Country doctor

Sen. Majority Leader Bill Frist, R-Tenn., began his speech Tuesday at the Republican National Convention by talking about his father. "My dad, a family doctor in Tennessee for 50 years," he said.

That would be Thomas Frist Sr., the founder of Columbia/HCA — a giant chain of more than 500 for-profit hospitals, outpatient centers and home health care agencies. HCA is worth about $20 billion.

So your basic Tennessee country doctor then.

(You can read more about Dr. Frist Sr. in this Mother Jones report on the "coin-op Congress.")

HCA, the Nashville City Paper reports, is under fire for billing practices."

A lawsuit filed in Las Vegas Thursday accuses Nashville-based HCA of using “unfair and deceptive trade practices” by charging higher rates to uninsured patients than for patients covered by an insurer.

The lawsuit, filed on behalf of plaintiff Diane Maguire of Las Vegas, is seeking class action status and does not specify a dollar figure for damages sought. …

Maguire was taken to HCA’s Mountainview Hospital in Las Vegas by ambulance for an asthma attack on Feb. 7. She was treated for respiratory distress and stayed in the hospital for seven days. Her bill came to $51,163, which the suit claims is exponentially higher than what would be charged to an insured patient. …

The U.S. hospital industry is struggling to deal with about 43 million Americans without health care insurance, a problem that extends beyond an individual hospital’s doors, [HCA spokesman Jeff] Prescott said.

That may help to explain the remainder of Sen. Frist's speech — which expressed his explicit contempt for patients with good lawyers and his implicit contempt for patients without insurance.

Frist folded in the "ownership society" theme in discussing HSAs (not to be confused with HCA — although the former will help to enrich the latter, and therefore its major shareholders, such as the Senator and his family). Republicans, Frist said:

… made Health Savings Accounts, HSAs, the law of the land. With an HSA you can invest tax-free in a personal savings account. You can roll it over year to year or withdraw funds if you get sick without paying a penny of tax.

HSAs are tax-sheltered investment accounts that can be used to pay for certain kinds of health care. Like most of the ownership society agenda, they will benefit only those who can afford the price of admission. In other words, they will help to make health care more affordable for those few people who can already afford the best health care. This pay-to-play drawback parallels John Cassidy's description in The New Yorker of Bush's similar tax-shelter proposals for private retirement accounts:

In 2003, the Administration proposed two new savings vehicles — Retirement Savings Accounts and Lifetime Savings Accounts — which would have replaced IRAs and allowed many wealthy Americans to save virtually tax free. The accounts were designed to work in the same way as some existing IRAs but with much higher contribution limits — $7,500 a year for each person — and fewer restrictions on withdrawals. If this proposal had become law, a well-to-do family of four would have been able to shelter more than $1 million over 30 years. Middle-class families, on the other hand, would have seen little benefit, because they spend most, if not all, of their income.

The shift to HSAs will mean two health care systems for the Two Americas: a quality, tax-free health care system for the rich, and an overtaxed health care system for everybody else.

They may sound like a good idea to multimillionaire "country doctors" and their multimillionaire sons, but for the rest of us, HSAs are useless.