Thursday, May 26, 2005

"Frist Family" Values

All Bill Frist wanted was to let President Bush's horror show judges have their "day in court," as it were. Well a "day in court" is exactly what John Smelik is going to get in Texas, against the for-profit Humana Hospital Corporation, alleging they negligently and fraudulently caused the premature death of his wife from kidney failure:
A case that could allow you to sue your HMO is going to court. A woman died from a health problem she knew nothing about, and her husband is now suing her insurance company blaming it for her death.

"She was soft," John Smelik said of his wife Joan. "She was gentle, and she was kind."

"She was an understanding kind of person," Smelik said. "She put up with me for 47 years."

Smelik loved his wife Joan so much he refused to leave her side after rushing her to the emergency room four years ago. He said without warning, her kidneys were failing.

Joan Smelik spent 19 days in the hospital.

"We said, 'Honey, we'll see you in the morning, and we love you,'" John Smelik said. Those were their last words to each other because Joan's kidneys shut down. (WOAI)
Neither John nor Joan were aware there was anything wrong with her kidneys, although the hospital had notified Humana (the insurer) of the fact many months before. So far, just another sad story of a health care system not working. So what else is new?

This. It is a case about suing your HMO, an issue in the 2000 Presidential campaign (you remember that one don't you?). Humana is not just an HMO. It is a for-profit HMO. For-profit health care, like HCA (Hospital Corporation of America), the Bill Frist family business. The same HCA that got tagged for defrauding Medicaid, Medicare, and Tricare (the federal program that covers the military and their families) for over $600 million dollars and wound up paying penalties reaching $1.7 billion. (You can read about it in a wonderful book about whistle-blowers and the Federal False Claims Act, Giant Killers by Henry Scammell, Atlantic Monthly Press, 2004.)

We got wind of this story from reader Kimberly Soenen (hat tip, contact info at end of post), who also supplied a background refresher. When George W. was Governor of Texas he refused to sign the Texas HMO Act which gave enrollees the right to sue their HMOs. Instead he allowed it to become law without his signature and then took credit for it in a debate with Al Gore. Then in a landmark legal case before the Supreme Court about whether patients could sue their HMO's, President Bush sent the Attorney General to argue the Texas HMO Act was pre-empted by federal law, prompting the Supremes to toss it back to Congress to enact a Patient's Bill of Rights. And guess who in Congress notified the press he had no interest in trying to get a federal Patients Bill of Rights passed?

Bill Frist.

[NB: If you are interested in further information or the court opinion regarding Smelik v. Humana, you may contact Kimberly Soenen at]