Thank you, Mr. Whiplash – comparison of Vencor Inc. with the villain character Snidely Whiplash of the television program ‘Rocky and Bullwinkle’ – Editorial
Richard L. Peck
You can’t have a morality play without a bad guy. While many actors love playing bad guys, you don’t often see someone volunteer for the role in real life. Apparently Vencor, Inc., the second largest company in long-term care, has no qualms about it. A couple of months ago, Vencor gave eviction notices to dozens of elderly nursing home residents whose care was supported by Medicaid. And the company made no bones about the reason why: It simply wasn’t making enough money from Medicaid, and had more lucrative uses to which to put its 300-plus nursing facilities.
It was a move befitting Snidely Whiplash – who, for the generationally challenged, was the black-hatted, mustachioed nemesis of heroic Dudley Doright on the old “Rocky and Bullwinkle” TV show. The situation still was in flux as of press time, but Vencor, while acknowledging that company officials could have handled the process more sensitively, contended the company was simply making a business decision. That seems hardly a sufficient excuse for such a disgusting human event, but think about it a moment.
Why should anyone think that long-term care providers, whether out to make money (for-profit) or avoid losing it (not-for-profit), should behave in any way other than as businesses. Without sufficient funds they are healthcare history, and of use to no one. And, let’s face it, businesses get nervous when their primary customer (in this case, Medicaid) pays minimally at best, while expecting top-quality service (as in OBRA ’87) at the same time.
You can take it further than that. Everyone knows that private pay has always been prized in long-term care. All nursing facilities strive to attract private-pay residents, and the bigger chains, like Vencor, rise or fall on Wall Street depending on how successfully they do so. The “stability” of government reimbursement that drew so many operators into long-term care in the first place loses its attractiveness when translated as “consistent losses.” And if government reimbursement is in the offing, Medicare is a better bet than Medicaid.
Seen in this way, Vencor was not out of line; it was just more brazenly honest than most. One has to wonder why the company so willingly donned Mr. Whiplash’s flowing black cloak, but maybe it was because Vencor thought that confronting today’s financial realities in long-term care was worse. Most Americans don’t realize that today’s long-term care financing is a travesty. By requiring impoverishment for most people to gain some minimal measure of financial support, the system is moving inexorably toward an era of “haves” and “have nots.” Those Americans whose 401Ks and mutual funds don’t do so well in the early 2000s will learn this, quite possibly the hard way.
The only thing sadder than the image of elderly men and women being forcibly discharged from facilities they had come to call home is the almost certain knowledge that they won’t be the last. Thank you, Mr. Whiplash, for showing us that.
COPYRIGHT 1998 Medquest Communications, LLC
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