Too Big Not To Fail

Being too big to fail did not work for the dinosaurs. And it is not working too well for our modern dinosaurs of business either.

Our local hospital, WakeMed, thought it was too big to fail. It billed Medicare millions of dollars for overnight stays in its heart center by patients who were released and did not stay overnight. Such false billing is fraud but the U.S. Attorney's office chose to overlook the criminal behavior and instead negotiated a fine of $8 million and WakeMed agreed to pay this pocket change. U.S. District Judge Terrence Boyle threw out the agreement and ordered the prosecuting attorneys to pursue indictments for those who were responsible for the fraud. If the case is proven it could disqualify WakeMed from receiving Medicare payments and, essentially, put the hospital out of business. I don't want to put my local hospital out of business but there have to be real consequences of fraud, not just a slap on the hand.

I discovered another sign that WakeMed is too big when I went to my cardiologist's office for a checkup. Emblazoned on the door was a new sign proclaiming that my doctor and his colleagues are now "Associates" of WakeMed hospital. The waiting room was much busier than usual, indicating perhaps that the association has brought them new patients. The receptionist required new information from me because, she said, they were now tied into the hospital's computer system. The only change I noticed in my care was that the doctor spent less time with me. But the new link with WakeMed also means that they can bill Medicare and Medicaid at substantially higher rates without any real change in the cost of providing the care. And this little caper is legal. I favor national health care but not if it is just going to support an epidemic of fraud and price gouging by the medical community. Now I have to look for a new cardiologist.

We also saw "too big to fail" at work in our recent elections. The U.S. Supreme Court's "Citizens United" decision enabled corporations and rich individuals to create Super Pacs. These new ogres collected and spent enormous amounts of money on TV ads supporting candidates who would be more susceptible to the bribery of lobbyists. Yet a statistical analysis of the results showed that the Super Pacs had almost no effect on the election results. My guess is that the American public has become adept at ignoring TV ads, especially ads that they see over and over again. The size of the Super Pacs may actually have gotten in the way of their message.