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Hospitals' profits trouble ethicists
APPLE VALLEY (AP) — A doctor has made a fortune running a company that buys hospitals and cancels their private insurance contracts so they can collect higher reimbursements, but some health professionals are criticizing that business model.
Prime Healthcare's business plan allows hospitals to forgo some much-needed but less lucrative services, such as chemotherapy treatments, mental healthcare and birthing centers.
Critics say communities' health needs are being shortchanged, but Prime Healthcare's owner Dr. Prem Reddy, 58, said there is nothing wrong with having patients receive only the amount of care they can afford.
"Why is it in healthcare we expect to have the same?" he told the Los Angeles Times. "It's an entitlement mentality. Why aren't the same people asking why everybody shouldn't be eating the same foods, or have the same clothes or same homes? Those are as essential services as healthcare."
Six of his eight hospitals have been added to the chain in the past two years and Reddy said he plans to take over up to six more facilities in the near future.
But some say Reddy and Prime Healthcare owe their communities more than they are offering.
"Everyone needs to make money, of course, and we can't fault him for that," said Dr. David Goldstein, director of the University of Southern California Pacific Center for Health Policy and Ethics. "But this is not like making widgets. In medicine, we have a duty to provide the best care we possibly can."
Like facilities in the Prime Healthcare chain, most hospitals make the bulk of their money on patients who hold private health insurance policies. Hospitals generally sign contracts with insurance companies, often agreeing to collect only about 30 percent of their costs of treatment from the insurers in exchange for the steady stream of business.
Prime Healthcare's hospitals, free of such private insurance contracts, can collect patients' entire bills from insurers.
The hospitals make up for fewer insurance company referrals by increasing traffic through emergency rooms.
Reddy also discourages doctors from giving patients treatment they can't afford, such as pacemakers and knee replacements.
He said his company's revenue is more than $500 million a year and that he is worth more than $300 million. Prime Healthcare now has more than 1,250 beds under its control.




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