Columbia is not the only corporate culprit in the hospital game. The nation's second largest hospital chain with 123 hospitals — now called Tenet — has a similarly checkered past. In 1994, Tenet, then called National Medical Enterprises (NME), pleaded guilty to federal conspiracy charges for paying kickbacks to doctors from the late 1980s through 1991. The company paid $375 million in fines and penalties, which is the largest health fraud settlement in U.S. history to date, though it could be surpassed by Columbia's pending fine. Now Tenet is hoping to pick up the turf of its former competitor, Columbia — which, in the throes of scandal, is divesting many of its hospitals.68 Ironically, one of the counts against Columbia is the same for which Tenet was busted by the feds — having inappropriate financial relationships with physicians. According to whistleblowers, Columbia also paid doctors special bonuses in order to have them refer patients to Columbia facilities so that the company could charge whoever was paying the bill.69 These sorts of abuses are endemic to health chains operating in a for-profit environment (be they not-for-profit or for-profit companies). The tendencies of the for-profit medical corporation — to emphasize profit, market standing, and empire building — are subjugating ethical patient care and community medical values.
Even after Tenet's embarrassing 1994 scandal, for instance, a 1998 federal investigation was launched alleging, according to the subpoenas, Tenet's "connection with an investigation of Medicaid and/or Medicare fraud" at its Florida hospitals. The federal inquiry, like the one in 1994, centered on financial arrangements between the hospitals and doctors.70 In 1997, the province of Ontario, Canada sued Tenet for allegedly bilking Canadian taxpayers out of at least $25 million for substandard treatment of patients. The government said agents for Tenet brought Ontario residents to its hospitals in the United States, provided improper care and then billed the Canadian province.71
The impact on patients of the hospital chain's profiteering can be seen by a 1997 $100 million settlement Tenet entered into with 700 former patients who claimed the company's physicians illegally imprisoned them in psychiatric hospitals in order to obtain claims payment from their insurance policies. The patients contended that they could not leave the health care chain's institutions until their insurance benefits had been exhausted. Patients said they were prevented from making telephone calls or talking to their family members. Many lodged charges of abuses, such as being placed in restraints for weeks on end or being forced to sit motionless for hours.72 |
