More criticism of weak oversight of U.S. hospitals
A recent article used the State of New York to demonstrate the problems associated with weak oversight of U.S. hospitals. The article noted that a 1999 report by the Institute of Medicine found that hospital errors caused as many as 98,000 preventable deaths each year. Despite this record, there is no federal oversight agency, and the Joint Commission on Accreditation of Hospitals--created by the hospitals themselves to compile standards and investigate problems--is underfunded with virtually no power to sanction. It employes only 1,000 people to accredit and investigate 17,000 in-patient institutions. Prior investigations suggest that it has never actually closed the doors of a hospital that attempted to stay open.
The State of New York pays more than the national average for hospitalized patients, and yet it endures a higher than average rate of complications. As a result, the state created the Berger Commission to recommend hospital closings and mergers. The Commission recommended, for example, that the University Hospital in Syracuse be merged with a private hospital in the City, and limited to 600 beds. The Commision suggested that in total nine hospitals should close and some 50 others should shrink. Syracuse was its benchmark target, however.
Both Syracuse hospitals had empty beds (Crouse was in bankruptcy and half of its 576 beds were unoccupied) and poorer than average quality ratings. In 2006, patients at the 366 bed University Hospital had a 1-in-37 chance of suffering post-op infection, compared to a 1-in-65 chance statewide. They had an 8.6 pecent chance of dying from pneumonia, compared to 5.5 percent odds state-wide.The hospitals closed ranks and recruited the support of unions, community groups and local and state elected politicians to successfully fight the Berger recommendations.
At a time when economists expect our bloated and inefficent health care system to provide us with less effective care than other first-world nations, despite double the cost, U.S. taxpayers and consumers cannot afford a system with such lax supervision. Predictions suggest that in the next two decades, medical care will consume one-quarter of our gross domestic product. No culture can dedicate one-fourth of all the goods and services it produces to medical care and still survive in a competitive "flat" world: we must demand greater efficiency and weed out bloated, ineffective providers. That won't happen absent meaningful government regulation.