“Bullshit! Dr. Lyon, get creative! You will either be part of the solution, or part of the problem. You implement an emergency room policy denying those sons of bitches access to our quality medical care, or I will find someone who will! These thieves overrun our ERs and consume our valuable resources. Hell, we need to be pampering the paying customer. I could give a damn if the bastards end up dying in the street! However, as a humanitarian, I do have a soft side. So, if need be, we will purchase vans to deposit their dead carcasses in the slums down on Lower Third. Do I make myself perfectly clear?”
The executives around the table began to chuckle, as they all were accustomed to GeeHad’s tyrannical outbursts, leaving little doubt as to his position on any issue.
“Yes, sir, loud and clear! I will find a solution,” Dr. Lyon answered affirmatively.
Dr. Lyon had been very adept at meeting GeeHad’s demanding expectations over the years. He had no other choice but to do so, though, because, as a convicted felon, no self-respecting hospital would give him privileges to continue practicing as an obstetrician. Convicted of Medicare fraud, Dr. Lyon had spent over a year in federal prison, but was miraculously pardoned by the governor. Now, at the age of seventy, he felt untouchable. Without question he could implement policies which, if scrutinized by federal prosecutors, would result in his underlings taking the fall. Such was the price of success. The more he thought about it, the more he relished the challenge. In his mind, there was something very exciting about circumventing the law.
“Johnny, what’s our problem on the expense side of the ledger?”
“Well, sir, the cost of doing business is increasing across the board. Our labor expenditures continue to escalate at an alarming rate. Also, the drug manufacturers, citing the cost of product development and the threatened loss of patent protection, find it necessary to increase the price of their products by fifteen percent every year. Additionally, our expenditures for supplies and products keep rising, as well as the costs for telephone services, water, electricity, and sewage,” Johnny replied, his voice lowering as he bowed his head.
“That’s outrageous! It’s clearly time to squeeze the greedy drug manufacturers and our worthless suppliers,” GeeHad insisted, pounding the table yet again. Seconds later, he was calm and rational. Dead silence suddenly filled the room. Everyone gathered around the conference table felt that this was the eye of the storm.
“Now Johnny, please share honestly with me your overview of where Lambed HCA stands,” GeeHad asked in a cold and calculating voice.
Johnny Cinch squirmed in his chair. He could feel the beads of sweat ooze from his pores as dozens of self-serving eyes ripped into his soul, demanding answers.
“Well, the percentage of self-paying patients continues to increase, whereas the percentage of paying customers is decreasing. The net result is the loss of millions of dollars a year due to indigents not paying their bills. For example, in the emergency room we collect only thirty-seven cents on every dollar billed. Given these facts, along with the prohibitive costs of complying with existing federal mandates, it’s a miracle that any hospital is turning a profit,” Johnny concluded in an ill-fated attempt to rationalize his dismal corporate report.
GeeHad took a few moments to review the quarterly profit-and-loss statements from each of the twelve hospitals he controlled. All appeared to be in line, but the numbers were extremely discouraging. His train of thought was interrupted by a thunderous explosion from a lighting bolt, which felt like it touched down only blocks from the hospital. The lights flickered but remained on. Once again, the boardroom was deadly silent.
GeeHad stood and walked toward the window. It was pitch black outside, so he could not see the street below begin to flood, but he could make out the tops of tall trees being whipped back and forth. The rain was now coming down in sheets, pounding against the glass, and the force of the wind was so strong that it caused the windows in the conference room to vibrate.
Suddenly, there was a brilliant flash of light, followed by another thunderous explosion, and then the lights went out. Sixty seconds later, the hospital’s generator came online, establishing emergency lighting. In the subdued lighting, the conference room took on a sinister glow.
Somehow, GeeHad felt energized by the violence of the storm. He turned toward his executives and, with a deep, confident voice, issued the marching orders.
“We are in a war, and in this war you either win or you lose. The bottom line is that we need to increase revenue and slash expenses. Effective immediately, I want fifteen percent tacked on to each and every bill. With regard to the bad debt generated by our self-pay and Medicaid trash, I want our collection department to aggressively hound these deadbeats. I expect vigilante groups on retainer to find these bastards and beat them unmercifully for stiffing Lambed HCA. We will squeeze every last dime out of them, while at the same time discouraging repeat business. Concurrently, we will establish a policy to keep the indigent out of our emergency rooms. Now, if the government has the balls to cut Medicare reimbursement, then I expect us to pad the bills. On the expense side, the most dramatic and immediate savings will come from layoffs. Strive to cut ten percent of your labor force over the next thirty days. With Christmas so near, I would like you all to take pride in churning out those pink slips, eliminating middle managers, aids, techs, and even cleaning personnel. Also, make life so unbearable for the senior nurses that they quit. By hiring new nursing school graduates, we can save ten dollars an hour, while maintaining our unsurpassed standard of care. Additionally, the nurses sit around half the time doing nothing. Make them empty the garbage and mop the floors!”
GeeHad paused and scanned the table. Looking for weaknesses, he made eye contact with each and every person.
“Is anyone uncomfortable with my mildly aggressive policy?” GeeHad asked. No one spoke up.
“Excellent! Well then, we are all in agreement.”
“Yes,” the executives of Lambed HCA mumbled collectively.
“Pardon me? I can’t hear you!” GeeHad shouted.
“Yes, yes, YES!” everyone in the room chanted, with ever-increasing fear-driven determination.
GeeHad was clearly pleased by their collective response, which seemed to be magnified by the fiery flashes of light and thunderous roar from outside
“Excellent. This meeting is now adjourned,” GeeHad concluded.
As he stood up, GeeHad motioned to Johnny Cinch. Johnny walked over, and the two men found a quiet corner in the room as the battle-weary executives staggered out. GeeHad’s personal aid, loyal confidante, and lover, Abdul, stood close by awaiting his orders.
“I certainly had fun cooking the books. Have you had a chance to review the real numbers? Our hospitals did remarkably well, exceeding all our expectations,” Johnny shared enthusiastically.
“Yes, but I wanted everyone around the table motivated and fearful that heads may roll,” GeeHad replied. “By the way, I noticed that Lambed HCA’s debt is starting to creep up again. I believe it’s time to consider offloading a portion of this debt onto one of our close affiliates. The figure I had in mind is twenty-five million.”
“Absolutely, consider it done. Knowing that you’re a fan of The Little Rascals, and that we have already chosen ‘Alfalfa,’ ‘Darla,’ and ‘Buckwheat’ as clandestine corporate entities, would you have a suggestion for the new corporate shell?” Johnny asked.
“In fact I do. Name the new entity ‘Swanky Spanky,’”
