Monday, February 10, 2014

People in glass houses.

We all have a tendency to blame others for our own flaws, but a recent letter takes this to new heights.

The head of the Hadassah Women's Zionist Organization of America has started a petition drive to get American supporters of Hadassah Medical Organization to argue for support from the government of Israel for this failed hospital.  And look where she puts the blame:

This crisis is the result of dynamics that have been building for years including unsustainably low reimbursement rates for services; unaffordable union contracts; and unrealistic commitments to the university who trains their students and conducts research at HMO facilities.

All of these, and more, occurred on the watch of the governing body of  HMO, a governing body controlled by HWZOA.  Worse still, that governing body never put in place sufficient financial control systems to properly monitor the business aspects of this hospital.  Recall that my review last year concluded:

Basic accounting, purchasing, personnel and other controls systems are not in place.  As just one example, the CFO currently often does not know what supplies and equipment have been ordered by people in the hospital until the bills arrive on his desk.  The human resources system is likewise inadequate.  Thus, effective costs controls are impossible. 

There are a multitude of other factors that have led to the hospital's near demise, but fundamentally:

That HMO has reached the point it has indicates a failure of governance.  Financial and existential crises do not develop overnight.  The current situation has been years in the making, and the inability of the board to acknowledge the trends in a way that would have enabled countermeasures to be put in place indicates a problem in the structure, focus, activities, and perhaps people on those bodies.

I am appalled and embarrassed that, with all the incredibly serious issues facing the relationship between the United Stares and the State of Israel, HWZOA would tap the political capital of American Jewry to solve a problem that is essentially of its own making.  By conducting this petition drive, HWZOA confirms that it should cede its ownership and control of this organization and let it be owned and operated by the Israelis.


bob meyers said...

The bottom line, there is no Bottom Line, 600,000 non profits in the USA alone

Anonymous said...

I have done some volunteer work at Hadassah, as well as at other hospitals, and I have been mulling over your posts. I also read Marcie Natan's signature drive letter. Two things jump out at me. First, I was appalled to learn about the complete lack of financial control and accounting systems at the hospital. Marcie's letter makes no mention whatsoever of that, and instead casts all of the blame on external dynamics that are surely only part of the story. And I agree, if these dynamics have been building for years and years, how come things had to get so bad before the board decided to tackle them? Anyone who has not read your report or know the real situation on the ground is being seriously misled.

Second, it strikes me that even if the petition is successful, it will simply delay the day of reckoning. I don't see how an organization with the level of mismanagement, financial and otherwise, that seems apparent, can turn itself around without some serious changes at the helm.

The new tower at Ein Kerem is a lovely space, but there are definitely many older parts of the hospital that feel more like some of the hospital wards I've visited in developing countries, in terms of infection control practices.

Thanks for taking this on, Paul. I spent some time as a patient at Boston's Beth Israel Hospital, and you did a terrific job saving that historic institution. I hope Hadassah can likewise be saved from a worse fate. It is a beloved institution, and maybe it is time to turn the reins over to the community that it serves.