We thought physicians already knew all the ways to skirt tax laws. How wrong we were. Now doctors can visit an island paradise, write it off and get advice on how to dodge future taxes, all in one trip.
Washington real estate developer Richard Rymland and three aesthetic surgeons have established the Bermuda Ocean Surgical Society, which, according to a news release, allows U.S. aesthetic surgeons to reserve one week per year at a staffed outpatient operating room on the island-sort of a medical time-share.
The cost for 10 years is $36,000, or $52,000 during the prime tourist season of July and August.
At King Edward VII Memorial Hospital's outpatient surgery clinic, set for groundbreaking this June, surgeons will be able to perform minor face lifts, chin implants and eye jobs. Then, both they and their patients can recover while enjoying "pink sands, vibrant coral reefs and a fine dose of Anglican sensibilities," according to the news release.
Not only can the surgeons write off expenses against their practice incomes, Rymland said, but surgical society staffers will introduce them to local bankers who can show them how to set up trusts that will be protected from U.S. inheritance taxes. In Rymland's words, "It's a pretty extraordinary place."
Over the last six months, Columbia/HCA Healthcare Corp. has looked at more than 80 hospitals for possible acquisition, sale or joint venture, a top Columbia executive said in a rare glimpse of the healthcare giant's inner workings.
Speaking at the American Hospital Association/American Society for Healthcare Engineers annual meeting last month in San Antonio, Larry Ward, Columbia's director of engineering services, said Columbia constantly is looking for more hospitals and ways to cut facility costs.
"We have done due diligence for acquisitions, divestitures and joint ventures, that sort of thing," Ward said. "How much will it cost to acquire it? We look at every aspect of the operation to help make our decision."
At Nashville, Tenn.-based Columbia, Ward is responsible for asset management, continuing education, due diligence acquisitions, capital and energy management. Columbia owns 340 hospitals and employs 250,000 workers.
"The biggest fear out there is downsizing," he said. "We have very rigid criteria we look at. There are rules of thumb we follow" in staffing facilities and departments.
For example, Ward said Columbia believes it uses fewer full-time-equivalent employees per facility than the industry average. He said every facility manager and administrator within Columbia is required to know optimal levels of staffing.
What are you worth to your employer? One might argue that David Colby is worth about $1 billion.
After all, that's how much Columbia/HCA Healthcare Corp.'s market capitalization dropped the day Colby, its treasurer and longtime chief financial officer, announced he was leaving.
Colby accepted the position of CFO of American Medical Response, an Aurora, Colo.-based company that is doing in the ambulance business what Columbia is doing for hospitals. American Medical is buying ambulance companies and lowering costs by merging purchasing, information systems and administration functions.
"I doubt that any one person would drop the stock that much," Colby said last week when asked about the $2.25 per-share drop in Columbia's stock April 2.
His explanation: "I don't think people fully understood the Blue Cross and Blue Shield of Ohio transaction." However, the Blues deal, in which Columbia will buy most of the insurer's operations for $299.5 million, was announced March 29, three trading days before Colby went public with his plans.
An added twist is that American Medical's market cap rose $22 million on the news of Colby's hiring.
Colby was one of the first executives hired by Richard Scott, Columbia's co-founder, and as such has been an important cog in the company's tremendous growth in becoming the nation's largest healthcare provider.
At American Medical, Colby, 42, hopes to have a shot at the top spot of chief executive officer, a level that might be difficult to reach at Columbia. It's hard to imagine Scott, 43, stepping down from the post of CEO and chairman (he assumes the latter title May 9) anytime soon.
This is an act only a retiring senator can commit: Senate Veterans Affairs Committee Chairman Alan Simpson (R-Wyo.) last month escalated his running skirmish with the Disabled American Veterans, where Jesse Brown served before becoming secretary of the Department of Veterans Affairs.
In a letter to DAV National Commander Thomas McMasters, Simpson criticized the DAV's annual testimony before a joint hearing of the House and Senate VA committees, which the congressionally chartered veterans service organizations make every year.
Sprinkled with sarcastic asides, Simpson's letter derided the VSOs' annual legislative presentations on healthcare and other benefit programs as "ritual Kabuki, with the congressional committees little more than serving as a backdrop for periodic cheers as the commanders stick it to the Congress."
Simpson, who does not attend those hearings, also described the VSOs' testimony as "railing and posturing against the Congress as being a group of ungrateful whelps who never do enough for veterans."
David Gorman, DAV's executive director, called the letter "personally degrading" to McMasters and objected that in subsequent hearings, Simpson has not sought answers to the questions he raises in his letter about DAV's testimony, nor has he asked for a meeting with DAV officials.
"It's a continuation of this guy's bias, which some people buy into and other people pass off as a constant irritant," Gorman said.
HCFA, infamous among providers for its computer "efficiency," announced last week it was donating 150 IBM computers to schools in the rural Mississippi counties of Panola, Quitman and Tallahatchie.
According to HCFA Administrator Bruce Vladeck, the machines were no longer needed because HCFA had "upgraded" its computer system.
"This is sound equipment that I would hate to see wasted," Vladeck said.
The Mississippi counties were chosen as part of the "Mississippi Delta Project," a public/private partnership involving communities, academia and private-sector organizations.