Wednesday, August 30, 2006

Sometimes There Are Consequences

A depressingly large number of the posts on Health Care Renewal deal with cases of mismanagement, conflicts of interest, and even corruption that infrequently seem to result in proportional consequences to those responsible.

There have been a few recent exceptions, to a degree.

UnitedHealth Foray Into Running British GP Practices Blocked

We had previously posted about attempts by UnitedHealth in the UK to take over practices formally run by local GPs. These attempts seemed to be facilitated by bureaucratic bidding requirements that emphasized being able to produce reams of business-speak more than ability to deliver good patient care.

The Times (UK) just reported that the High Court has now blocked one of these attempts, the same one used as an example in our post. The Court found that the Primary Care Trust (PCT) which put the contract out for bid "had a duty to consult [with the local community] and they did not properly perform it." The PCT now must again put the contract out for bid.

"Naturopathic Physician" To Go To Jail

We had previously posted (here and here) about a local "naturopathic physician," who claimed to be able to treat a variety of conditions, including ones as serious as metastatic cancer, with harmless and effective natural treatments. Curran purported to do "live blood analyses," which lead to diagnoses of such things as "parasites" in the blood.

The Providence Journal just reported that Curran will be going to jail for 12 1/2 years. The judge said that Curran was "not your run of the mill scam artist," but "the worst of the worst," who "scared the living daylights out of people." At the trial, it turned out that not one of approximately 300 people who had the "live blood analysis" was given a clean bill of health.

Scrushy Must Re-Pay His Bonuses

Although former HealthSouth CEO Richard Scrushy was acquitted of federal fraud charges, we previously posted about his conviction by a state court for bribery, conspiracy, and mail fraud. Now the Associated Press has reported that Scrushy must also re-pay $47.8 million in bonuses he received from the company during years when the company was actually losing more than $400 million. The judge said, "without annual net income, Scrushy could not have had the opportunity to earn the target bonuses."


In my humble opinion, we need to restructure the health care system so that there are negative incentives for bad behavior, and that these incentives are proportional to the badness of the behavior. Individual health care professionals are subject to strict licensing requirements and can be sanctioned by state boards in the US for behavior that is short of criminal. However, the leaders of the biggest health care organizations can often walk off with golden parachutes even after egregious behavior, save for those few who end up with criminal convictions. Somehow, we need to ensure that there are big negative incentives for health care leaders, like Scrushy, who put lining their own pockets ahead of fulfilling their organizations' missions.

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