Letter: Mission’s deconstruction has been a team sport

Graphic by Lori Deaton

As the new owners of Asheville’s community hospital system, HCA Healthcare’s transitional misplays continue to be a source of outcry and drama.

Would that hand-wringing local and state leaders had been nearly so energetic in researching HCA’s notoriety before throwing this hot potato to the guys with the biggest hands.

In the herdlike rush to condemn the new owners, the old owners, carrying substantial accountability for the mess, have largely escaped scrutiny.

Though reality was hushed, Mission was in serious trouble way before HCA was given the checkered flag. Major hospital systems are rarely discarded because of how well they are run.

Between federal and state authorities passing sweeping health care entitlements without realistic funding; ignored patterns of camouflaged fees and costs; cost-shifting medical service overheads to those with private insurance; open-door border policies; a community of unleashed drug enthusiasts; and a broader culture that likes to eat big and exercise little, Mission has been in a state of overwhelm for years.

HCA knew what it was getting into. They are masters at maneuvering through a hybrid national health care labyrinth of socialized medicine — crony capitalism — and remnants of authentic free enterprise.

In spite of the hurdles, they are succeeding — unlike more and more health care management companies — in preserving a mostly functional hospital system with profit for their shareholders.

HCA didn’t create the mess. But, unlike too many politicians and consumers insisting on health services that are free, exceptional and accessible all at the same time — they are good at keeping things real.

What they are not good at is keeping things nice. HCA has no demonstrated understanding that in health care, high-touch is every bit as necessary as high-tech.

Therein lies their willingness to let attorneys and accountants run their organization; work nurses and staff beyond sustainable capacities; and defend a convoluted emergency service more akin to a house of horrors than a house of help.

Going forward, there will be more clanging and banging but don’t expect things to really change. Mission hospital system is now first and foremost a business.

There will be many good things that go on there, but in the end, the money side of things will prevail.

Though it’s easy to unilaterally place the blame on HCA, the deconstruction of our community hospital system has been a team sport.

— Carl Mumpower


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8 thoughts on “Letter: Mission’s deconstruction has been a team sport

  1. Michael Hopping

    Give ear to the lamentations of our Jeremiah! Behold another triumph of Capitalism, terrible in splendor. Bow before that golden throne and stoke its holy fires with losers, lest you become one yourself!

  2. Voirdire

    Really? ….”In spite of the hurdles, they [HCA] are succeeding — unlike more and more health care management companies — in preserving a mostly functional hospital system with profit for their shareholders.” What I think HCA is succeeding at/in is the predatory capitalism arena… and that’s it. And then there is this… “What they are not good at is keeping things nice. HCA has no demonstrated understanding that in health care, high-touch is every bit as necessary as high-tech.” Nice? “High-Touch”? You really think this is a PR problem that HCA has here at Mission? I’ve heard a lot of disingenuous -talking out of both sides of your mouth- nonsense from this writer, but this, your latest word salad screed here takes the cake. whew.

  3. SpareChange

    I’m surprised to see Mr. Mumpower embrace the lexicon of the left’s postmodernist heroes, like Jacques Derrida, in his reference to the “deconstruction” of Mission hospital. Although given the tortured lengths he goes to in presenting this alternative reality of the disgraceful state of Mission Hospital, his embrace of critical theory in this case seems appropriate.

    It allows him to deftly dismiss many of the hard facts and truths about HCA’s performance, by in effect suggesting that, “HCA is not bad or to blame — they are just the innocent victims of context, circumstances, and other powerful forces working upon them.” It all sounds very much like the kind of overthinking, rationalization, and contextualizing of bad behavior that Mr. Mumpower would normally be expected to condemn.

  4. luther blissett

    Dr. Mumpower is right that the changes pre-dated the HCA acquisition. However, he thrashes around for reasons and comes up with nothing but empty political slogans. Under Ron Paulus’s leadership Mission aggressively acquired speciality practices (and could then charge outpatient billing rates) and bought out primary care practices to consolidate control over the region’s health care infrastructure. The intention was twofold: to avoid being squeezed by large regional entities doing their own expansion and consolidation in WNC (Duke, UNC Health, Carolinas, etc.) and to fatten up Mission for market to a national corporate buyer.

    This isn’t ‘crony capitalism’. It’s just plain capitalism.

  5. Carl Mumpower

    Hi RG,

    I had a point – several of them – but I think my new point may be just how easy it is to trigger folks. I’ll try to do better next time. (;


    • SpareChange

      Try to reframe events anyway you wish, or fool yourself into thinking this is all just good fun because it provides you with a chance to trigger the “libs,” but it still comes off as an attempt to contextualize (i.e., excuse) Mission’s well documented bad behavior.

      Of course there are always other actors who may bear some responsibility, but HCA alone is responsible for how it staffs its facilities and treats patients, and there it has been repeatedly found to be sorely lacking, if not criminally negligent — not just at Mission, but across the broad spectrum of their hospitals.

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