US criminal and civil fraudsters awarded HSE contracts

The rape and pillage of our health service continues apace. An article today reveals how a giant US dialysis equipment manufacturer, Fresenius, has been charged with fines of half a billion dollars. Naturally, Mary Harney's HSE can find no better organisation than Fresenius to award tax payers money to so that it can start operations here in Ireland.

http://www.indymedia.ie/article/87613

What guidelines are the HSE working to? How can such organisations be entrusted with vital health care services? Would we put a c******d accountant in charge of The Ministry for Finance? (Oh wait, we did do, didnt we?).

Thanks for posting that article and well worth reading. Quick summary of it from my view if you don't mind -

Quote :

This morning Raidió na Gaeltachta reported that Fresenius, a dialysis giant awarded multi-million contracts by the HSE, had been fined almost half a billion dollars by the US Justice Department in 2000. 'This case broke all US Justice Dept records for both criminal and civil fines', said Marie O'Connor.

Quote :

The Government is putting patients at risk, she warned, by trading in health services. 'The private for profit health care industry is widely acknowledged to be one of the most corrupt in the United States. Medicare fraud stood at a staggering $23billion in 1996.'

Quote :

'The Fresenius dialysis contracts raise the issue of what constitutes due diligence' said Dr John Barton, consultant physician and Health Services Action Group Vice-Chair. The quality of patient care is at
stake, he underlined, as well as taxpayers' money. 'Can HSE now explain how having a history of fraud payments in the United States is compatible with due diligence in awarding multi-million health care contracts?

Quote :

The Fresenius scam involved fraudulent and fictitious blood testing claims; kickbacks to dialysis facilities in return for blood testing contracts and fraudulent claims against State health insurers. The
world's largest provider of kidney dialysis products and services was fined a total of $486m by the US Justice Department.

Quote :

Fresenius had previously been refused planning permission for another site near Purcellsinch, Co Kilenny. Mark Murphy, Irish Kidney Association spokesperson, was quoted as saying he was not impressed with the planned facility in John St.

Good article - that's half of it above. I left out the juicy bits about the FBI and the Justice Department investigating them.

Lots of questions come to mind - who is involved in granting planning permission for this kind of fraudulent enterprise? What criteria do we use to assess them? This is clearly a fraudulent organisation who is about to become a stakeholder in our health service - it's not in the class of Microsoft flipping the market in favour of themselves, there's people's health involved as well as business ethics and codes of practice.

Who will monitor this kind of company now that they're here? It means we have to set up another watchdog regulator office I suppose. Can their contract be indeed rejected at this stage?

What were the other tenders for the contract and on what grounds were they favoured?

Are we really willing to accept practicioners of dodge to come here and care for us?

Planning permission is just for a building that anyone can use.

At the time that Barrington's came up in relation to breast cancer treatment problems, I believe it was said that there was no public regulation of private healthcare. Surely that can't be right?

Another problem that seems to come up in relation to privatisation is that there are "business confidentiality" issues that seem to prevent public elected representatives being given information on matters to do with private contracts.

Aragon wrote:

The rape and pillage of our health service continues apace.

As is usual with Indymedia and the various kinds of hyperbole its posters regularly indulge in, when you scratch a little at the surface, you find a different story.

Fresenius is a worldwide corporation with numerous subsidiaries. The 2000 fraud case involved a company called LifeChem Inc, which is a commerical lab owned by a company called National Medical Care Inc, which is in turn owned by Frenenius, who are based in Germany.

The for profit dialysis industry is largely controlled by 2 companies, Gambro and Fresenius. Both have been fined by the US Federal Government under the False Claims Act. Fresenius in 2000 $385m in 2000, and Gambro $310 in 2004. Both tendered for the HSE contract in question.

What any of this has to do with the "rape and pillage" of the Health Service I don't know. Unless the Indymedia types (eg
Joe Higgins of the Campaign for a Real Public Health Service) are suggesting that the State builds its own dialysis machines and centres, I'm not sure exactly how the HSE can avoid dealing with the private sector.

And if you have to deal with the private sector, chances are you are going to have to deal with a company who has been fined by the US Federal Government:

http://www.taf.org/top100fca.htm

Not a great advert for the private sector though Seinfeld, at the end of the day.

seinfeld wrote:

... are suggesting that the State builds its own dialysis machines and centres, I'm not sure exactly how the HSE can avoid dealing with the private sector.

And if you have to deal with the private sector, chances are you are going to have to deal with a company who has been fined by the US Federal Government:

http://www.taf.org/top100fca.htm

There's a lot there. Should we try to run our own centres and train and cultivate our own staff where possible and where viable. Running a dialysis centre is not the same as drilling for oil in the Atlantic or building a power station. What's wrong with buying machines and training our own staff in them? Is it really necessary that it's private in this case?

Who makes the decisions that it is private or not? Shouldn't we make the decision carefully when to use private companies? Who in the HSE or government makes the policies that somehow debar us from developing our own industries? Shouldn't the office of the C&AG not be expanded at the expense of other offices and these decisions analysed and studied?

If we are using private industry then isn't it possible to avoid the fraudulent ones?

cactus flower wrote:

Not a great advert for the private sector though Seinfeld, at the end of the day.

No its not, anymore than the misdiagnosis scandal at Portlaoise is a good advert for the public sector.

Auditor #9 wrote:

seinfeld wrote:

... are suggesting that the State builds its own dialysis machines and centres, I'm not sure exactly how the HSE can avoid dealing with the private sector.

And if you have to deal with the private sector, chances are you are going to have to deal with a company who has been fined by the US Federal Government:

http://www.taf.org/top100fca.htm

There's a lot there. Should we try to run our own centres and train and cultivate our own staff where possible and where viable. Running a dialysis centre is not the same as drilling for oil in the Atlantic or building a power station. What's wrong with buying machines and training our own staff in them? Is it really necessary that it's private in this case?

When indeed is it simply unavoidable that we use private companies and who in the HSE or government makes the policies that somehow debar us from developing our own industries? Shouldn't the office of the C&AG not be expanded at the expense of others offices and these decisions analysed and studied?

If we are using private industry then isn't it possible to avoid the fraudulent ones?

Its a tricky one alright.

The thing is, we don't exactly have a glittering record when it comes to running our own services, and it you have to squeeze every penny of your health budget, do you go for the tender you want or the tender your conscience wants?

By the way, due diligence has nothing to do with this. Due diligence is a process which a company completes during the acquisition of another company to ensure that the value of the acquired company's assets is what it claims they are.

The HSE obviously doesn't engage in due diligence when acquiring services from third parties. No government agency does.

And Dr. John Barton, who is quoted in the Indymedia article, was the FG candidate in Galway East in 2007.

seinfeld wrote:

Its a tricky one alright.

So our state companies and bodies don't do due diligence i.e. they don't behave by the business book? Aren't acquisition procedures not textbook formulas that we should follow?

I'd wonder with all this European integration going on why our health system isn't supervised by a pan-european or even global organisation. No one trusts the WHO I suppose. What about the OECD?

For some people there's the suspicion that there is dodginess at foot and for others there is the suspicion that there is incompetence; a pan-european body which does regular comparative studies on these systems might be useful though they wouldn't or couldn't advise on details like a dialysis machine in Kilkenny. Or could they?

seinfeld wrote:

cactus flower wrote:

Not a great advert for the private sector though Seinfeld, at the end of the day.

No its not, anymore than the misdiagnosis scandal at Portlaoise is a good advert for the public sector.

I am still not clear as to whether the diagnostic errors there were in excess of the norm. The problem seems to have originated with too many false positives rather than missing cancers. We would have to assume that private diagnostic companies would both have the normal levels of error and would also be inclined to cut corners in the interests of profit.

cactus flower wrote:

seinfeld wrote:

cactus flower wrote:

Not a great advert for the private sector though Seinfeld, at the end of the day.

No its not, anymore than the misdiagnosis scandal at Portlaoise is a good advert for the public sector.

I am still not clear as to whether the diagnostic errors there were in excess of the norm.

They were. Ann O'Doherty's report confirmed that. What she said was normal was the number of misdiagnosis found during the course of an investigation into excessive misdiagnosis.

cactus flower wrote:

The problem seems to have originated with too many false positives rather than missing cancers. We would have to assume that private diagnostic companies would both have the normal levels of error and would also be inclined to cut corners in the interests of profit.

The problem is Portlaoise was that the centre was too small, which meant that it had older, infrequently used machinery and insufficent levels of competence and expertise.

Something similar could happen in the private sector, although its unlikely that such a centre would exist in the private sector, as it wouldn't have sufficient throughput to make it viable.

Suggesting that all private companies cut corners is stretching it a little. Most private companies adopt the wisdom of the commercial aviation industry:

"If you think safety is expensive, try having an accident."

there's no good reason for complete lack of oversight, in either a small or a big hospital.

seinfeld wrote:

Aragon wrote:

The rape and pillage of our health service continues apace.

As is usual with Indymedia and the various kinds of hyperbole its posters regularly indulge in, when you scratch a little at the surface, you find a different story.

http://www.taf.org/top100fca.htm

fg have been banging about this for the last week, it was on the front of hte indo yesterday and james reily was on newtalk news today citing all this as well.