Lack of federal-level hospital oversight leaves patients suffering

By Anne Zieger

Patients around the country may be suffering with expensive, inadequate care due to the lack of a federal agency charged with hospital oversight.

Instead of one centralized agency for oversight, the U.S. relies on a hodge-podge of state health departments, combined with the Joint Commission. And often, even when hospitals have been found not to meet minimum quality standards, the agency overlooking them doesn't have the power to actually close the hospitals or even slap them with significant financial penalties.

Part of the problem is that even though a hospital may not be very good, it is generally still a major employer in its area. So if it is threatened with closure or cuts, the community rallies around it to save jobs.

Often, the only agencies actively trying to ensure that national standards are met are the Joint Commission and Medicare. But a non-profit can only do so much, and Medicare's intent was to provide healthcare for the elderly, not to police quality infractions. Medicare can, and does, leverage its spending to encourage quality improvement, but it doesn't have strong enough enforcement powers to forcibly take the lead.

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