The dysfunction of modern health care likely arises from larger trends within the economy and the society. We frequently discuss how poor leadership and governance within health care and other organizations exist in a context of focus on short-term revenue above all else (financialization); perverse incentives, particularly leading to excess executive compensation unrelated to leaders' actions or performance; deception, especially in marketing and public relations coupled to suppression of internal dissent and whistle blowing; lax regulation and law enforcement, in a climate of regulatory capture and by governments afflicted with the revolving door allowing conflicts of interest and corruption, etc, etc.
I was thinking of this last weekend while like many Rhode Islanders we were shivering in an unheated house. A big but not unprecedented snow storm had apparently caused the failure of multiple high-voltage electrical transmission lines and substations, which should be designed to resist such conditions. (National Grid says cause still unknown for failure of high-voltage lines serving East Bay, Aquidneck Island.)
Poor leadership and governance under these circumstances likely lead to threats to public health and safety. Focus on cost-cutting and current revenue to drive executive compensation may lead to bad design, manufacture, and maintenance of critical systems. So maybe we should not be surprised at a recent barrage of cases involving threats to health and safety by well-known corporations:
Walmart in Supply Chain Crackdown after Bangladesh Factory Fire
Apple Vows to Eradicate Child Labour from Workforce
HSBC Got Away with Murder: the Bank Laundered Money for Drug Traffickers and Terrorist Groups...
Probe of Boeing 787 Battery Fire Expands
Sewage-laden Carnival Cruise Ship Docks in Mobile, Alabama: Passengers Finally Disembark from Vacation Vehicle Turned Smelly Nightmare
Amazon 'used neo-Nazi guards to keep immigrant workforce under control' in Germany
Those were just the cases I could easily recall. Readers are invited to add more to the comments section.
At least, I don't think I can blame poor leadership and governance for a huge exploding meteor:
But maybe a society less dominated by top insiders skimming off more and more money would be better prepared for the next meteor strike.
One can only hope that this onslaught of increasingly jaw-dropping cases that threaten health and safety that would have been unimaginable a short time ago might lead the public to demand accountable, transparent, mission-focused, honest leadership of the big organizations, for-profit, non-profit and governmental, that now control our lives.
Want to Be a PCORI-Funded Researcher? - Originally posted May 20, 2013 Our second year of patient-centered comparative effectiveness research funding kicked off May 15 with the release of five up...
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