Lancaster General Health has  published its annual 990 federal financial report and the results are described in an unbiased first page article of the Sunday News.  Below are excerpts with comments:

“Lancaster General Hospital’s yearly surplus fell last year for the fourth year in a row, due in large part to a growing number of patients relying on government programs like Medicare and Medicaid — and reimbursement rates that haven’t kept up with the cost of care…”

“[Spokesman John] Lines said 60 percent of LGH patients are enrolled in Medicare or Medicaid. “The other 40 percent is commercial insurance, people who are insured by their employer. That’s where we make our money.”

WATCHDOG: The main reason that LGH is able to earn extraordinarily high profits as compared to almost every other hospital in the state is its monopolistic control of hospital and other health care services which enables it to extract high reimbursements from insurance companies who in turn charge businesses and individuals more than would otherwise be the case.  This is not necessarily a bad thing if the profits earned by this Public Charity were properly expended.

“We’ve moved staff from services that are either no longer in demand, or where demand is decreasing to areas where demand has been on the rise,” he said. “There’s an increased focus on wellness to make patients healthier before they need costly care. Going forward, LGH may rely more on philanthropy for new ventures.”

WATCHDOG: We cannot reconcile LGH’s unwillingness to provide funding to the Urban League when it offered to sponsor a syringe exchange with a “focus on wellness to make patients healther before they need costly care.”

“Hospital CEO Thomas Beeman — a captain in the U.S. Naval Reserves who was on a military leave of absence from the hospital for eight months of the 12-month reporting period. Beeman was paid while on leave — in fact, he got a raise, though one lower than the LGH average.  Beeman’s compensation totaled $1.35 million last year, up from $1.32 million the year before — a 2.1 percent increase.”

“Lancaster General Hospital’s yearly surplus fell last year for the fourth year in a row, due in large part to a growing number of patients relying on government programs like Medicare and Medicaid — and reimbursement rates that haven’t kept up with the cost of care.”

WATCHDOG: At least half of the drop can be attributed to the $1,350,000 gift to Beeman and the extraordinary increase of compensation to Executive Vice President Jan Bergen, “$1.1 million in compensation last year — up from $733,145 the year before.”  Bergen’s husband is partner in the law firm that LGH’s chairman heads.

“Lancaster General disbursed grants and other payments to local governments and other organizations totaling $4.3 million last year, up from $3.97 million the year before. The City of Lancaster received $1.38 million; the School District of Lancaster got $1.34 million.

WATCHDOG: This is still tiny considering LGH is a public charity that generates mammoth profits and operates in a totally opaque manner.  It has a self-selected board of trustees made up of white leaders of the medical profession and business establishment.  As such, it lacks a smidgeon of diversity.  Moreover,  LGH refuses to allow public comment even at the single public annual meeting mandated by regulations.

We applaud the quality of care, competence and dedication of the medical staff and workers, but we do resent certain physicians and executives  profiting excessively (and there is much we cannot see due to lack of transparency) while LGH’s mission, “To advance the health and well-being of the communities we serve,” is in many ways neglected.

It is time to return this captive Public Charity to a board of trustees that truly represents all aspects of the Lancaster community.

Lancaster General Health is a 501(c)3 tax exempt organization, a ‘public charity.’ Therefore, it pays no real estate taxes to the county, city or school district which otherwise might amount to over a million dollars a year. Also contributions to LGH are tax deductible, encouraging donations.

Its president, Tom Beeman, was absent a year while serving as a captain in the U. S. Navy. LGH, a ‘public charity’, paid him the difference between what he was paid by the Navy and his regular annual compensation. The difference amounted to about $1,150,000.

For a ‘public charity’ to gift $1,150,000 to an executive was mentioned by the Lancaster Sunday News but went without criticism or further comment.

The following pertains to 501(c)3 non-profit hospitals and is excerpted from “The Private Inurement Prohibition” posting at Guide Star USA:

…“The courts and the IRS have consistently ruled that any unreasonable benefit or inurement, however small, is impermissible and can result in the revocation of a charity’s tax-exempt status.”…

“In ‘an excessive compensation case, the ‘excess benefit’ is the amount by which the total compensation paid by the charity to an insider exceeds the reasonable value of the services provided by the insider to the charity’.…

“Section 4958(a)(2) of the Internal Revenue Code also imposes a tax equal to 10 percent of the excess benefit on any charity manager, typically a board member, who knowingly approved the excess benefit transaction, unless his or her participation was not willful. (emphasis added)…”

If the $1,150,000 pay is ruled improper, each LGH board member may be fined $115,000 by the IRS.

While the Attorney General office is conducting this necessary investigation, it should also look into LGH blatant and contemptuous refusal to allow public to its meetings, most recently even preventing the public from being able to address the board and audience during the Annual Meeting session.

It isn’t that the individuals who make up the board of directors set out to cheat the public who actually own LGH. Rather, it is their misguided sense of being the omniscient stewards of what is best for the community. It is the arrogance of not feeling responsibility to share what they do through public exposure. It is not allowing representation on the Board of Directors other than to members of the affluent Caucasian establishment. It is the silence of the editorial voice of the Lancaster Newspapers, Inc. whose Executive Director is a Board member. (Shades of the Convention Center conflict of interests.)

LGH can set its own prices with insurance companies. The result is the public pays higher premiums. Hence come LGH extraordinary profits averaging around $100 million a year.

LGH has been allowed to go dangerously astray without public check. It has a strangle hold on the medical community and monopolistic control of health pricing.

Lancaster is justly proud of the people who work for LGH and for the quality of the care it gives.  But the public with the aid of the media needs to break through the wall of arrogance and secrecy, insist that the directors represent the diverse interest of the community, and demand that LGH indeed conducts its stated mission:   “To advance the health and well-being of the communities we serve.”

A positive first step would be to help fund the syringe exchange that the Urban League has offered to establish to reduce the spread of HIV / AIDS and other diseases and to help get addicts off drugs and back to their loved ones and productive activities.

Sadly, who dares criticize LGH, Lancaster’s powerful sacred cow?  Thus the need for intervention by the State Attorney General and the State Department of State, both involved in the supervision of 501(c)3 institutions.

Do you notice a common thread among the below?  All are powerful establishment figures, either affiliated with Lancaster General Health for their livelihood or a head of a major Lancaster institution.   There is a lack of diversity.

Should Dennis Getz, Executive Vice President of the Lancaster Newspapers, Inc., even be a board member? Is this a way of muzzling possible criticism from the Fourth Estate?

Clergy? No.   Social workers?  No.  School teachers?  No.  People of color?  No.

It is hard to perceive an advocate for the legitimate needs of the community as defined by their mission statement:  “To advance the health and well-being of the communities we serve.”

More likely, the discussions are about enriching LGH, its executives and affiliates.

All of the above are at the summit of prestige and affluence, all ‘givers’.  Not represented are leaders of charities that are ‘receivers’ who are essential advocates of the health and educational needs of the community.

Little wonder the hospital only gives a pittance of its vast earnings to struggling organizations who also seek to “advance the health and well-being of the communities.”

We are not questioning the integrity or dedication of the individual trustees.  We are challenging the lack of representation of the diverse needs of the community and failure of the LGH to provide transparency concerning its plans and dealings.

Board Members

	Alexander Henderson, III, Esq. Chairman Hartman, Underhill & Brubaker		Robert F. Latshaw, MD Lancaster Radiology Associates
	C. Clair McCormick Vice Chairman Lebzelter’s Total Car Care		Bruce R. Limpert  CPS Management Services
	Thomas E. Beeman, Ph.D. Lancaster General Health		Deborah K. Riley, MD Infection Specialists of Lancaster, P.C.
	Rebecca S. Bumsted Retired		John Rose Horst Group (Retired)
	Gibson Armstrong Pennsylvania State Senate (Retired)		Antonio Suarez McDonald’s
	T. Raymond Foley, MD Regional Gastroenterology Associates of Lancaster		Michael W. Van Belle High Industries Inc.
	Dennis A. Getz Lancaster Newspapers Inc.		Philip R. Wenger Isaac’s Restaurant & Deli
	James E. Hipolit, Esq. Irex Corporation		Patrick D. Whalen Northwestern Mutual Life Insurance Company
	Joanne B. Ladley Kitchen Kettle Foods Inc.

As of March 19, 2012

At their recent annual meeting, Lancaster General Health took the unprecedented step of eliminating an opportunity for comment while the audience was present.  The good news appears to be that new federal governmental regulations for tax exempt public charities will require discussions with representatives of  the community at large and the submission of an annual public summary and response.  The bad news is that LGH may be able to ignore the regulation by paying a $50,000 fine.

From the Internal Revenue Service:

…This notice addresses the community health needs assessment (“CHNA”) requirements described in section 501(r)(3) of the Internal Revenue Code (“Code”) and related excise tax and reporting obligations, applicable to hospital organizations that are (or seek to be) recognized as described in section 501(c)(3) of the Code. The CHNA requirements are among several new requirements that apply to section 501(c)(3) hospital organizations under section 501(r), which was added to the Code by section 9007(a) of the Patient Protection and Affordable Care Act (“Affordable Care Act”), Pub. L. No. 111-148, 124 Stat. 119, enacted March 23, 2010.1 This notice describes specific provisions related to the CHNA requirements that the Treasury Department (“Treasury”) and the Internal Revenue Service (“IRS”) anticipate will be included in regulations to be proposed under section 501(r). This notice also invites comments from the public regarding the CHNA requirements…

Section 501(r)(3)(A) provides that a hospital organization meets the CHNA requirements with respect to any taxable year only if the organization (i) has
conducted a CHNA that meets the requirements of section 501(r)(3)(B) in such taxable year or in either of the two taxable years immediately preceding such
taxable year, and (ii) has adopted an implementation strategy to meet the community health needs identified through such CHNA. Section 501(r)(3)(B)
requires that a CHNA (i) take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and (ii) be made widely available to the public. Although most of the requirements under section 501(r) are effective for taxable years beginning after March 23, 2010, the CHNA requirements are effective for taxable years beginning after March 23, 2012. See section 9007(f)(2) of the Affordable Care Act….

(3) A description of how the hospital organization took into account input from persons who represent the broad interests of the community served by the hospital facility (as defined in section 3.06 of this notice), including a description of when and how the organization consulted with these persons (whether through meetings, focus groups, interviews, surveys, written correspondence, etc.). If the hospital organization takes into account input from an organization, the written report should identify the organization and provide the name and title of at least one individual in such organization with whom the hospital organization consulted. In addition, the report must identify any individual providing input who has special knowledge of or expertise in public health (as provided in paragraph (1) of section 3.06 of this notice) by name, title, and affiliation and provide a brief description of the individual’s special knowledge or expertise. The report also must identify any individual providing input who is a “leader” or “representative” of populations described in paragraph (3) of section 3.06 of this notice by name and describe the nature of the individual’s leadership or representative role.

From HEALTH AFFAIRS:

FIFTY YEARS AGO the poor and uninsured were often charged the lowest prices for medical services. In a classic health economics article, Reuben Kessel explained in 1958 why it was rational for physicians to charge the wealthiest the most and to discount prices for the poor.¹ It included a quote from a “highly respected surgeon” that, according to Kessel, “presents the position of the medical profession”:

I don’t feel that I am robbing the rich because I charge them more when I know that they can well afford it; the sliding scale is just as democratic as the income tax. I operated today upon two people for the same surgical condition—one a widow whom I charged $50, the other a banker whom I charged $250. I let the widow set her own fee. I charged the banker an amount which he probably carries around in his wallet to entertain his business friends.²

Almost fifty years later, uninsured and other “self-pay” patients are often presented with bills by hospitals, doctors, and other health professionals with charges that are 2.5 times what most public and private health insurers actually pay…

Click here to read the full article.

By Arnold S. Relman, MD *

From THE NEW YORK REVIEW:

The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer. The federal share, including payments for Medicare and Medicaid, was 23 percent of the national budget in 2009 and is a prime cause of the deficit.1..

However, today’s competitive health care market, with its private health insurance companies and fee-for-service payment system, severely limits the potential cost savings of a delivery system based on not-for-profit group practice. Private insurers contribute to high costs not only because of their profits and overhead, as already noted, but because doctors and hospitals have to pay the considerable costs of billing the insurance companies and collecting money from them. I favor a much less expensive single public payer system supported by a universal, progressive, designated health care tax. Fee-for-service payment gives doctors incentives to provide more services than needed and allows for fraudulent billing. It should be replaced by an advance payment to physicians for comprehensive care on a per capita basis…

Hospitals, as we have seen, are now hiring more physicians to work in groups. As hospital employees, these physicians inevitably feel pressure to protect their employers’ income by filling beds and using hospital facilities for tests and procedures. They are less likely to control costs than physicians in independent not-for-profit groups. It is not yet clear which type of group will dominate, but those owned by physicians would probably be more supportive of reform…

Click here to read the full article.

EDITOR: This is a thoughtful article and well worth reading.  Moreover, it has very specific implications for our local situation.

Lancaster General Hospital has spread it tentacles to virtually every aspect of health care in the county, not only virtually monopolizing hospital service but acquiring a large proportion of medical practices.  Medical practices and LGH have no financial incentives to further public health measures.  This is  contrary to other countries with Single Payer of nn-profit insurance systems that are far  superior to the USA in both care and cost.

The public pays for this in two ways:

1) Its health is jeopardized.  For example, LGH refused to help fund the establishment of a full scale syringe exchange and to devote proper capacity for the treatment of  addicts since there is no money to be made off of government funded Medicaid.  (LGH provides a part time ‘fig leaf’ of a clinic.) LGH does not take the lead in educating students,  the public and businesses on healthful practices.

2)  LGH can set its own prices with insurance companies.   The result is the public pays higher premiums.  Hence comes LGH extraordinary profits averaging around $100 million a year.

‘Public Charity’ LGH President Tom Beeman was paid his full salary of around $1,300,000 when he took a year off to serve in the Navy.  $1,300,000 would have funded a top notch syringe exchange for 13 years and led to a significant reduction of heroin addiction, overdose deaths, and the spread of social diseases including HIV / AIDs to the general public!!!  In any  case, how lawful is such an expenditure?   Just like  refusing to have public comment at their annual meeting, the self perpetuating board and leadership of LGH show their arrogance and isolation from public opinion and control.

Relman’s contention is that most young doctors prefer to be part of large practices and salaried.  This  growing trend lends itseslf to real reform of our health care system.

*Arnold Seymour Relman M.D. (b. 1923, New York City, New York) is a professor of medicine, social medicine and emeritus at Harvard Medical School, Boston, Massachusetts.[1] He is a former editor of the New England Journal of Medicine (1977–91) and writes extensively on medical publishing and reform of the U.S. health care system. In November 1988 Relman was awarded Honorary Fellowship by the New York University School of Medicine.[2]

By Phillip Smith

From the DRUG WAR CHRONICLE:

For the past eight years, the San Francisco Department of Public Health has been handing out the opioid antagonist naloxone (Narcan) in a bid to reduce heroin overdose deaths. This week, the city marked what it said was the 600th life saved by using the overdose-reversal drug.

This drug stops heroin overdoses — 600 so far in San Francisco.

The city distributes naloxone through needle-exchange sites, nonprofit organizations, and community organizations that deal with injection drug users. The department also prescribes the drug to people in residential hotels and the friends and families of heroin users, and conducts training sessions in the county jail.

Not only have hundreds of overdose deaths been averted, but the department also reported that heroin-related visits to the city’s emergency rooms had declined by half between 2004 and 2009.

The lifesaving measure is funded by a department expenditure of $73,000 a year, which goes to the Oakland-based Drug Overdose and Prevention Education Project (DOPE Project). DOPE uses the money to buy and distribute the drug and train people on how to use it.

“San Francisco has always been a heroin town,” Alice Gleghorn, DPH’s head of Community Behavioral Health Services told the SF Weekly. “At one time, San Francisco had an overdose death every day, and that rate has really gone down. I hope our naloxone programs have contributed to that drop. But we don’t have the money to do the research.”

Eliza Wheeler, director of the DOPE Project, compared naloxone to insulin and said its use posed few problems for injection drug users. “The folks we see are pretty adept with administering drugs, so they’ll be okay. People are very capable and willing to save their friends’ lives… my experience is that people are really proud of themselves,” Wheeler said.

Harm reduction is saving lives in San Francisco. Perhaps other cities and counties should take heed.

EDITOR: Those in charge of health care in San Francisco care about the community at large unlike here in Lancaster.  The main concern here appears to be how much many can be made as part of the highly profitable but opaque so called public charity, Lancaster General Health.

LGH won’t help the Union League to establish a syringe exchange despite an estimated 5,000 to 10,000 heroin addicts countywide.

The annual Lancaster General Health Board of Trustees meeting took place at the Stager Auditorium at 5 pm on  Wednesday.  The format was changed from last year and it went as follows:  A one hour and fifteen minute agenda was presented, then the meeting adjourned for one hour, after which there were three additional presentations.  Alex Henderson made the announcement that at the adjournment the board would be available to answer questions from the public.

Thus in its sole meeting open to the public of the year, public charity LGH  prevented members of the public from addressing its board, officers, the medical community, and the local media should it be allowed by its editors to cover and write about the event.

About 125 people were in attendance. Former state senator Gib Armstrong is on the board. Former county commissioner  Pete Shaub was an audience member.

At the adjournment, NewsLanc reporter Christiaan Hart-Nibbrig approached board members and other LGH officials, introduced himself,  and said that NewsLanc’s publisher Robert Field was  out of the country but wanted Hart-Nibbrig to read a letter at the meeting during the public segment.  He handed a copy personally to Chair Alex Henderson, President Tom Beeman and Executive Vice President Jan Bergen.   Senator Armstrong received a letter as well.

There were NO PRINTED agendas to the meeting.  The reporter asked  Bergen for a printed copy.  She took him to Lines, who assured him he would forward an agenda on Thursday.  T he financial report — submitted by Dennis Getz — took all of 96 seconds of presentations.  In that report, Getz said LGH “was in good financial condition.” His report showed that the bond/credit rating of the hospital was very good.  He also pointed to other healthy financial indicators which are up.

The entire meeting had a perfunctory, boilerplate feel to it…  A ‘dog and pony show’.

Failure to permit public comment may have been a violation of federal regulations.  In any case, this is still another example of how LGH disdains public input and criticism, now taking the unprecedented and arrogant step of preventing  the well represented Lancaster  medical community in attendance from being exposed to views from the public.

[EDITOR:  NewsLanc recognizes the skills, dedication, hard work and the excellent care given by the staff at Lancaster General Hospital.  The below is not critical of them, but of how the Public Charity is mismanaged for the benefit of a few at the expense of the public.]

Year after year, the evidence grows that Lancaster General Health system with all of the financial benefits of a “Public Charity” is largely run as a feeding trough for its top executives and physicians, to the neglect of the overall public health needs of the community.

Although LGH masks its operations, embargoing media from its committee and board meetings, it is required by law to publish its annual federal 990 Report and to allow the public access to its Annual Meeting.  (The Lancaster Newspapers did not cover the LGH annual meeting last year despite its abundant news content.)

Even as reputable a publication as the Sunday News either doesn’t have or is unwilling to dedicate financial analyst  resources to plumb the depth of the 990 Reports, so its report relies heavily on whatever spin it receives from LGH  through spokesperson John Lines.

As examples, below are quotes from the Sunday News article of May 22 followed by  NewsLanc comments:

SUNDAY NEWS: “Lancaster General employees have a defined-benefit pension, [Lines] said.  Actual salaries increased by just half of 1 percent across the board.”

NEWSLANC: Base salaries for the executives listed on the 990 Report went up 8.5% for those employed throughout both years.  (Without our appropriate adjustments, the figure would be 11%.)

SUNDAY NEWS: “Hospital CEO Tom Beeman — who has been a captain in the U.S. Naval Reserves for 27 years and began a military leave of absence Oct. 15 — was the hospital’s highest-paid employee in 2009-2010, with a total compensation of $1.323 million, including a base compensation of $649,037 and bonuses and incentives of $300,000. This actually represented a decrease from his 2008-2009 total compensation of $1.347 million.”

NEWSLANC: The drop in pay was only to offset the salary that Beeman received from the Navy.  The trustees were very patriotic with the charity’s money that should more appropriately have been used for the stated mission of LGH:  “To advance the health and well-being of the communities we serve.”

SUNDAY NEWS: Lancaster General provided $83.3 million in charity care, unreimbursed Medicaid expenses and other “community benefits” in 2009-2010, according to its tax form; that represented a major increase from previous year’s total of $71.2 million. Unreimbursed Medicare expenses alone totaled $63.6 million in 2009-2010 — 8.57 percent of all LGH expenses for the year.

NEWSLANC: “Unreimbursed Medicare expenses” are calculated as discounts from the inflated ‘retail’ price, not from what LGH actually charges insurance companies and the Amish Community.  It is as if General Motors treated auto discounts as public charity!  Anyone without insurance is charged the ‘retail’ rates that often lead to personal bankruptcy.

SUNDAY NEWS: “Lancaster General disbursed grants and other payments totaling $3.97 million in 2009-2010, a drop from the $6.66 given out in 2008-2009. The reason: In 2009-2010 LGH gave more than $2.6 million to SouthEast Lancaster Health Services so it could purchase the building for its Arch Street clinic.”

NEWSLANC: Over $2.65 million of the $3.97 million went to the City and the School District of Lancaster in lieu of real estate taxes.  While commendable, the contribution is far lower than would be the actual real estate taxes were LGH a for profit entity.   The County has no economic interest in accurately re-assessing tax exempt properties such as those owned by LGH and Franklin and Marshall College.

Items classified as “Lancaster Public Charity” of questionable appropriateness are: $135,000 to Franklin and Marshall College (“alms for the rich”); $14,980 in supplies for the Haiti Relief Funds; $150,000 for the James Street Improvement District; and $25,000 for the Lancaster Central Market.  Albeit worthy causes, they do not comply with LGH’s “Mission statement: To advance the health and well-being of the communities we serve.”

Conspicuously missing is LGH’s refusal to contribute one cent to the struggling syringe exchange sponsored by Bethel AME church.  Nor would LGH provide funding for the Urban League when it offered to take over and enlarge the exchange.  There likely is no greater pay back for public health than the funding of syringe exchanges, since they not only deter the spread of disease but they also are the entry point for addicts to be referred for counseling and treatment, and thus returned to society as productive members.

————————————

LGH Chairman Alex Henderson and other members of the board have a distorted vision of the role for a “public charity” in a community.  Since the board appoints future members, it lacks public and government input.   Thus, there is nothing that members of the public can do to impact hospital policies and practices.

NewsLanc urges LGH to open their board meetings to media as do government agencies and to allow at least half of their trustees to be elected in the same manner as school district trustees.  Then there would be a greater alignment of the public charity with the public needs.

The ultimate solution would be either a merger with Geisinger Health System or the creation of LGH’s own health insurance company.   Then the economic emphasis would switch from ‘fee for service’ to how to promote good health and improve quality control in order to avoid the need for hospital and medical services and thus reduce costs.

As things now stand, the sicker the population, the more money LGH makes.  This is hardly in the public interest!

The World Health Organization ranked health care quality by countries.  The USA came in 37^th.

The OECD ranked Infant Mortality rates per thousand for 2005:   Sweden – 2.4; Japan – 2.8; Norway – 3.1; France -3.6; Germany – 3.9; Switzerland – 4.2; UK – 5.1; Canada – 5.3; Poland – 6.4; United Sates – 6.8.

The OECD ranked Health Expenditure as a Percentage of Gross Domestic Product 2005:  USA – 15.3; Switzerland – 11.6; France – 11.1; Germany – 10.7; Canada – 9.8; Sweden – 9.1; UK – 8.3; Japan- 8.0

“How many people go bankrupt because of medical ills?  In Britain, zero.  In France, zero.  In Japan, Germany, the Netherlands, Canada, Switzerland: zero.  In the United States, according to  a joint study by Harvard Law School and Harvard Medical School, the annual figure is around 700,000.” *

“Here is a statistic to ponder: Among those nine rich nations, the per-capital rate of ‘Deaths Due to Surgical or Medical Mishaps’ was the highest by far in the USA.”*

“The profit-making health insurance giants in the United States generally spend about 20 percent of all premium income on administrative expenses; the French [rated first in the world] insurance plans routinely keep administrative costs below 5 percent.”*

France spends around $3,200 per person for health insurance which was rated the best in the world.  The USA spent more than $7,000 per capital, did not cover 45 million, and was rated 37^th.  “In the U. S. system, even with its built-in inefficiencies, that saving would meet the basic health care needs of all of the American who are currently uninsured.”

What has gone wrong with health care in the U. S. A?   In large part obvious reforms have been made difficult by special interest groups who are irrationally enriched by our current system.  But since the reforms that are necessary through a capitalistic system as in the case of France are apparent, we must look to the mistaken emotional devotion of a large segment of our population to a broken system.

We need not look further than the public’s blind eye to the causes and the use of the huge profits of our own Lancaster General Hospital to catch a glimpse of the larger national problem.   But how dare we question “mother” LGH in which we are borne, birth our children and form which we seek cure for our ills?

Can we rationally consider not-for-profit insurance companies, such is the case in France and elsewhere,  or government administration (Medicare / Veterans Administration) such as England and Canada that perform the same administrative  functions at a quarter of the administrative costs?

Make no mistake about it:  Health Care costs which are approaching 20% of Gross National Product will turn what was once the foremost economy into a ‘rust belt.’   There simply will be no funds available for investment.   The world our grand children will live in will not offer the opportunities and pride that did the world of our parents.

*“The healing of America” by T.R. Reid, 2009