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The Big Quotes

“Some large hospital systems are making record profits, paying zero taxes and sitting on enormous reserves while overcharging customers. Meanwhile, they are consolidating providers, which drives up costs and leaves fewer options for Coloradans.” — Colorado Gov. Jared Polis, 2023 state of the state address

“Nonprofit hospitals — which make up around half of hospitals in the United States — were founded to help the poor. But a Times investigation has revealed that many have deviated from those charitable roots, behaving like for-profit companies, sometimes to the detriment of the health of patients.” — Episode description for The Daily podcast, produced by the New York Times.

“Hospitals buy drugs for pennies on the dollar, then get to charge for the full price of the drug. This is a clear example of placing profits over people, not healthcare.” — Rev. Al Sharpton, calling for greater oversight of 340B

What it means for you

By David Jarrard

A majority of people say they now believe hospitals are more focused on making money than caring for their patients.

We asked 1,000 US adults this question a few weeks ago; 53 percent say hospitals put profits over patients and two thirds would easily believe a health system is not doing enough to earn its tax exemption.

You’re not surprised, are you? Even a casual observer can sense how the tide of sentiment and trust has turned on provider organizations and, if left to flow unabated, could cause the industry to be drowned by it.

The quotes above aren’t from a random activist or snarky media fishing for clicks.

The first is from a sitting governor of a Western state in a prepared speech delivered from the podium. So, carefully prepared, vetted and considered to be – stay with us here – politically advantageous.

The second is from the New York Times, reflecting a year-long deep dive by reporters and analysts into the hospital industry. They’re not liking what they find. And they’ll produce more stories like it and others will follow.

But, who cares, really? Polis is just a politician. Reporters have an agenda. Maybe Sharpton’s opportunistic. They ignore this or that fact. It’s the insurance companies playing games. Or the labor unions. No one in our service area reads the Times anyway.

Truth is, this stream of speeches and stories, emanating from credible voices with an impassioned point of view, are many and are increasing in volume, building on each other.

These currents emerge downstream from cultural headwaters.  They are bright signals of – and accelerants to – a deeper, shared conversation about how things are perceived to be today and how things should be tomorrow.

They reflect momentum. They are a narrative.

And if providers of healthcare are in a political campaign to win influence and money, they’re losing.

Yes, yes. We know. Our healthcare systems are the country’s front line for delivering extraordinary care on the back of a financing system so broken, byzantine and currently explained by a word salad.

Far from perfect, and sometimes their own worst enemy, provider organizations nonetheless take the risk, employ the nurses, serve the patients and keep the lights on while riding razor thin margins even as others in this multi-trillion-dollar industry make a lot more money, hazard little and still go home at 5 p.m. But that imbalance is not today’s story.

Instead, provider organizations are shouldering the blame as the level of public frustration with the cost, quality and value of care reaches new heights. Here, Gallup confirms our own survey we’re publishing next week.

As an industry, we must act to counter this narrative together or become victims of it separately, huddled in our respective markets.

At risk? Influence, political and market strength, money in all its forms. And through that, the ability to independently shape the delivery of care and, ultimately, to fulfill organizations’ missions. So, a lot.

Two takes for this Sunday.

1. Money matters. Money, in all its various and inconsistent definitions, is shaping every healthcare conversation today and is deep in the heart of this growing tension.

As an industry, we’re clumsy at this, left flat-footed in almost every payer negotiation, labor contract dispute and legislative reimbursement hearing.

The industry talks about money inconsistently, using different words and standards system by system, state by state. Yes, our geographically fragmented structure can make for excellent, locally attuned healthcare delivery. But it leaves provider organizations vulnerable when competing for mindshare and money with consolidated, country-spanning insurance companies who speak with one voice and one vocabulary.

Fact is, the conversations about money aren’t really about the dollars. Not fully. To talk about money is to talk about your values and your care; how you handle money signals what’s truly important and what is not. When you need to “talk about money” it’s not merely a conversation about spreadsheets; money represents behavior and mission.

As healthcare leaders and communicators, this is the work before us.

2. Momentum. Healthcare delivery has always been the subject of media and political critiques, and rightly so. Even so, today’s energetic rhetoric is not a passing matter, something to be waited out.

Instead, we’re watching the incubation of a cultural and political environment in which it is considered safe – even necessary – to critically scrutinize provider organizations through the least-favorable lens. It’s a precursor to actions that our industry won’t like and that will impact us directly through reimbursement challenges, payer negotiation, labor contracts and more.

The risk of inaction is high and growing.

These and other findings are drawn in part from our fifth National Consumer Survey to be released next week. It unpacks more about the public’s perception of provider organizations, how they are making decisions when choosing healthcare services, and how money threads through it all.


Contributors: Emme Baxter, Tim Stewart, Isaac Squyres, Kevin Phillips, David Shifrin

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