Coming
to grips with Corporate
Medicine
This page summarises the section.
Many of these
pages in turn link to pages in other sections which
illustrate the arguments made.
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Nay
Corporate
Medicine
A short 600 word invited article published
in 2003 which brings the problems in
corporate medicine together. A good
place for everyone to start.
(Created
8/03)
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Belief
Versus Reality in Reforming Health
Care
(pdf file)
A paper "Belief Versus Reality in
Reforming Health Care"contrasting
for-profit with not-for-profit health care
is to be published in the August 2005
edition of "Health Issues" and may be
available on their web site in due
course
(8/05)
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Different
Medical
Systems
This page briefly traces the early
history of medicine into the 20th and the
21st century. It looks at the development
of marketplace medicine and the recent
targeting of the sector by private equity.
It explains the essential difference
between the various
systems.
(Created 4/00 Last update
10/07)
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Understanding
Corporate
Medicine
This page examines the inadequacy of our
current understanding of corporatised
health care and then develops an
alternative theoretical framework.
(Created
8/00 Update 8/03)
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Personality
and
Success
Entitled "Sociopathy", this page
looks at the sort of people who succeed in
a competitive corporate system and the
culture which
develops.
(Created 1/01 Last Update 1/06)
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Rationing
in Australian health care
services
There was much talk about health care
rationing in the 1990s. This is a response
to an editorial in the Medical Journal of
Australia (MJA). This letter, making
points about the corporate threat, was
published in the MJA in June
1998.
(6/98)
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Senate
Submission re private
equity(pdf
file 659 KB)
Private equity is sweeping the world and
is buying up some of the largest hospital
and nursing home groups in the USA and
Australia. In 2007 I made a submission to
the senate economic committee that
examined the marketplace in health and
aged care, and looked at the social
implications of the move to private
equity. (5/07)
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Australia's
Experience with Health
Reform:
Are
there lessons for
Canadians?
(pdf
file)
In October 2004
I
was invited to speak to groups of
Canadians in
Alberta,
Canada.
I provided them with a
longer
background paper which is on the web site
of the Alberta Consumers Association as a
pdf file.
This
explores the nature of for profit health
care in the
USA
and Australia.
It examines
the ideological basis for the development
and application of market
principles.(11/04)
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Looking to the
Future
These web oages
are not about devising some new health system or
promoting another model of care. It looks at the
failure of corporate market medicine, why it has
failed and what the processes at work are. It
criticises models built on ideology. The Canadian
Colleen Fuller's contention that we have taken the
wrong road and should try another is strongly
supported. I have used the insights and experiences
gained in writing these pages to suggests
understandings and directions which we might try in
looking for a road which gives a greater chance of
success. The next page is really the final page
of the web site but there is nowhere else to put it
on the map. It builds on the previous
pages.
Lessons
for the Future : I
tried to look at what has happened and at the
understandings I have developed as I wrote all
these web pages in order to make some suggestions
for a different sort of health system in the future
- a different road to try.
- Theoretical
Grounding - I look at
some of the global events and writings which
have influenced my perceptions of the health
care marketplace and of how we might move ahead
more sensibly.
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S
T
O
R
Y
Personal
Story
This page gives an
outlne of how my personal challenge to one company,
Tenet/NME progressed to my challenging corporate
medicine in Australia and internationally. Whistle
blowing moves to dissent.
S
T
O
R
Y
S
T
O
R
Y
S
T
O
R
Y
S
T
O
R
Y
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Personal
Background
Short account of past
experience
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Blowing
the whistle
Tenet/NME
The
battle to eject Tenet/NME from Australia -
a more detailed personal
account
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A
DISSENTING VIEW OF HEALTH AND AGED CARE
CORPORATISATION : CONFRONTING SUN
HEALTHCARE IN AUSTRALIA
1997-2001
This page examines the ideological
conflict. It describes the efforts I made
during the years following Columbia/HCA's
departure in 1997 to confront the
introduction of competitive corporate
health care and to force Australian
authorities to address the problems. Much
of the material relates to Sun
Healthcare's conduct and my efforts to
have it ejected from Australia. The page
provides links to a representative
selection of some of the letters and
reviews I wrote.
The
battle to introduce managed care was in
progress and doctors were resisting. I
believed that US managed care corporations
would be brought in to control them.
The
inappropriateness of market ideological
solutions for health care was repeatedly
emphasised. The letters and criticisms I
wrote expand on the issues.
- Kaiser,
Vista Healthcare, Alpha Healthcare
and Sun
Healthcare.
- letter to FIRB 22 May 97 re
Kaiser, Vista, Alpha and
Sun.
- US
corporations move into
Australia
- follow up letter to FIRB 23 May 97
about Sun Healthcare, AXA, Vista,
and managed care in Australia - sent
with documents.
- Letter
to New South
Wales
- letter to NSW minister for health
re Sun Healthcare 26 May
1997
- Managed
Care - Critical Reviews from the
USA
- letter to FIRB 27 June 97
enclosing material about managed
care.
- US
corporations continue to move into
Australia : SUN HEALTHCARE the
Pacman of subacute and aged
care
- letter to politicians 2 June
97
- US
Newspapers support my assessment of
corporate
practices
- July 1997 review of developments
in Columbia/HCA scandal, and recent
exposures of conduct in the USA
comparing with similar conduct in
Australian business. Used to stress
our vulnerability and challenge
Sun's entry to
Australia.
- US
Healthcare corporations. Sun's entry
into Australia
1
- Letter to FIRB 21 July 97 re
information about recent US
corporate problems stressing the
risk Sun poses and advising that I
am being sent court documents. I was
trying to delay FIRB's decision to
admit Sun to Australia while I
sought information.
- US
Healthcare corporations. Sun's entry
into Australia
2
-A delaying letter faxed to FIRB 29
July 97 - listing the documents I
now have.
- Sun's
entry into Australia - Court
documents
1
- letter to FIRB 30 July 97
outlining the probity and integrity
issues raised by the
documents.
- Sun's
entry into Australia - Court
documents 2
-
Letter to FIRB 2 August 97 enclosing
the documents and summarising
politicians irresponsible and blind
behaviour - by inference stressing
the important role which FIRB
plays.
- Sun's
entry into Australia - the nature of
US corporate practices
1
Letter to FIRB 16 August 97 stirring
the pot after press reports
indicated that the sale had been
delayed while FIRB investigated.
Refers to the inadequacy of
Australian health regulations and so
the importance of the FIRB
process.
- Political
Blindness
-
An August 97 review of political
behaviour when previous US companies
entered Australia, describing how
politicians had deliberately turned
a blind eye and betrayed the trust
of Australian citizens. I was very
suspicious that Wooldridge's plans
depended on using US companies -
prophetic in the light of how Sun
was subsequently allowed into
Australia.
- Letter
to FIRB from Federal Department of
Health 25 June
97
- Letter later obtained under FOI in
which Wooldridge's department
disingenuously denies responsibility
even though some Sun acquisitions
are licensed by this
department.
- Sun's
entry into Australia - the nature of
US corporate practices 2
-
Letter to FIRB 14 September 97
asking for notification and
explanations.
- SUN
HEALTHCARE CORPORATION - ACQUISITION
OF AN INTEREST IN ALPHA HEALTHCARE
LIMITED
-
Letter from FIRB 22 September 97
notifying me that Dr. Wooldridge's
junior cabinet colleague, the deputy
treasurer overruled the NSW
objection and allowed Sun to buy
into Alpha.
- Sun's
entry into Australia - FOI documents
-
letter to FIRB 24 September 97 re
release of documents under FOI
arguing for the importance of a full
release. My impression was that FIRB
were uncomfortable with the decision
and might oblige.
- Hospital
licenses Alpha/Sun Healthcare --
Contracts with Alpha to treat public
patients
-
Letter to NSW Health Department 22
September 97 reaffirming my
objection to hospital licenses for
Sun/Alpha and explaining why the
licenses should be
rejected/revoked.
- Corporate
Medicine
- A late 1997 appendix to letters
sent out to doctors and hospitals.
It reviewed corporate medicine in
the USA and Australia. It commented
on a large number of other listed
documents which were included with
the letters.
- US
Corporate Medicine re-enters
Australia -- Sun Healthcare
-
letter sent, with above appendix and
documents, to senior doctors in
Australian hospitals in October 1997
- including Alpha
hospitals
- Freedom
of Information - Sun
Healthcare
- I reject a November 1997 FIRB
request to disclose my identity to
an FOI applicant on the basis that
they might sue me for
defamation.
- US
health care corporations are leaving
the sinking
ship
- letter to FIRB 17 November 1997
warning that the revolt against
managed care and the prosecution of
fraud by the FBI's operation
"Restore Trust" in the USA would
pressure the more unsavoury
megacorps to look internationally
including Australia.
- FOI
application --- Sun Healthcare
-
letters to FIRB 26 December 97 and 9
January 98 refusing permission to
disclose my identity to an FOI
applicant and using the opportunity
to comment.
- Federal
Correspondence and FIRB
documents.
In November 1997 I wrote an
extensive review of matters
surrounding Sun's entry into
Australia. I also wrote a review and
comment on documents. This link is
to the section describing the FIRB
FOI documents. They revealed the NSW
objection, Wooldridge's denial of
responsibility and the deputy
treasurers decision to overrule NSW,
the state where Alpha operated. All
this material was sent with the
documents to key politicians and
others and then put
on this web
site.
- Letter
to Australlian Consumers
Association
- During this period I wrote and
sent documents about all these
matters to many organisations and
groups. This is a 25 February 98
letter in which I am also critical
of some of the Consumer
Association's publications and their
approach. I am critical of the way
their ill informed rush to promote
evidence based medicine has resulted
in the incorrect specification of
evidence to support invalid societal
beliefs.
- Letter
to Queensland Health 1 February
1998
- Queensland like other states was
embracing privatisation and
colocation. The health minister and
the press enthusiastically supported
Mayne health. I objected, supplied
many documents and criticised until
I was asked to meet with the health
department. In my letter of
acceptance I seized the opportunity
to described corpoorate misconduct
and itemised many issues of concern
about corporate health and Mayne
Nickless.
- Aged
Care and Pathology Licenses
-
Both are licensed by federal
government departments in Dr.
Wooldridge, the health minister's
portfolio. On 11 January 98 I
supplied documents and lodged
objections to licenses for Alpha and
Sun Healthcare - also commenting on
the ministers duplicity.
- Letter
from Alpha to FIRB dated 5 August
1997
- This four page letter to FIRB (in
4 linked pages) in support of their
entry to Australia was only released
to me under FOI in February 1998. It
made much of Sun's expertise in aged
care and indicated its intention to
use this expertise to enter aged
care, Dr Wooldridge's area of
responsibility.
- Alpha
Healthcare - response to
FIRB
- my comments and criticisms of the
Alpha letter to FIRB, written and
circulated early 1998.
- Letter
re Nursing Home Licences 22 Feb.
1998
- Letter to federal aged care
licensing authority after they had
repeatedly ignored requests to
acknowledge my objection. I use
Alpha's letter to attack Dr
Wooldridge and their
conduct.
- Deficiencies
in FIRB
regulations
- Letter to Senate Community
Affairs Reference Committtee dated 3
march 1998 asking once again for a
inquiry into deficiencies in the
FIRB regulations. Past failures and
the disgraceful conduct in the Sun
affair are canvassed.
- Letter
to FIRB re Sun
Healthcare
2 March 1998 addressing and the
manner in which Sun Healthcare had
been brought into
Australia.
- DEFICIENCIES
IN
FIRB
- I wrote a criticism of the FIRB
process in health care and used it
to motivate the issue more
widely.
- Rationing
in Australian health care
services
- letter published in the Medical
Journal of Australia in June 1998 in
regard to rationing by corporate
entities.
- Letter
to Victorian Health
Authority
- Alpha Healthcare became the front
runner to build and run the new
Mildura Public hospital in Victoria.
I wrote again on 19 September 98
objecting on the basis of Sun's
conduct.
- Licenses
for pathology laboratories and aged
care facilities
-
Letter to federal aged care and
pathology licenses 17 October 98
after extensive information about
poor care in US nursing homes owned
by corporate chains became available
to me. Sun was a major
offender.
- Objection
to licenses for the Mildura
Hospital
- another letter dated 18 October
1998 into the black hole of the
Victorian health department during
the government of the coalition
party under extreme right wing
rationalist , Premier Geoff
Kennett.
- Sun
Healthcare ---
URGENT
Incorrect information from the USA
suggested Alpha/Sun was entering
nursing homes in Australia. I rushed
off documents about care to the FIRB
on 30 October 98 to prevent further
investment by Sun in Australia if I
could.
- Alpha/Sun
Healthcare - Moran/Sun Health
facilities
--- License Objections -
representative sample of letters I
sent out to state licensing
authorities and others in January 99
soon after Alpha/Sun abandoned the
Mildura contract - essentially
driving the message home and
capitalising on the
victory.
- Refusal
to acknowledge documents. I ask you
to intervene
personally
- Letter to Dr. Woooldridge, Federal
Minister for Health on 7 January
1999 after his department refused to
acknowledge documents. I followed
this by enlisting support and
pressure from state and federal
members of parliament and the
president of the AMA.
- SUN
HEALTHCARE DOCUMENTS - WHERE TO SEND
THEM
-
letter to the federal minister for
aged care dated 13 January 99
advising that I possessed important
documents about Sun Healthcare. I
described the black hole previous
letters had gone to and asking to
whom I should send the material to
have it acted on.
- Letter
to FIRB re Sun Healthcare 19 January
99
- On this occasion I indicated that
I possessed documents and described
them but only offered to send them.
I wanted a response.
- Licenses
for aged care facilities. Sun
Healthcare controlled facilities
-
Letter to federal licensing
authority 20 January 99 summarising
the latest documents and offering to
send them. I wanted a
response.
- Letter
to FIRB re Aetna dated 4 February 99
-
I had heard that the giant managed
care group Aetna Healthcare was
snooping around Australia looking
for opportunities.
- Is
Columbia/HCA entering Australia
again?
-
letter to FIRB 19 February 99 after
the Australian newspaper suggested
Mayne was a takeover target and that
Columbia/HCA was
interested.
- Letter
from FIRB 24 February
99
- expressing a willingness to
receive submissions and information
in the public interest.
- Multinational
Health Care
Organisations
- Letter to FIRB 9 March asking how
I can find out which companies are
entering Australia as FIRB does not
release this information and health
care companies no longer publicise
their intentions.
- Sun
Healthcare
- a pointed letter to the federal
Pathology licensing body dated 17
March 99 as after 15 months I have
still not had the promised response
from those examining the
material.
- Sun
Healthcare - - - -
URGENT
- a letter to FIRB 16 March 99 after
reports that Sun was to increase its
holding in Alpha to 55% and so have
full control. This would need FIRB
approval.
- Letter
to Queensland state Minister for
Health 10 November
98
- regarding Alpha?Sun and aged care.
She forwarded it to the federal
minister.
- Letter
to me from federal ministers for
aged care's office dated 2 March 99
-
in response to my letter to the
Queensland minister.
- SUN
HEALTHCARE 9 March
99
- letter to federal aged care
department referring to my other
letters and asking about probity
requirements.
- Letter
to Shadow minister for Family
Services and Aged Care 16 March
99.
I take up some of the issues with
the opposition minister who has
previously asked to be kept
informed.
- Letter
to Northern Territory 12 April 99
-
The Northern Territory adopted a
privatisation policy (later modified
after criticism) to which I had
responded. I spoke to someone in the
Northern Territory Health Department
on the phone and discovered he had
been one of my contacts in Western
Australia during the 1995-5 Tenet
battle. I wrote to him.
- International
Healthcare Corporations- Quest
Diagnostics
- when Quest Diagnostics acquired
SmithKline Beecham's Australian
laboratories I wrote to the FIRB (16
April 99). Both had reached massive
fraud settlements - caught by
operation
labscam.
- Letter
for Minister for Aged Care , the Hon
Bronwyn Bishop 14 April
99
- a reply to my letter of 13 January
99. I am given an address to send
documents.
- Letter
from Health and Aged care 21 April
99 --
claim that they are concerned that
suitable persons provide care but no
mention of regulatory requirements
in regard to probity.
- SUN
HEALTHCARE -- LICENSES FOR AGED CARE
FACILITIES
-
Letter dated 23 April 99 to the new
licensing authority for nursing
homes supplied to me above objecting
to Sun Healthcare.
- Approved
providers for aged
care
- Letter dated 27 April 99 to aged
care section of health department
suggesting that the probity
requirement had been dropped from
legislation in order to facilitate
free trade agreements in health and
aged care.
- Letter
from Health and Aged Care licensing
7 May
99
- None of the companies in which Sun
has an interest have applied for
nursing home licenses.
- Aged
care
licenses
- Letter to Aged care licensing 26
June 99 sending large amount of
recent material on two floppy disks
describing the US aged care market
crisis and the consequences for care
- Sun featured
prominently.
- Letter
from the Pathology Licensing section
of the HIC 8 June
99.
-a safe response 8 months after my
submission as Alpha/Sun's pathology
businesses had been sold some months
before - something the letter did
not mention.
- Sun
Healthcare - the corporate
marketplace
- letter to Pathology Licensing
section dated 25 June 99 in reply in
which I raise and press the issues
of probity and ask for a copy of the
relevant section of the
regulations.
- Sun
Healthcare 24 June 99
-
a letter to doctors in Alpha
hospitals in Australia referring to
the Victoria probity review and to
Sun's staff cutting in the
USA.
- International
Healthcare
Corporations
- Letter to FIRB 25 June 99
supplying over 400 pages of material
about US health and aged care
problems, Sun's crumbling financial
position etc.
- re
rumoured break up of Mayne Nickless
- international purchaser
-
Letter to FIRB 6 March 2000 warning
of plans to break up Mayne and the
search for an international buyer -
uses Sun as an example of FIRB's
past failures.
- Sun
Healthcare Bankruptcy -- VERY
CONFIDENTIAL
INFORMATION
- Letter to FIRB 29 April 2000 about
Sun's bankruptcy in the USA and
inside information that Andrew
Turner, Sun's chairman was
attempting to form a new company to
buy and run Sun's international
operations.
- Takeover
of Mayne
Nickless
- Letter to FIRB 3 may 2000. Talk of
a multinational buying Mayne. I
wrote to FIRB on the issue of
probity and the
marketplace.
- Andrew
Turner may buy much of Alpha
Healthcare
-
Letter to FIRB 14 August 2000
advising that Andrew Turner has
resigned from Sun and has formed or
joined a number of other companies
which were buying up Sun's
international
operations.
- Andrew
Turner and Ballantrae Healthcare
&
Rehabilitation
- Letter to FIRB 3 October 2000. Sun
was in receivership in Australia.
Turner and many Sun staff had joined
Ballantrae Healthcare in the
USA.
- Andrew
Turner and Healthcare companies
-
Letter to FIRB 18 December 2000.
Turner had formed EnduraCare and was
recruiting Sun staff.
- Shell's
purchase of control of
Woodside
-- Letter to FIRB 7 January 2001
seizes the opportunity to enclose
material and make the point that oil
companies are second only to health
care in the fraud stakes and that
Shell is a prime
offender.
- JUSTICE
RECOVERS RECORD $1.5 BILLION IN
FRAUD PAYMENTS : HIGHEST EVER FOR
ONE YEAR
PERIOD
- 2 November 2000 government press
release. Health fraud comprises over
50%. Sent to FIRB and
others.
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