MEDICAL MUSICAL CHAIRS

Even spendthrift California cannot afford to pay for its "public" medicine system

Downey Regional Medical Center may have to close its emergency room because of the exorbitant costs of treating uninsured patients, hospital officials said. Nine other emergency rooms in the county have shut down since 2003. Downey's, which served 46,307 patients last year, would be the largest recent closure and would force crowded hospitals in Whittier and Bellflower to absorb its patients, county officials said. "It's going to be horrible," said Carol Meyer, the county's head of emergency services. "Our emergency system is falling apart."

On Tuesday, the private nonprofit hospital asked the county Board of Supervisors to help pay for treating poor patients by approving a plan that would have entailed a tax hike. Supervisors rejected that appeal, arguing that helping Downey could prompt other hospitals to come calling for aid. The county's Department of Health Services is staring at a $1 billion shortfall over the next three years. "I don't know how you could ask us to subsidize a private nonprofit," Supervisor Gloria Molina said. "Every single hospital would line up, because they have the same situation as you do."

The number of uninsured patients using private emergency rooms in Los Angeles County has leaped by a third in the last five years, according to a recent study commissioned by the Hospital Association of Southern California. About 2.25 million county residents are uninsured - one of the highest percentages of any major U.S. metropolitan area.

Emergency room losses cost Downey Regional between $7 million and $11 million last year, said Robert Fuller, the hospital's chief operating officer. He said the hospital has gobbled up a $60 million surplus during the last five years, with half of that spent on treating uninsured people. As an alternative to closing its emergency room, the hospital is considering no longer accepting patients brought in by ambulance from outside Downey's city limits.

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Second bogus psychiatrist revealed in Queensland public hospital system

Still trust your local regulators?

The Queensland Government's health crisis deepened yesterday when it was revealed that a second bogus psychiatrist had worked in one of the state's major regional hospitals. Documents sent by Queensland Premier Peter Beattie to hospital inquiry commissioner Tony Morris QC yesterday showed that Vitomir Zepinic - a Yugoslav immigrant with no medical or psychiatric qualifications - worked as a psychiatrist at Toowoomba Hospital for almost two years. The revelation that Mr Zepinic had worked at the hospital west of Brisbane from April 2000 to March 2002 came just a day after it was revealed at the Morris inquiry that Vincent Berg, a bogus psychiatrist with phony qualifications from the former Soviet Union, had worked at Townsville Hospital in 2000. The existence of the two impostors was not revealed to the public until this week.

However, the documents produced by Mr Beattie revealed that the Government had a contingency plan for Wendy Edmonds, then health minister, to announce the two cases in parliament in 2002 in the event that the Opposition learned of the bogus psychiatrists. Under the heading "Topic: Bogus Shrinks", a ministerial staff member prepared an answer for Ms Edwards to a "possible parliamentary question". The documents revealed further evidence of efforts made by former Queensland Health director-general Steve Buckland to conceal Mr Berg's tenure at the hospital from the public, including his former patients.

Psychiatrists and administrators at Townsville Hospital sent a briefing note to Ms Edmonds recommending that Mr Berg's activities be made public so that all of his former patients could be located to determine whether they needed treatment. They said that the patients should be informed that Mr Berg's qualifications were invalid. But in a handwritten notation, Dr Buckland said that his decision not to inform the patients was "appropriate, ethical and clinically sound given that the client base have a mental illness". Dr Buckland was sacked last week in a major overhaul of Queensland Health prompted by the Morris inquiry's investigation of Jayant "Dr Death" Patel.

John Allan, director of Townsville Hospital's Mental Health Unit, told the inquiry in its second day of Townsville sittings that when he tracked down more than 200 of Mr Berg's former patients, he felt frustrated and "compromised" by his inability to tell them that the self-styled psychiatrist was a fake. Mr Allan said one of Mr Berg's worst mistakes was to take a long-term schizophrenic, who was facing a murder charge, off his medication. The man was later acquitted of murder because of his mental illness.

Mr Zepinic was deregistered by the Medical Board of Queensland in May 2002 after it was discovered that although he had completed post-graduate training in psychotherapy, he had no formal medical qualifications.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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