Mar. 21 -- A fight between Florida's hospital industry and a consumer advocate from Southern California has degenerated into an ugly war of words, complete with personal attacks and accusations of racism.

K.B. Forbes, a former political consultant, has been campaigning against hospitals in Florida and other states. His complaint: Hospitals routinely gouge uninsured patients, who often are the least able to afford health care, by charging them far more than insured patients, whose bills are pre-negotiated and paid for by large health-insurance companies.

Now, in scathing print and broadcast ads, Forbes' consumer-advocacy group -- Consejo de Latinos Unidos, or "Council of United Latinos" -- is accusing Florida hospitals of practicing "economic racism" by overcharging the uninsured, a group that includes a disproportionately large number of minorities.

One television spot by Forbes, who is half-Chilean, begins with an old photo of a "Colored Waiting Room" sign, from the days before integration. Hospitals' billing practices help perpetuate such racist attitudes, according to the ad's announcer. Some ads rhetorically ask Gov. Jeb Bush why so many nonprofit hospitals in Florida are able to report annual operating margins in the tens of millions of dollars each. "Answer: In part, by charging patients without insurance three to four times as much as the actual cost of care," states one ad.

At least two of Forbes' print ads single out Florida Hospital in Orlando, which reported an operating margin of $78.6 million in 2002. "Why do you let them keep their tax-exempt status?" one ad states.

Executives at the Florida Hospital Association, incensed by the campaign, have threatened legal action against media outlets that run the ads. The trade group, which denies that the industry's billing practices for uninsured patients are racist, recently called a news conference in Tallahassee to accuse Forbes of accepting money from insurance companies and helping promote insurers' legislative agenda.

"In the interest of fairness and openness, it's time for you [Forbes] to give a complete accounting of your relationship with insurance companies and political organizations," said Ralph Glatfelter, the association's senior vice president.

Some insurance groups support Forbes' contention that uninsured patients are grossly overcharged, if only because it gives them an opportunity to criticize hospitals' pricing structures generally.

"Everyone knows that hospital prices are a ruse that bear no relation to the actual cost of providing care," said Merrill Matthews, director of the Council for Affordable Health Insurance, an advocacy group made up of insurance companies that write individual and small-group health policies.

Forbes -- a former English-language teacher who once helped manage the campaigns of Republican presidential candidates Pat Buchanan and Steve Forbes (who is unrelated) -- said in a recent interview that Consejo has been approached several times by insurance companies offering money or other support. But he said his organization has rejected all such offers.

Hospital executives say they are suspicious of $100,000 in start-up money offered to Consejo in 2001 by a foundation controlled by J. Patrick Rooney, the chairman and chief executive of Long Beach, Calif.-based Medical Savings Insurance Co. Forbes acknowledges that he briefly served as communications director for another insurer that Rooney ran in the mid-1990s, and that the two are still friends. But he says Consejo did not accept the foundation's money.

Forbes also acknowledges that Consejo's Florida director, long-time political activist Ernesto Pichardo, resigned recently in part to work with HealthCheck, a coalition of Florida insurers, businesses and consumer groups that is pushing legislation to force hospitals to post their prices on the Internet.

Hospital executives see another link between Forbes and insurers in similarities between his ideas on how hospitals should charge uninsured patients and another insurance-backed proposal now before the Florida Legislature.

The industry's proposed legislation would impose a cap on payments made to hospitals by managed-care health insurers for certain emergency-room services.

Payments would be limited to no more than 120 percent of the amount the federal government's Medicare program reimburses for those services.

Forbes has given speeches in California and Colorado promoting a plan that calls on hospitals to charge uninsured patients about 135 percent of Medicare's required reimbursement rates.

Hospitals argue that the plans are too similar to be coincidental. But Forbes says that such an approach to reimbursement rates is not unusual -- hospital charges are often set as a percentage of Medicare rates. Besides, he says, he was promoting his plan years before the insurance industry submitted its proposal to Florida lawmakers.

Questions about Forbes' background appear to have spooked other consumer-advocacy groups that champion the plight of the uninsured.

Ron Pollack, executive director of Families USA, said he agrees that uninsured patients should be offered greater discounts for hospital services. But Pollack said he's put off by Forbes' refusal to join Families USA's fight for national policies to reduce the ranks of the uninsured and is unsure of Forbes' motivations.

"I'm somewhat worried about Mr. Forbes and his organization's involvement in this, because it does appear that he has a close tie, J. Patrick Rooney," Pollack said.

Forbes called the hospitals' allegations "a pathetic attempt to deflect attention away from their own egregious behavior."

"We are not going to go away," he said.

<< Back