Harry "Give 'em hell" Truman said that he needed only to tell the truth and his opponents thought it was hell.
There's a new twist on that idea in Washington. This time, it's not negative comments but positive ones that have prompted the gnashing of teeth.
As Jonathan Gardner of our Washington bureau reported (May 29, p. 2), the hospital lobby is stewing over an optimistic report from a Goldman Sachs investment analyst. The report says that the for-profit hospital sector is in good financial shape, and the outlook for the industry "is the best it has been in years." Moreover, Medicare "is probably the best payer for hospitals today." It notes that the industry has offset payment restrictions with productivity increases.
There's more bad news. These commendable trends--by implication--apply to much of the not-for-profit sector as well.
The Goldman project was the first-ever review of hospital equity markets by analyst Edmund Driggs. He did amazingly well, no doubt aided by his newness. People who orbit in healthcare circles for long tend to accept the proposition that hospitals are on the brink of extinction and that only a Marshall Plan for the industry can save them.
This is the view touted by hospital lobbyists as they try to persuade Congress to cough up even more Medicare relief from the 1997 Balanced Budget Act than it did last year. The Goldman report, apparently circulated by opponents of such relief, suggests extra money is unnecessary.
Mr. Driggs has since said that he didn't intend his report to be a policymaking tool. He scrambled up Capitol Hill to tell congressional aides that his work is being taken out of context.
Relax, Mr. Driggs. You have only pointed out the contradiction of arguing to Congress that the industry is in peril while hospitals assure investors and lenders that business is good.
The truth is that the industry--overall--is in good shape. Hospitals depend heavily on Medicare because private payers, through managed-care plans, have stopped writing blank checks to providers. And because Congress and all the constituencies surrounding healthcare cannot agree on a rational payment system, a way to insure the uninsured and a way to close unproductive facilities, the government must subsidize a big chunk of the bill.
Rather than wear different masks for different audiences, the industry ought to level with the public and with lawmakers. They may think the truth is hell, but they can handle it.