But there is no 100 percent reliable rating system that advises patients if they really could benefit from a stent, or where to find a hospital that will do the right procedure if they need cardiac treatment—without regard to its bottom line. Such information would help patients—and journalists, too, who must sometimes report on whether a doctor gives good medical care or simply is a good revenue producer for a hospital. As the marketplace gods increasingly dictate the medical care we get, the press will be called on to figure all this out.

What’s the public to learn when we hit brick walls—when public data doesn’t really help, and when the medical-industrial complex believes that silence is the best policy?

UPDATE: On Sunday, the Tampa Bay Times published a story adding some light as well as another layer of complexity to the saga of HCA.

The paper examined insurance billing records and found Florida’s for-profit hospitals, as a group, perform nearly 50 percent more catheterizations and one-third more angioplasties than nonprofit hospitals on a per bed basis. HCA, which accounts for about half of the state’s for-profit hospitals that report invasive cardiac procedures, did more of them on average than other Florida for-profit facilities.

The story raised good questions: Are hospitals doing these procedures because patients demand them—patients who would rather undergo invasive procedures than try medicine, diet, and exercise? Are patients attracted via the heavy advertising that hospitals use to reel in patients for more profitable treatments? These go to a larger ongoing story—the mix of money and medicine, and we hope the Tampa Bay Times and others will stay on the beat.


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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.