The Howard government's budget has set Australia on the road towards a "two-tier" health system: one tier for the wealthy, and another for the rest. In the United States, where such a system is in place, the human cost is appalling. A recent investigation by the San Francisco Bay Guardian exposed the nightmare patients are suffering at just one California hospital.
"On April 5, 1996, Robert Jackson's heart stopped while he was strapped to a bed at East Bay Hospital", wrote reporter Belinda Griswold in the August 13 SF Bay Guardian. "Jackson died after East Bay administered a potent anti-psychotic 'cocktail' without checking Jackson's blood or medical condition. Jackson arrived at East Bay with a high level of the powerful anti-depressant Anaphrenil in his blood, but East Bay proceeded to medicate him with drugs known to cause cross-reactions with Anaphrenil.
"Robert Jackson was not evaluated by a medical doctor at East Bay, he was simply described as 'agitated' and given an injection. When he stopped breathing an hour later, East Bay called an ambulance to take him to Brookside Hospital. He was dead on arrival."
East Bay Hospital offers a case study in the deadly perils of a for-profit health system. Private companies which claim to understand "efficiency" are taking over functions that were once in the "bloated" and "wasteful" public sector.
Over the past 13 years, nine counties in northern California have signed contracts with East Bay Hospital to handle the care and treatment of hundreds of mental patients, most of them low-income people, who can't be accommodated in cash-starved and overcrowded public facilities. Every year $6 million of government health budget money is instead given to East Bay to look after poor patients — a sizeable percentage of its operating revenue.
East Bay's "efficiency" has been achieved by packing its most disturbed patients five to a room, strapped into beds under heavy medication, and left alone for long periods. Staffing levels are far lower than public hospitals consider adequate. The medical lab, which is run by another company, does not operate after hours. Patients are given powerful tranquillisers without checks to see if they already have drugs in their blood.
There is no emergency room, no facilities for emergency surgery, no physician on duty around the clock. The hospital has been regularly cited for negligence, but state officials continue to allow public money to fund it.
Patients are, on average, restrained for more than 15 hours a day. Complaints have been received about patients not being offered food, water or use of the toilet during restraint. In one case, a woman patient was left for several hours naked, unattended, tied to a bed, in an open ward where male patients were present.
Unwatched patients have been able to get hold of razor blades and cut their wrists. Another patient, supposedly under "suicide watch", suffocated himself with a plastic bag given to him by a staff member.
In 1993, a restrained patient was found dead in a condition of rigor mortis, indicating he died as long as four hours earlier, even though East Bay medical records claim he was checked for vital signs every 15 minutes. The unfortunate patient was over-medicated without first having his blood tested. In 1996, an almost identical death occurred.
In the past five years, four people who arrived at East Bay Hospital with symptoms such as anxiety and depression have died from causes that patient rights' groups say were directly related to their treatment.
East Bay has been cited at least 25 times for infractions of regulations governing medical care since 1991.
"Nobody has been able to keep East Bay in line, and the abuses have continued", the SF Bay Guardian wrote in an editorial on August 18. "That's the big problem with privatization: The public loses the ability to make sure its cash is well spent — and sometimes the 'efficiency' of the private sector clashes directly with the public interest in providing essential services, such as mental-health care for low-income people ... The next time some politician or business executive starts talking about the virtues of privatization, Bay Area residents can shut them up with three simple words: East Bay Hospital."