Wednesday, January 19, 2005

Those Government Health Care Blues

A few recent examples of mismanagement in the government health care sector:
Cuts in Ontario
The province of Ontario, Canada planned to lower hospital expenses by moving more patients into improved primary and community care settings. The improvements are not complete, the care as not yet been transferred, yet as the Toronto Star reports, the province is pushing cuts in the hospital budgets now. As this editorial suggests, the result is likely to be drastic nursing shortages and longer queues for care.
An IT Flop in the UK
The UK is spending 6.2 billion pounds sterling to improve its health care information technology (IT). An early, key project was a system to improve general practitioners' (GPs) abilities to refer patients to specialists. By now, this 196 million pounds sterling system was supposed to have scheduled over 200,000 patient referrals. In reality, it has handled 63. It turns out that very few GPs were familiarized with the system, which lead to an "information vacuum." Furthermore, the system was apparently not designed to handle such situations as patients who needed referrals to more than one professional for treatment. (See reports in the Manchester Guardian here and here.)
US VA Researcher Busted
A former cancer researcher at the Stratton Veterans Affairs (VA) Medical Center just plead guilty to negligent homicide, and several other charges, as reported by Newsday. Paul Kornak had proclaimed himself to be a doctor, although he never completed medical school. He was hired by the VA despite a previous criminal record stemming from forgery of a previous medical licensing application. Per the Albany Times-Union, co-workers alleged that they were punished after trying to report irregularities in the cancer research program he ran to hospital administrators. An attempt by hospital pharmacists to involve the Federal Bureau of Investigation was stymied when VA officials told the FBI that one of the pharmacists was under investigation, although he was never charged with doing anything wrong. Kornak was finally tripped up when his commercial sponsor, Ilex Oncology, found more "irregularities" in his reports.
The moral of the stories is that government is not immune to health care mismanagement. Maybe more transparency, accountability, and involvement of medical professionals and the public could prevent some of these problems.

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