Wednesday, December 15, 2004

Mismanagement Are Us

The media today contains a host of stories about health care mismanagement at all sorts of organizations.

Not for Profit RI Blue Cross Fights to Keep Paying Directors

The Providence Journal reported that not-for-profit RI Blue Cross is fighting in court to continue providing health insurance to its own board members, including the chair, also the head of the RI AFL-CIO, despite a new law that forbids compensation to board members without state approval. RI Blue Cross , which has about 70% of the health insurance market in little Rhode Island, fired its CEO this year after news reports of his huge salary, receipt of a $600,000 no-interest loan which he did not pay back, and, receipt of free acupuncture treatments from a practitioner who wanted to influence Blue Cross reimbursement policies. Meanwhile, Blue Cross was paying health care professionals poorly (often less than Medicare), while hiking premiums at double-digit rates.

"Where's the Outrage Over King/Drew?"

King/Drew Medical Center in Los Angeles, run by Los Angeles County, was documented by the Los Angeles Times to have a history of medical errors and systemic quality problems, accompanied by high costs, and chronic personnel difficulties, (most strikingly 120 workers' compensation claims involving injuries incurred by falling out of chairs.) Today, op-ed columnist Pat Morrison wondered at the silence of the politicians responsible for its oversight. Perhaps, they were afraid to criticize "the most symbolic and substantive institution in the black community", (per Asseymblyman Mervy Dymally). Morrison concluded that to politicians, "saving the hospital and its jobs matter more than saving the patients whose lives depend on it."

British Foundation Hospital Trust Loses its Chair

The chair of one of the new foundation hospital trusts in the UK was fired by the external Monitor organization after it incurred more than an 11 million pound deficit since April, reported the Guardian. The trust's board and the Monitor organization have been exchanging charges about who is to blame. The Monitor accused the trust's board of covering up the deficit, after initially projecting a large surplus.

Medicaid Money Went for Care of Dead People

Several state Medicaid organizations were accused of mistaken payments. In Colorado, millions went to pay for care of people who were already dead, per the Rocky Mountain News. In Washington (state), 1.4 million pills, including the narcotics Vicodin and Percocet, went missing, per the Seattle Post-Intelligencer.

Flawed Defibrillator Evaded FDA Scrutiny

The New York Times reported how defective defibrillators escaped FDA oversight. The former CEO of Access Cardiosystems, locked in a legal battle with the company, notified the FDA late in 2003 of potentially defective products. An initial inspection did not find major problems, but when the company received more reports of problems last summer, the FDA responded failed to send inspectors back. A recall was finally ordered in November, and the company closed its doors, leaving customers, including emergency services units, scrambling to replace their now useless defibrillators.


Egan Allen said...

The healthcare system is really a non-system; it is a headless horseman. Neither a free market nor a governmentally-run entity the US healthcare system is really a floundering g'mish of government and private interests with doctors and their patients stuck in the middle.

The influenza vaccine fiasco is case in point. First a shortage and now a glut! No well-oiled marketplace would see this happen. It also would be less likely to happen in the UK or Canada, for example, where single-payer systems operate.

We are stuck in a dysfunctional mess!!


Kevin C. Fleming said...

I am not entirely clear how a single payer system would remedy the shortage problem. As in my post above, the better conclusion is that our standard health care market interventions promote rather than reduce the likelihood of shortages.

Single payer policies in farming, for example, have never been particularly successful, as the mass starvations in the the Soviet and Chinese systems have demonstrated. Such shortages are expected whenever a government attempts to control prices.

Egan Allen said...

Who said anything about "controlling prices"? There are ways for government to interact with the private sector to subcontract goods and/or services.