Best Healthcare System in the World

The heart transplant program at Newark Beth Israel Medical Center had a problem, the one year survival rate of their program was well below the national average.

Rather than addressing the issues that led to poor performance, they adopted an interesting tactic, they kept patients on life support until the year had passed, boosting their statistics.

This is a classic example of Goodheart's Law, "When a measure becomes a target, it ceases to be a good measure."

This is also highly unethical, and likely constitutes criminal fraud:

In 2018, Darryl Young was hoping for a new lease on life when he received a heart transplant at a New Jersey hospital after years of congestive heart failure. But he suffered brain damage during the procedure and never woke up.

The following year, a ProPublica investigation revealed that Young’s case was part of a pattern of heart transplants that had gone awry at Newark Beth Israel Medical Center in 2018. The spate of bad outcomes had pushed the center’s percentage of patients still alive one year after surgery — a key benchmark — below the national average. Medical staff were under pressure to boost that metric. ProPublica published audio recordings from meetings in which staff discussed the need to keep Young alive for a year, because they feared another hit to the program’s survival rate would attract scrutiny from regulators. On the recordings, the transplant program’s director, Dr. Mark Zucker, cautioned his team against offering Young’s family the option of switching from aggressive care to comfort care, in which no lifesaving efforts would be made. He acknowledged these actions were “very unethical.”

ProPublica’s revelations horrified Young’s sister Andrea Young, who said she was never given the full picture of her brother’s condition, as did the findings of a subsequent federal regulator’s probe that determined that the hospital was putting patients in “immediate jeopardy.” Last month, she filed a medical malpractice lawsuit against the hospital and members of her brother’s medical team.

You know, if we treated crooked doctors and crooked stock brokers with even half of the severity and ferocity that our criminal justice system treats black graffiti artists, these folks would be held without bail awaiting trial.

………

The 2019 CMS investigation determined that Newark Beth Israel’s program placed patients in “immediate jeopardy,” the most serious level of violation, and required the hospital to implement corrective plans. Newark Beth Israel did not agree with all of the regulator’s findings and in a statement at the time said that the CMS team lacked the “evidence, expertise and experience” to assess and diagnose patient outcomes.

The same could be said for the doctors and managers at Newark Beth Israel Medical Center.

Jail the doctors and the administrators, and shut down their transplant program.  

Simple as that.