Colombia Healthcare

Individual Case Q2-4

2a&b: Many ethical theories and principles were present in Columbia/HCA’s business practices. The company got paid more money than what they earned and took advantage of Medicare/Medicaid to get as much funding as possible. Extreme upcoding made it very difficult for other hospitals to compete with Columbia/HCA’s aggressive pricing policy. Eventually, the severe upcoding led to the downfall of Columbia/HCA via sweeping investigations from federal authorities.

This company violated the Conventionalist Ethic by committing fraud. This ethic assumes the view that business is like a game in which people should act in their self-interests, as long as the law is upheld. Since the local physicians owned a stake in Columbia/HCA’s hospitals, the patients’ best interests were often neglected. There were not enough employees hired so they did not go out of their way to please their patients like they should have.

Physicians would recommend overcrowded Columbia/HCA hospitals, thus financially benefiting from their biased decisions. Physicians were adhering to the Conventionalist Ethic in an appropriate manner, since they were not breaking the law. However, one could argue that physicians were breaking their Hippocratic Oath by practicing medicine in a manner not in the best interests of their patients.

Another one of the issues was whether Columbia/HCA had fraudulently overstated home-health care laboratory-test expenses and knowingly miscategorized other expenditures so as to inflate the amounts for which it sought reimbursement. Some costs from the Columbia/HCA business model consisted of layoffs, extremely high managerial bonuses, etc. From a broader and much more comprehensive perspective, Columbia/HCA forced competing healthcare providers to lower their prices. HCA was the market leader in the healthcare industry, therefore making competition a necessity for HMOs and managed healthcare.

3a&b: The company strategies and...