An Exclusive Interview with the Editor of WhereTheMoneyGoes.com

I like it. 2 anonymous trouble makers interviewing each other! This is what the web was meant for. However, to really make money you need to move from being a hospital CEO to running an insurance company (as Jack Rowe did when he went from Mt Sinai to Aetna)!

Good stuff, although I don't think in the grand scheme of things revoking non-profit status will do anything to help the problem of the uninsured that the Fariness Foundation folks claim they care about -- the Wa Po article this morning on the guy running the Fiarness Foundation showed a pretty direct connection with looney Rooney (founder of Golden Rule) and the other white guy in American healthcare who goes to an all-black church where he sits next to Richard Scrushy http://www.sourcewatch.org/index.php?title=J._Patrick_Rooney

If you think that Golden Rule helps out the uninsured with their HSAs,then please come join the conversation over at my blog!

I would be very interested in seeing some stats on Intermountain Health Care (IHC). They claim they are not-for-profit, yet they enter into an EMR venture with one of the biggest for-profit companies on the planet (GE). When I was a practicing physician in the Salt Lake City area, I saw first hand how their predatory business practices of funneling business from their health plans to their doctors and hospitals while freezing out others hurts everyone else. They control 60% of the market.

There has recently been noise about revoking their tax status, but they have a lot of Mormon friends in high places in state and local government who protect their interests. The effort was turned back in this year's session of the State Legislature. Many members of IHC's board are revered and prominent Mormons with strong influence on public opinion in Utah. This and the perception that they are the Mormon health care system--despite having been spun off by the church decades ago--protects them from all who seek fair competition in the Utah health care market.

Hey!

Great to see that someone is finally onto the whole hospital price-gouging issue.

Let me just state that I used to work as a medical claims rep for a company that handles outsourced medical claims for hospitals, and they also had a collection agency.

You would not believe what goes on in some of these companies that handle the outsourced billing and collections functions. Our entire unit was hired with zero prior experience in medical billing or claims, we were told that we would all have a mentor to fully train us when we came in, but once you got your foot in the door, you found that they hired some of their supervisors out of a shoe store down at the local mall and threw them in a claims position. Needless to say, the quality of the work was not top quality at all. I have never heard of such a system where you hire people, some practically right off the street, to work on a brand new hospital client's account, but with zero knowledge about how to get claims processed and paid correctly. The learning curve in this type of business is pretty steep, what with all of the medical and insurance terms, and here we were, stuck with some twit they had pulled out of the local mall, and she was referring to employees as "stupid" as well as calling the client "retarded." It was so unprofessional that I left within a year to go to college and earn a degree on a full-time basis. I mean, I just up and left, even without a new job lined up, because they were just that bad at this place.

There are people handling medical records and sensitive financial information about hospital bills who you wouldn't want babysitting your kid for five minutes. That's how sleazy some of these billing/collections companies are.

Also, every so often, there would be some type of internal "error" in the accounting, but rather than pay commission out to a rep based on last month's commission, or even by taking the average and using that as a reasonable figure, the VP would tell the reps thanks for bringing the error to his attention, but then no one would get the proper commission that month. In other words, they just suffered a loss due to the mistake that no one cared to make right by at least offering some type of compromise, like perhaps taking the average monthly commission rate earned and just offering that up rather than have the rep screwed out of close to $100 that month.

There was ill will among the reps, which I am certain affected the quality of the claims work (these are the people who try to get the insurance companies to pay the claims so the patients don't get stuck with the total bill), and the turnover was extremely high. People were leaving all the time, most within 6 months, 8 months, or a year at most. Only a small number of people had been with this startup at least 2 years or more since they opened.

The managers also routinely used psychologically abusive management tactics on the reps right from the trial period on, always attempting to make them feel like they weren't working the claims fast enough, and yet everyone knew that we were overloaded with too many claims and severely understaffed, as the managers were trying to pay out less money to labor and just squeeze a lot of sloppy work out of the small number of reps they did hire. It was just a ridiculous work environment where they didn't care to give high quality ongoing training to each and every rep so they could get more claims paid, and on top of it, you would see all of these financial shennanigans with mysterious errors in how commissions were calculated. I really feel that they routinely just decided to screw the reps to cover the cost of the training week every time they hired a new batch of claims reps!

I highly recommend that the news media do some investigation of the various hospital billing/collections companies here in Illinois. If you think the hospitals themselves engage in questionable activities such as price-gouging, you should see who is sent the claims and collection accounts!

Regarding the publicity surrounding the tax exempt status of non-profit hospitals, both from the public at large as well as from legislators at the state and federal level, I just wanted to make a suggestion to anyone considering using those outsourced billing and collections agencies.

There are some real fly-by-night operations out there that do not have adequate internal safeguards to protect sensitive information such as hospital/insurance company contracts. At least one known outfit in Illinois has their contracts in paper form in large binders as opposed to having everything computerized where a lock on the print function could keep disgruntled employees from running off to the news media, a competitor, or just whoever with photocopies of private documents.

It isn't right when employees do such things, of course, but it isn't as if we haven't all read in the news about misuse and distribution of sensitive information.

Along with concerns over patient information, I do not think everyone really keeps in mind enough that hospital contracts can be copied and distributed in ways that ought not happen, especially if the business associates or insurance companies that have access to such contracts do not have strong safeguards to protect the information.

If you are in healthcare and are shopping around for a company to handle your hospital billing, re-billing, and denied claims issues, you owe it to your institution to carefully check out what type of safeguard the company has in place as to how the contracts are stored and who has access to them. I literally witnessed an employee whose fiancee had been incarcerated (he had recently been released, apparently) working with hard copy (as in paper) versions of client contracts. One can only imagine what an employee with that type of taste in a mate could be capable of.

I have seen reps in third-party billing companies copying hospital contracts because the small firm had only hard copy in a binder, and yet that type of information belongs in a computerized system where it can be stored safely, with a lock on the printing function, and where a password is required to even access the system (as opposed to someone easily grabbing a large binder that is stored right next to the photocopy machine).

Healthcare professionals would be absolutely shocked at some of the things that go on in some of the billing/consulting firms.

Just something to think about if out comparing outsourcing companies. Be sure to ask if your contracts will be loaded into a secure computer system where any print activity is either limited or monitored closely.

I just had to comment on the "questionable expenses the hospital covered for its bigwigs" part of that interview. It is no big secret that the hospital industry association known as HFMA (Healthcare Financial Management Association) holds annual meetings in Las Vegas, Nevada, a state that has legalized gambling and prostitution. One can only imagine how eager some of these "bigwigs" are to get out to Vegas to spend some of that money that they make while working for non profit and tax exempt hospitals. If I were the IRS or the news media, I would be looking at that executive compensation very carefully.

Also, if you read the wherethemoneygoes.com website, you'll see that the editor over there has uncovered salary differentials when it comes to how women over at The University of Chicago hospitals are paid for top positions as compared to male executives. Very very interesting, indeed.

If these hotshot execs are going to drive a Mercedes out to Nevada, home of the infamous legal prostitute ranches, then isn't it time that some of these tax exempt hospitals, some with religious affiliation, just pay their taxes already? Because I can assure readers that as much as people like Mr. Holt are trying to paint this controversy as the brainchild of a rich insurance executive, those rich insurance company execs are paying their taxes. How much tax money has been generated from a religious hospital to support local (often underfunded) schools?

Yes, insurance companies are for profit. Now, isn't it time that the Lexus-driving hotshots who take their million dollar a year salaries out to the land of legal prostitutes, Elvis impersonators, and gambling casinos agreed that their tax exempt hospitals ought to pay taxes already? Especially when they are pushing people into medical bankruptcy over medical debts due to the aggressive collections practices that got Provena Covenant and Carle Foundation into hot water?

The interviewer asked why hospital profit was bad, but the whole issue behind the hospital billing, collections, and charity care thing is that many hospitals purport to be non-profits, and yet they look very much like any other for-profit business, complete with money spent on advertising to bolster their images (especially when they get into trouble, which has been happening a lot lately with all the state attorneys general opening inquiries around the nation).

And even more importantly, some hospitals are involved in Medicare fraud allegations!

http://www.usdoj.gov/opa/pr/2002/May/02_civ_257.htm

Why are the taxpayers subsidizing these scoundrels???

Yes, YOU are paying for this chicanery!

http://www.kellogg.northwestern.edu/news/hits/050515ds.htm

Enough already.

Wow. Loved that reference to "hypocrisy" there, as I was just reading this piece that appeared in a newspaper called Naperville Sun, an Illinois newspaper, that was entitled "Hospital Giving is a Local Matter"--search it on the web for the entire article.

In this article, it reads "The latest development is a survey – funded by a union with its own agenda against the hospitals – that looked at 21 hospitals in Cook County and reported they enjoyed $326 million in tax breaks while making only $105 million in charitable contributions."

A union with an agenda? Although everyone is aware that there are adversarial relationships between management and labor/labor unions throughout America, the premise of the argument by hospitals--that they are spinning to the press--just seems absolutely flawed here. There has been an ongoing investigation of non-profits that stretches all the way to Washington. If the unions are jumping into the fray, then that's understandable that they have their own agendas, but that doesn't negate the very real fact that this issue is national in scope.

It is probably more along the lines of the unions having seen the stormclouds of legislative scrutiny from Washington brewing, and so they jump on board to get themselves some attention by helping to fund a study. I mean, that is probably closer to the truth, that they joined in on the effort to hold these non-profit hospitals more accountable to the taxpayers, but not that they instigated it from their end of things.

To insinuate that this is some plot hatched by unions with agendas is just getting it backwards, and while the Sun reporter doesn't exactly state that is the case, there have been other reports in the news where the hospitals have been giving that yarn to reporters to deflect attention from the allegations. It is more like the other way around in that the unions just joined the fray.

Do some research into the issue to see how many organizations are actually involved with this whole political affair. The IRS, Senate Finance Commitee, House Ways and Means Committee, GAO, multiple state attorneys general throughout the United States who have opened up investigations, trial lawyers filing class actions, citizen and community groups, the local press, the national press, CBS news show 60 Minutes, state departments of revenue, powerful senators on both sides of the political aisle, and yes, even the unions.

But that's a lot of people involved! These non-profit hospitals need to answer to a lot more people than just a union they may be having a spat with. Readers and other concerned citizens ought to take these reports where hospitals just blame spats with unions with a serious grain of salt.

This is such a great interview, here, that it makes readers want to learn more about the political hot potatoe of an issue known as the America Healthcare Crisis. In fact, I decided to see what this big industry trade association, the HFMA, which is also known as Healthcare Financial Management Association, had to say about the issue from their end of things.

If you do a web search--I used Google for mine--using the terms "HFMA '60 Minutes' Right Subject Wrong Focus," you can read a piece that reads like something that came from some paper-pushing, bureaucratic Minister of Propaganda for the healthcare finance industry.

In the piece that is on the HFMA website, Richard Clarke writes, "Forbes, Grassley, and the Bush Administration all are circling around the problem, but not hitting its true cause: how do we, as the richest economy in the world, allow more than 45 million Americans to go without health insurance?"

Now, in noting the obviously partisan political overtones there from someone who appears to be taking some type of swing at Republicans by only mentioning President Bush, Republican Senator Charles Grassley, and KB Forbes, who in the past handled the Steve Forbes political campaign, I noted that Mr. Clarke completely managed to leave out the very real fact that Democrat Lisa Madigan, the Illinois Attorney General, is also outraged over the behavior of non-profit hospitals, albeit from the view of one who is involved with the issue as it pertains to Illinois rather than at the national level in Washington.

There is definitely bipartisan criticism swirling around the nation with regards to this issue, and yet Clarke only chose to single out three conservative leaning personalities as part of what seems to be his lame attempt at turning the HFMA into the political equivalent of Teflon, where criticism is meant to not stick?

Here's something to chew on if you are just becoming well read on this issue: Many non-profit hospitals have settled Medicare fraud allegations, with one hospital settling for $265,000,000!!! Gee, but that's a lot of clams for a settlement. Why wouldn't you feel confident in fighting something that serious in court if you felt that you had done nothing wrong? Were they afraid that they would have had to pay out even more than a quarter of a million dollars had they let it wind through the court system? One can only speculate, but I'd sure like to know how the fact that some hospitals have been accused of alleged FRAUD can be deflected away with what appears to be a lot of spin and rhetoric from the folks over at HFMA.

In my humble opinion, that we have a large number of uninsured Americans is only part of a much (cough) larger (cough cough cough) problem, if I may steal Mr. Clarke's argument for a moment. The larger problem seems to be, in my opinion, that this industry is chock full of crooks!

Nice interview, but while everyone is watching the Provena case in the state of Illinois, perhaps anyone who knows of anyone who is just absolutely being harassed by some of these predatory collections goons who work on behalf of these price-gouging hospitals can use this resource for help.

Search the web using the term "Illinois Pro Bono Defending Hospital Collection Cases" and take a look at what options may be available to anyone in need of legal assistance. No, I am not affiliated with Illinois Pro Bono, but thank goodness this information may be able to help someone out.

Fight back.

In reading this interview, I noted that the interviewer asked, "Given the way that large companies can work legal and financial loopholes, do you have reason to believe that the situation may be even worse than it seems?"

It certainly seems quite easy for the non-profit hospitals and the for-profit billing and collections agencies that they utilize to work all kinds of PR loopholes based on some clever spin, that's for sure. For just one example, take a look at the website for one Illinois company that you can find on the web. Go to http://www.rpmstaff.com and read through their services offered.

Here, they actually address the issue head on and even offer services related to helping hospital clients identify possible charity care eligible patients. But at the same time, they still offer to steer debtors to lenders where the debtor may very well end up in the hands of some predatory lender. Some of these lenders are known to charge ridiculous amounts of interest or perhaps even demand that property (perhaps a home that is all the debtor has to his or her name) be put up as collateral to secure the high interest loan to pay the medical debt!

In this charity care debate, one must ask what the end result is for the often poor patients with either no or just enough assets that a predatory lender might be able to snatch. Just because the firms that handle the outsourced billing and collections work for the hospitals are not advertising that THEY do property liens now (and outsourcing, by the way, enables these hospitals to cut labor costs, which really helps with their bottom lines), this does not mean that the patients who have incurred medical debts are going to be safe from possible medical bankruptcy.

This isn't supposed to be a party for the financial services companies commonly known as "predatory" lenders, and even if some billing and collections firms are trying to appear to take the moral high road, I would be very interested to know if they are getting a financial cut from the accounts they steer towards some of these lenders. In fact, I hope the news media looks carefully at that angle when reporting on this issue in the local and national press.

And finally, while everyone from the hospitals to the collections firms to the industry trade associations keeps pumping out PR management rhetoric, could someone please tell me why these folks keep running their annual industry conventions in Las Vegas, Nevada? Religious hospitals have highly paid executives always hanging out in a state that is known for legalized gambling and legalized prostitution, and the taxpayers of the United States of America are working hard to subsidize this. Am I the only one who sees through the baloney here?

Put away the casino chips, quit those visits out to the legalized Vegas hooker ranches that some of you visit while telling your families that you're away "on business," or just pay your taxes already.

Great interview! And yes, there is a lot of hypocrisy going on in the healthcare finance industry.

If you read something from the big industry association's own journal, you can see for yourself. It is titled "Leaving Las Vegas" in the HFMA August 2005 issue of their journal.

Here it is, right from them:

"There's nothing like walking through a casino to get to an educational session on reimbursement. Or getting directions to the restroom from Elvis. Or listening to an amazing overcome-the-odds speaker help us remember the significance of what we do. To be sure, everyone was leaving Las Vegas with lots of great memories!"

I'll bet they left with great memories. Let's see, what else can you find just outside of Las Vegas? The Chicken Ranch? The Bunny Ranch? The Mustang Ranch?

Work hard, American taxpayers. You can sleep well knowing that indigent Americans are being pushed into medical bill-induced bankruptcy while the handsomely paid non-profit hospital executives who work in hospitals purporting to be doing work in the healing mission of Jesus Christ are having a blast along with their pals at the industry trade association in Sin City. Yes, you are subsidizing this. It is enough to make you sick, no?

Great interview! And yes, there is a lot of hypocrisy going on in the healthcare finance industry.

If you read something from the big industry association's own journal, you can see for yourself. It is titled "Leaving Las Vegas" in the HFMA August 2005 issue of their journal.

Here it is, right from them:

"There's nothing like walking through a casino to get to an educational session on reimbursement. Or getting directions to the restroom from Elvis. Or listening to an amazing overcome-the-odds speaker help us remember the significance of what we do. To be sure, everyone was leaving Las Vegas with lots of great memories!"

I'll bet they left with great memories. Let's see, what else can you find just outside of Las Vegas? The Chicken Ranch? The Bunny Ranch? The Mustang Ranch?

Work hard, American taxpayers. You can sleep well knowing that indigent Americans are being pushed into medical bill-induced bankruptcy while the handsomely paid non-profit hospital executives who work in hospitals purporting to be doing work in the healing mission of Jesus Christ are having a blast along with their pals at the industry trade association in Sin City. Yes, you are subsidizing this. It is enough to make you sick, no?

This whole issue has brought the hospitals so much bad PR that it is scary to think about the fallout, which could very well be desperation in finding competent and professional employees who want to work in billing and collections either on site, as in working in the hospitals, or from the outside, as in working within a private, for-profit company on behalf of the hospitals. Upon perusing Career Builder from time to time, you can see many hospitals constantly having open positions, so you kind of worry about the quality of people who will be handling medical and financial info now.

Sure hope these hospitals step up monitoring of those people who work the patient accounts by doing many many more audits, especially HIPAA compliance audits.

We all know what happens when employers are desperate; standards are lowered to get bodies to fill positions. You kind of cringe at the thought of what someone who harasses indigent patients over the phone for money they don't have is like. The words "creepy" and "sleazy" come to mind. Sure hope some of those people are getting proper criminal background checks and all that stuff.

To answer the question as to why some profit is bad, it isn't about some profit, per se, but that we keeping opening the papers only to see non-profits slapped with lawsuits. Qui tam lawsuits. Medicare and Medicaid make up a huge portion of the hospital revenues, and there is a lot of abuse going on from that end of things let alone the issues of exhorbitant drug markups and pricing well above actual cost. It is a sham to the nth degree that taxpayers subsidize what basically amounts to legalized white collar crime, if not a lot of already illegal white collar crime in terms of Medicare/Medicaid fraud.

And it is a small industry, too. Everyone knows each other. Insiders can easily pull the forms where hospitals report financials and see just what the heck is going on. That no one admits that they can see that some of these hospitals may be gaming the system is quite telling. Sure they all know what's going on. That's why the entire industry came together to get on Dan Rather's case when the 60 Minutes expose called "Is the Price Right?" aired. Go to the CBS 60 Minutes site to watch the video, because it is there. See how the hospital people are so arrogant that they thumb their noses at Senator Grassley in the expose. Scammers all.

As for those outside firms that they use? They literally outsource most of the business office functions so that they save money. Are they using the savings to benefit the most vulnerable in society? The sick and poor? How about the working poor? What are they doing with the savings from that outsourcing? What are they doing with profits from Medicare fraud? And once they get busted, who pays for the whole legal process? Who? The taxpayer? Who?

Washington had better move it, or there are going to be a lot of very angry taxpayers to answer to.

In reading "I don't need the hassle. I know what these hospitals are doing to anyone who criticizes them. Doctors who write me are afraid of getting fired," I would be interested in seeing more people come forward to talk to the press about how they were treated by industry powers-that-be for trying to draw attention to possibly unethical behavior.

Have seen that 60 Minutes thing with Dan Rather where they interviewed KB Forbes, a patient advocate, and he would be a great person to blow the whistle on anyone in the industry harassing people for doing some serious "whistleblowing" about what goes on within the industry. Perhaps get people who have left for other fields, and who are more willing to talk to the press? People who were demoted from a position for asking too many questions? People who were threatened with a job loss if they didn't shut up and just keep quiet? Just an idea, but I'm sure that advocates for reform can find at least a few more people who are willing to talk to the press if they knew they could get legal help if harassed as retaliation for telling their stories.

Get some interviews with people who are willing to talk and hit the media with it! Employees pay taxes, too! The best is when you can get a group, so everyone can corroborate stories, thus contributing to believability of the stories.

Any groups of employees ever experience issues with getting screwed out of commission money that they earned, as was mentioned in another post? Get together and go to the press. Or write your state Attorney General's office with the information.

Most importantly, get and stay active, because the squeaky wheel gets the grease. People need to not be complacent or afraid to tell their stories to the press, whether it is local or national. Your tax dollars are paying for the corruption, and it'll cost even more if you don't get involved and the corruption continues.

And just a little FYI, but this whole investigation is going on with non-profits because of the fallout from the Jack Abramoff scandal in Washington. Non-profits are targets of IRS and legislative scrutiny now like never before, so strike while the iron is hot and perhaps we can all bring about some much-needed reform. We can't have these corrupt and overpaid weasels wasting taxpayer money through fraud. Get active.

So! Greedy pigs in the healthcare industry are now being terrorized by the press, the lawyers, the IRS, and Washington in much the same way that they have been terrorizing the nation's most vulnerable, which would be the poor patients who didn't ask to get sick and whose only crime was getting sick? Hah. Good!

As someone who has worked in the biz for people who terrorized their own employees, tried to get them to do maid tasks in the company kitchen rather than actually hire a real maid, turned the heat down so much to save money on heating costs over the winter weekends that everyone was getting sick after a freezing Monday morning, and who were too cheap to give some of their more professional employees a computer to use that wasn't on the fritz all the time, I am just experiencing an absolute sense of schadenfreude in watching all of this unfold.

Take it from an insider, some of the people in this hospital finance biz are, at least based on my experience, the most greedy and cheap people on Planet Earth, and one of the worst moments in my professional experience was experiencing a day when someone set off the fire alarm by burning something in the kitchen, and instead of being thankful that no one was seriously hurt, the managers commented that it would cost them money to pay the fire department to come out to check on the smoke alarm situation. How cheap can you be, folks? I mean, you couldn't get much more greedy and cheap than that.

The press and the lawyers can't hound some of them enough. Three words to the press and the lawyers: KEEP IT UP.

On this "cutthroat young MBAs" issue. Can someone in the know get together some information so that taxpayers can learn more about these collections firms that everyone keeps talking about? I would like to research which firms the local non-profit hospitals are using and see how often they sue patients while also noting whether the hospital draws patients from a less affluent zip code. Have no idea where to start. There should be an expose on the collections companies, too, since they have so much contact with the patients. Do the execs who run the hospitals even pay enough attention to what is going on in those firms they send the work out to? It basically sounds like they make a lot of money and spend it in Las Vegas and then they finally wake up when the proverbial (expletive deleted) hits the fan. More info please. We citizens want to know more. Who is doing the lawsuits and collections? And do the people who run firms with self-pay patient collections divisions have any conflicts of interest, like also being on boards for various hospital-related trade associations? Is there the potential for a lot of back-scratching to keep everyone mum about abuses in the system within the industry? Inquiring minds demand to know.

Interesting interview and comments. And lookie here at what was found at policymattersohio.org site. "Panel Explores Nonprofit Hospitals' Charity Care, Tax Breaks" is the name of a piece under something called "The Hannah Report," and it is outrageous what is printed there for Thursday, June 16, 2005.

Read this portion: "Lori Swanson, solicitor general in the Minnesota attorney general's office, detailed worldwide junkets, expensive perks including masseuses in the boardroom, and exorbitant salaries -- findings they uncovered in compliance audits of three nonprofit hospitals in that state. She said they also found aggressive debt collection practices and salary garnishments."

Masseuses in the boardroom?? Are these female masseuses? In religious hospitals? Oh my God, but this is not coming from my taxes!

Aren't church leaders speaking out about this? Where are the church leaders to ask why the poor are being hounded for money so an overpaid rich man can have a "masseuse" in the boardroom? In the boardroom? What is going on here? Outraged. Just outraged.

In that post about "junkets." Did not know what a "junket" was, so looked it up. It is apparently a term used to describe trips taken around the world at someone else's expense, like government or taxpayers.

Yes, maybe the investigative reporters and journalists need to get out there to places like Las Vegas where these people are spending time in the casinos, because some of us would really like to know who is paying for those trips to "Party at the Palms" in Las Vegas, like on that E (Entertainment) cable channel where those Playboy Playmates go to hang by the pool all day and drink in bars at night.

Where else are they going? The French Riviera? Monte Carlo? Some of us would really like to know just who the hell is paying for this, because we keep seeing that there are a lot of men in these top positions in the hospital and healthcare financial industry, but not many women. What is going on here? Is this about rich and horny men running these so-called not-for-profit hospitals with faith-based missions tied to religion, only the men are in reality going on "worldwide junkets" as mentioned in that other post about the Ohio investigation?

Hello press? Get busy.

Have comments on this notion by some people that non-profit hospitals aren't making much money, which is what the interview was trying to discredit. They are making plenty of money, mainly because they understaff and underpay their own employees while the top people make big salaries that can even run up to a million or two million a year.

At a website for hospitalbillauditing.com, which seems to be run by people who do auditing work, on their page titled Hospital Billing Practices, it says that "The typical hospital billing department is overworked, understaffed and buried under mounds of paperwork" and that "There tends to be a high rate of job dissatisfaction and turnover among employees, who are usually underpaid."

Therefore, anyone looking for an army of disgruntled people who are willing to talk to the press or to investigators who are looking into this whole matter of price-gouging and excessive CEO compensation can just go and find anyone who has worked in hospital billing, either directly in a hospital or for a billing company that does it for them, for stories about execs who are rude to their people while taking lavish vacations themselves. This whole affair is like an Enron and Arthur Andersen scandal in the making, only it involves non-profits as opposed to for-profits.

Yeah. Have to agree. Hot story for the press, that's for sure. Especially the link of religion-based, non-profit hospitals with gambling casino trips in places near legal brothels. Hoo boy. Can just see the headlines now. Example: Are Faith-Based Hospital Executives Spending Millions in Sin City?

Re: Q. "What responses have you received, or press coverage, or support?"

A. "Press inquiries, no press coverage, hospitals do too much advertising."

Fox News Channel would be the best bet. Has anyone told them? President Bush has touted those Health Savings Accounts in Washington, and Tony Snow, formerly of FNC, has gone on to become a White House spokesperson. Fox would totally be willing to help if someone were to write in and tell them that they'd like to see this issue covered. If you want press coverage, then write Fox. In fact, I am thinking of writing them right now. Taxpayers should know about this, so if the newspapers that get so much hospital advertising won't run stories, then perhaps the best answer is to just go to the national media?

Someone mentioned that HFMA association. I worked for a place once that had top execs who were part of the HFMA running this place where we did some work that involved contacting patients for various hospital clients.

They had this unprofessional favoritism environment going where managers would go out with select subordinates that they invited out to parties and bars, and then it would get back to the other people who were not on the invite list that they had all been gossiping about other staff members. We would hear them talking about it amongst themselves, although they probably didn't mean for us to overhear it.

If people questioned some of the business practices, they would be on the Do Not Invite list, but then people would hear about what people were saying about them. I mean, look. If you are in management, you should be fraternizing with other management level staff on your own time, not inviting your own employees to go drinking in bars so you can trash the reputations of other employees who were not invited. And then, of course, people who asked too many questions would mysteriously be fired all of a sudden.

HFMA affiliated people, too!

If they gossip about their own employees, do they disclose patient information recklessly off work time, too? You have to wonder.