OFFICIAL SAFEGUARDS THAT DIDN'T SAFEGUARD

A bureaucrat flouted health policy by allowing Bundaberg Base Hospital to accept more complex operations without adequately reviewing staff credentials, the Morris inquiry has heard.

Michael Cleary, the director of medical services at Prince Charles Hospital, Brisbane, told the inquiry today that he had inspected the Bundaberg hospital's credentialling and privileging process after the Dr Jayant Patel scandal had broke.

Indian-trained Dr Patel has been linked with more than 80 deaths at the Bundaberg hospital Dr Cleary said suspended hospital district manager Peter Leck had given clinicians including Dr Patel ramped up "interim clinical privileges". These privileges relate to the type of operations that can be performed by clinicians, based on their skills and hospital resources.

The South-East Queensland hospital's documentation about credentialling and privileging was located by Dr Cleary after an "extensive search" when he acted as Bundaberg's district manager for three weeks after Mr Leck was stood aside. "There was ... very little evidence that credentials were reviewed - therefore there was only partial compliance with Queensland Health," Dr Cleary told the inquiry.

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NEW BOOK COMING

In September, the Cato Institute will release the book Healthy Competition: What's Holding Back Health Care and How to Free It, a blueprint for re-invigorating America's troubled health care sector. Michael F. Cannon, Cato's director of health policy studies, and Michael D. Tanner, Cato's director of health and welfare studies, explain how market competition makes products of ever-increasing quality available to an ever-increasing number of consumers.

They demonstrate how market competition can do the same for medical care and health insurance. The authors even show how encouraging competition can lower the cost of public health programs and improve government regulation of health care. Cannon and Tanner recommend spurring greater competition in the private sector by expanding health savings accounts (HSAs). The authors propose creating "large HSAs" that would give workers control over all their health benefits, rather than just a portion as HSAs now do.

The authors offer advice to Congress, the states and the new Medicaid Advisory Commission (a panel created by Congress) on reforming that program. They argue that Congress should reform Medicaid as it reformed the old AFDC cash-assistance program: cap federal funding and give states broad flexibility to reduce dependence. At the same time, states should encourage private competition by returning their Medicaid programs to their original mission of providing medical care to the truly needy.

The book explores Medicare's enormous unfunded liabilities - which are six times those of Social Security - and argues allowing today's workers to save a portion of their Medicare taxes in a personal account. The authors argue this would encourage competition and "minimize the cost of meeting existing Medicare obligations."

In a foreword to the book, former Secretary of State George Shultz writes, "Cannon and Tanner offer proposals that would further tap the power of markets to make health care more valuable and more affordable. That makes Healthy Competition essential reading."

Michael F. Cannon is the director of health policy studies at the Cato Institute. Previously, he served as a domestic policy analyst at the U.S. Senate Republican Policy Committee under Senator Larry E. Craig (R-ID). Michael D. Tanner is the director of health and welfare studies at the Cato Institute, where he directs research on new, market-based approaches to health, welfare and other government "entitlements."

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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?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

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