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Frist's family's HCA's seeing a higher percentage of uninsured patients might seem like something new, but this challenge has been afflicting hospitals in major urban settings for years. HCA had managed to dump the challenge onto others for many years while they acquired hospitals, but ultimately the states where they were buying hospitals apparently started making them take uninsured patients rather than just moving them to public hospitals after performing wallet triage. Most of these for-profit hospitals had claimed for years that they could provide better, cheaper care than the public hospitals they wanted to push out of business. It would seem they can't. I'm sure Frist's family is just working on some way to claim that for-profit hospitals should receive a higher reimbursement rate from the government and insurance companies because they're such...ah...such...umh...nice guys, yeah that's it. Frist wont' tell you for-profit hospitals are vampires sucking the life out of the nation's health care system.

Rebecca Allen, PhD

As a health-care worker, I can attest to the veracity of PrahaPartizan's comments above. But I think we need to look at this as part of a bigger picture: how empires collapse. Part of the pattern is that elites become more interested in perpetuating their power, and feeding their greed, than in contributing to the empire. You see this kind of feeding frenzy, in which the elites gorge on the rotting carcass. Eventually the whole structure collapses. I think that's what we're seeing here, in the whole Republican-corporate hegemony. It exists only to consume, not to create new value (either for business or society).


short-term effort to boost the president's political stock, with the long-term costs left to some bigger sucker.

I think this sort of what Perlstein had in mnd with the Superjumbo.

Literally, Boeing took a great gamble that netted great rewards. Now, thirty years later, they barely tinker with it, lest that make them undeperform 'quarterly expectations'.

I think the short-term/long-term dichotomy is Wall Street's contribution to it all.



Anonymous Liberal

Your post reminds me of a post from Digby a while a go. Digby noted that (and I paraphrase) the GOP has been successful in the same way that Enron was successful. You can only defy the basic rules of accounting for so long. At some point GOP fiscal policy, which bears more than passing resemblence to Enron's accounting practices, will be exposed and we will have a crisis. The "smartest men in the room" are at it again. Great post.


Great post. And re: Anonymous Liberal's comments above and Frank Rich's column on Sunday (9/25), the resemblances to the practices of the Enron era go even farther.

First is the rationale that old rules did not apply – that you could spend freely and cut corners and avoid sacrifices of any sort because the bounty of a new and huge opportunity awaited just around the corner (and always just around the corner). Any embellishment, shortcut, or outright lie would be forgotten in the wild success that would soon follow. And while the people at the top did reap great rewards, the rank and file were ultimately ruined because they were so foolish as to believe their leaders’ rosy promises.

Any attention to inconvenient facts was derided as a failure to understand the new ways of the world, while a specious breed of “optimism” took over – one that was merely hubris combined with wishful thinking, an increasingly desperate hope that the manipulation of appearances could not just influence reality, but become reality.

We can only hope that, as with Enron, the truth eventually not only comes to light, but remains there.


I think your on to something here, but I think the problem is deeper than you think.

To give some background - bear with me I'll get back to the subject - my father was a scientist and scientists tend to have a different perspective than everyone else. First they think of money as fairyfloss - they think in terms of real absolute limits not financial or political ones. Secondly, they think everyone can be wrong - opinion polls have nothing to do with the truth. And third, the absolute worst that you could be - you would be disowned if you were - is a salesman.

But today we live a world ruled by salesmen. And there are not enough scientists around today who resent it. (Despite the best efforts of the Scientific American).

But the biggest con of all, is the story that what is good for "General Motors is good for America". It has been taken too literally and it has been forgotten that the interests of a Business in particular, and the interests of business in general, are two different things. To the extent that capitalism works it works through representing and balancing COMPETING interests. And interests that aren't represented in the market (future generations?) need to be if the market is to work for everyone.

Getting the balance and competition back in to business, AND ensuring that the referee is unbiased should be PRO-BUSINESS agenda. And we finally need to evaluate and give externalities the central role in the economic system that have in the roles of real people instead of pretending they don't exist.

I'm afraid if that isn't done somewhere along the line a nasty populist revolution is brewing.


I hope someone smarter than me will discuss the manager-owner IT, tech, and telecommunications business culture of the late '90s.

Because the shelf-life of technological innovation is so short (and the enthusiasm of investors so great over that short life), managers had a strong inducement to "pump-and-dump" during their window of opportunity, that is, before another technological solution ate their lunch.

Businessmen became short-term players.

richard lo cicero

And all of this while we have the first "MBA" Administration. I really think that it has been obvious for a quarter of a century at least that something is seriously wrong with business education in this country. After all someone has to learn this behavior. I don't think its inate in Capitalism or it would turm up everywhere.

California Health Insurance

Universal health care can be a great impact on health care system. It is unfortunate to hear so many lack health insurance. We really need to improve our health care system. Health insurance is a major aspect to many and we should help everyone get covered.

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