Industry had its “robber barons.” John D. Rockefeller, Andrew Carnegie, Cornelius Vanderbilt, Leland Stanford, and J.P. Morgan more than 100 years ago. They grew rich through paying starvation wages, ruthless union busting and monopolistic control of the steel, petroleum, and transportation industries. It’s now the medicine industry’s turn to produce robber barons of equal avarice. Here are the top three captains of the medical industry and this is how they accumulated their vast wealth.
Thomas Frist Jr., MD, and family: Dr. Frist co-founded Nashville, Tenn.-based HCA Healthcare with his father in 1968. Their start was humble but in five years they had become the worlds largest publicly owned hospital-management company. They owned 100 hospitals five years later and reached 255 after another 10 years. They kept growing in leaps and bounds. when they merged with the troubled Columbia Hospital Corporation in 1994. The next years were spent paying out fines, penalties and settlements to the government and shareholders. They eventually recovered and as of May 2020, owned and operated approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom.
The pandemic years were very profitable ones. They reported a net worth of $7.5 billion in 2020, $15.7 billion in 2021 and a year later, of $21.8 billion. They managed to triple their wealth during those pandemic years by squeezing their workers (their staffing levels were 29% below the national average), poor wages and cutting supply costs at a time when their workers were re-using single use equipment and going without personal protective equipment (PPE). It’s not known how many of their workers died for the Frists to become Covid-19 multi-billionaires.
The Sackler family: According to Forbes, the Sacklers have a collective net worth of thirteen billion dollars. That’s more than the Rockefellers or the Mellons. Their fortunes were amassed by three physician brothers, Arthur, Mortimer and Raymond. It wasn’t from their physician skills, They possessed gifted marketing skills.
A memo prepared by Kefauver’s staff noted, “The Sackler empire is a completely integrated operation in that it can devise a new drug in its drug development enterprise, have the drug clinically tested and secure favorable reports on the drug from the various hospitals with which they have connections, conceive the advertising approach and prepare the actual advertising copy with which to promote the drug, have the clinical articles as well as advertising copy published in their own medical journals, [and] prepare and plant articles in newspapers and magazines.”
Descendants of the three founding brothers acquired Purdue Frederick. The company aggressively pressed doctors to prescribe their pain killer oxycontin wooing them with free trips to pain-management seminars and paid speaking engagements. They lied about the drug’s low abuse potential and about the length of the pain relief. Their field was cleared when the American Pain Society introduced the “pai. n as fifth vital sign” campaign. Up till that point physicians were told to use opioids for acute injuries and cancer pain. Now, doctors were getting sued and disciplined for “under-using” opiates. Thus, the seeds were sewn for the catastrophic opioid epidemic that would claim more than 60,000 lives every year and make the Sacklers and their descendants very rich people.
Rick Scott: A lawyer with no prior health care experience, Scott bought two hospitals in El Paso, Texas in 1987 and formed Columbia Hospitals . He made them profitable by cutting services, supplies, and staff, and he used his profits to take his company public. That move generated funds to acquire hundreds of hospitals, surgery centers, and home health locations, where he applied his same winning strategy.
In 1994, he partnered with Hospital Corporations of America (HCA) and merged the companies. He and his cronies flourished. Before long, the chorus of whistleblowers became deafening leading to FBI raids of Columbia/HCA hospitals in Texas and then across the country. He was released by the board with a $5.1 million severance, $300 million in stock and a 10-year consulting contract for $950,000 per year.
Books have been written describing Scott’s accounting sleight of hand. He successfully fooled Medicare auditors and became wealthy by cheating American taxpayers. Rick Scott took his booty to Florida and began a highly successful career in politics. He will probably run for president one day.
The above are the top three medical robber barons. One of them profited from the pandemic, another by creating an epidemic of opioid abuse and the third by taking Medicare fraud to an unprecedented level . As long as healthcare remains profit-driven and Medicare operates on the honor system there must be thousands of lesser barons tied for fourth place