The US Supreme Court has ruled money is equivalent to speech. It now appears that money is also equivalent to a medical education and training.
In an op-ed in the Milwaukee Journal Sentinel last fall, I wrote about the importance of experience and transparency in providing specialized pediatric care. I cited the example of St. Mary’s Hospital in Florida, where an unusually high number of infants died following cardiac surgery; investigation revealed they were performing far fewer than the recommended minimum number of cases to maintain the necessary skills and competency. After an outcry from professionals and the public, the hospital – owned by the global for-profit Tenet Healthcare – shut down its pediatric cardiac surgery program.
End of story? Not really. CNN reports that the following month, the state of Florida decided to repeal its standards for cardiac surgery, which had been in place since 1977. Why the change? It may just be coincidence, but as reported by CNN, Tenet Healthcare has donated $100,000 to Florida Governor Rick Scott’s PAC, and another $100,000 to the Florida Republican Party, in 2013-14. I looked at the contribution disclosures from Tenet, and while they are bipartisan in their giving, which is extensive, their contributions to both Gov. Scott (himself a former for-profit healthcare executive) and the Florida party are substantially higher than the next highest contributions.
In addition to repealing the state standards in August 2015, a year earlier a negative review of the St. Mary’s pediatric heart surgery program by the Florida Cardiac Technical Advisory Panel was suppressed at the request of the state surgeon general. The physicians on the panel are, needless to say, irate, and are considering a legal challenge to the state’s moves, which they believe are politically motivated. Officials at both Tenet and the governor’s office deny there was any discussion between them about the cardiac surgery standards or the case of St. Mary’s Hospital. (Naturally.) It would be almost impossible to prove a specific quid pro quo; it always is. But the timing and details in this case are, to say the least, suspicious.
Transparency about outcomes is important in helping parents choose the best and safest care for their children, but it came too late to save the at least eight babies who died at St. Mary’s. There is a critical role for standards and oversight to ensure safety in the healthcare system. When political contributions – regardless of party – are allowed to overrule clinical expertise in setting those standards, that’s more than corruption. It’s conspiracy to commit murder.