How hospital consolidation inflates prices & hurts patients

Image courtesy of Sandra Alvarez
 

 

 

 

 

IN THIS EPISODE

 

This time on Code WACK! What can be done to ensure that nonprofit hospitals are delivering fairly on their community benefits – and worthy of their huge tax breaks? How does corporate lobbying complicate efforts to improve the oversight of these facilities? Who benefits when hospitals reduce costs without lowering prices for patients?

To find out, we spoke to filmmaker Sandra Alvarez, director of the new documentary InHospitable, which tells the story of patients and advocates as they fight for their lives and take on a billion-dollar hospital system. This is the second of two episodes with Sandra about her film InHospitable. 

 

 

SHOW NOTES

 

WE DISCUSS

 

Can you share a story about how the University of Pittsburgh Medical Center/Highmark Insurance dispute affected a patient caught in the middle?

 

“Sure … Evie had a Medicare Advantage program through Highmark and … she had a heart condition, she had had multiple cancers … All her doctors were at one hospital at UPMC.

Once she would have to switch to the different medical provider, the Highmark medical provider, she would have to go to five different hospitals to be able to see all the different specialists and, she’s elderly, she has an elderly husband, and so it was just going to be very challenging and very overwhelming for her to be able to do that. – Sandra Alvarez

 

 

After making this film, what is most concerning to you about running hospitals like businesses? 

 

“… if you have people at the top of these health systems who are business people, right, they’re MBAs, they know business, they know how to run a business. They know about bottom lines, they know about profit margins …

And so they’re just trying to figure out, okay, how do we turn a profit? How do we maximize our revenue?

And I think that that’s tricky when the products of the company are human lives ” – Sandra Alvarez 

 

 

What role does corporate lobbying play in all this?

 

“I think that it’s one of the reasons that we all – the folks that are kind of outside of the health policy world – don’t really understand what’s happening with hospitals … because … from what I understand, most politicians – red or blue – are taking money from hospitals and hospitals are tricky …

It’s so easy to rail against insurance companies. We all hate our insurance company for one reason or another. But, you know, hospitals are places where they saved my dad’s life. I mean, it’s a little bit of a tangent, but five months after I started filming this documentary, my father went into cardiac arrest and he was in the hospital for three months at Jackson Memorial Hospital in Miami. And they saved his life.”  – Sandra Alvarez

 

 

What impact has this film had so far?

 

“…we have been able to screen it for the antitrust subcommittee in the House and the Senate. (Sen.) Amy Klobuchar, I was told she watched the film … and it inspired them, the Senate Antitrust Subcommittee, to do an entire hearing on hospital consolidation. And they invited a couple of the people that were in our film to speak at the hearing, which was great.

And so we have a goal now to screen it with the State Attorney General’s Association and we have a lot, a lot of community screenings requests coming in from all over the country.

Nonprofits, patient advocacy groups, medical schools, health policy programs in different universities. I would love for this to screen in every single health policy department in the country, because I think that those are the folks that are, you know, that’s, that’s the future of the people that are going to be going into this world, right?

And so we just had our big theatrical run in L.A., New York and Pittsburgh and now the next thing coming up is to get wide distribution on a streaming service and video on demand, so stay tuned for that.” – Sandra Alvarez

 

Helpful Links

 

InHospitable, Sandra Alvarez, Director

 

How nonprofit hospitals get away with the biggest rip off in America, Medical Economics

 

Policies To Hold Nonprofit Hospitals Accountable, The Center for American Progress

 

Jayapal and Spartz Introduce Bill to Stop Hospital Noncompetitive Behavior, Congresswoman Pramila Jayapal

 

The Fairy Tale of a Non-Profit Hospital, The Health Care Blog

 

How has hospital consolidation affected the price and quality of hospital care? Robert Wood Johnson Foundation

 

Hospital Global Budgets: A Promising State Tool for Controlling Health Care Spending, The Commonwealth Fund

 

Medicare For All Would Improve Hospital Financing, Health Affairs

 

 

Episode Transcript

 

Read the full episode transcript

 

 

Biography: Sandra Alvarez

 

Sandra has spent her career directing and producing a wide spectrum of documentary and television programs appearing on CNN, Netflix, Sundance Channel, History Channel, BBC America, A&E Network and Discovery Channel. 

 

Her recent documentary, InHospitable, documents patients and advocates as they fight for their lives and take on a billion-dollar hospital system.  

 

Her previous work includes serving as one of the directors of the Netflix original documentary series HOT GIRLS WANTED: TURNED ON, which premiered at the Sundance Film Festival.  She served as a producer for CNN’s documentary series THE NINETIES and THE HISTORY OF COMEDY.

 

Get Involved / Take Action

 

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