Wednesday, January 05, 2005

Your Health Care Tax Dollars at Work?

Doctors hear again and again about how the health care they provide is too expensive, but we hear little about how large health core organizations drive up the costs of care. Here are some miscellaneous stories about dubious spending decisions by government bureaucrats in a variety of health care organizations....

Golden Parachutes for the TB Sanitarium District Board

Cook County, in Illinois, may be the last to have a separate agency to care of tuberculosis patients. The Cook County Tuberculosis Sanitarium Board, circa 1947, no longer has any sanitariums, but runs four TB clinics. Independent from local public health agencies, it has the power to levy real estate taxes to support itself. It has been charged in the past with some dubious management practices, such as failing to bill insured patients for its services, continuing to levy taxes when its reserve funds exceed its annual budget (per the Chicago Tribune), and paying for its Board Chairman's health insurance despite legal prohibitions (per the Sun-Times). As a recent political battle swirled over whether to fold the agency into the Cook County Bureau of Health, the TB Sanitarium Board voted to award "golden parachutes," according to the Chicago Sun-Times, to outgoing employees and board members, only to have judge hand out a temporary restraining order against it.

Federal Investigations of the Failed Bay Pines VA Medical Center Computer System

The Justice Department and the Veterans Affairs Inspector General have opened criminal and civil investigations of how Department of Veterans Affairs managers had spent over $200 million on the Core FLS computer system, a system which never worked, reported USA Today and the St. Petersburg Times. The Core Financial and Logistic System, developed by BearingPoint (formerly KPMG Consulting), flunked its trial at the Bay Pines VA Medical Center. Per the Tampa Tribune, "CoreFLS was intended to keep better track of hospital supplies and improve financial management. Instead, it led to supply shortages that delayed surgeries and spurred complaints."

More Charges About NIH African Nevirapine Study

A former NIH physician has charged publicly that a study of nevirapine to block maternal-fetal HIV transmission was so sloppily done as to be invalid, but was kept in operation because NIH officials were "so heavily invested in the trial's outcome." Dr. Jonathan Fishbein also charged that the NIH is trying to fire him because he blew the whistle on this study's problems, but the NIH says he performed poorly during his probabitionary period. (AP report available here, as well as many other places.) This story, including the apparent role of political considerations in decisions to keep the research study running, was previously discussed on Health Care Renewal here.

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