospital chain. Legislators should give regulators new tools to rein in unjustifiable and exploitative trauma response fees and stop injecting more politics into the fight over the future of HCA trauma centers.

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