California Democrat Pete Stark has tried to expand health care coverage throughout his 36 year career, but now that the moon is in the Seventh House and Jupiter has aligned with Mars, some worry the congressman’s abrasive style might, ironically, complicate efforts to reform the industry.

As chairman of the House Ways and Means Committee’s health panel, Stark will have a seat at the table when the matter comes up which should be about 8 seconds after the Big O gets sworn in.

But the man is just not the conciliatory type. Last week for example, Stark dismissed the idea of negotiating with Big Insurance on the matter of healthcare reform.

“I think their intention is to see the Democrats fail, regardless of what it does for health care in this country,” the 77 year old told the Wall Street Journal.

That was just a warm-up for his touchy-feely description of Big Insurance which he called “the General Motors of medical care delivery.”

Doink!

Stark supports by the way, the Big O’s plan to retain employer-based insurance while organizing a new competitive government entity through which individuals and small businesses can purchase coverage.

Stark also wants Tom Daschle, the Big O’s soon-to be-confirmed secretary of HHS to negotiate prescription drug prices through Medicare and the new public program.

“This idea that we just pay anything pharmaceutical companies are going to charge is ludicrous,” Stark says in describing the current Medicare plan.

That remark was sure to pin back the Dobermans’ ears over at Big Pharma, and before long Ken Johnson,  senior VP at Pharmaceutical Research and Manufacturers of America popped up with a surface-to-air missile of his own.

“We remain opposed to restrictive policies that reduce access of medicines to patients in need and undermine the program’s success,” he told the Journal.

These parries don’t even make it to Stark’s “greatest hits” though. There was the time for example he called former Connecticut Republican Nancy Johnson “a whore for the insurance industry.”

And who can forget the time he addressed Colorado Republican Scott McInnis as “you little fruitcake.”

Stark’s coup de grace though had to be during hearings to override Bush’s veto of SCHIP legislation last year, when he said our government wouldn’t fund children’s health while it was sending young people “to Iraq to get their heads blown off for the president’s amusement.”

Stark later apologized for that one.

The First Annual Bernie Madoff Award for Global Business Chutzpah goes to Siemens, Europe’s largest engineering firm which just copped a plea to bribery and corruption charges involving public officials and politicians on 4 continents.

The multinational agreed to pay $800 million worth of fines in America and another $540 million in Germany. That was in addition to the $280 million it coughed up to settle an earlier, similar charge.

But the size of the fines wouldn’t have, by itself, put Siemens over the top for the Madoff Award. It was the perverse sense of openness with which the process unfolded, as if people throughout the organization knew and accepted this was the way to do business.

According to the Economist, Siemens set up in full view 3 “cash desks” in its offices. Everyone knew employees could tote empty suitcases there and have them filled with cash to be used in paying off public officials for awarding contracts to Siemens.

Managers could pull out as much as $1.3 million at a time in support of efforts to secure contracts for the company’s telecoms-equipment division, according to the US Department of Justice.

Between 2001 and 2004, nearly $67 million was withdrawn in those suitcases, and all tolled according to Justice, Siemens paid foreign officials $805 million over a 6-year period.

No questions were asked, little documentation was required and managers needing money could approve their own requests.

Until 1999 Siemens actually claimed tax deductions for the bribes, booking them as “useful expenditure.”

“There was no complex financial structuring such as you would find among drug smugglers or money launderers,” Mark Pieth, chairman of OECD’s working group on bribery told the Economist. “People felt confident they were doing nothing wrong.”

Now that’s chutzpah!

Timed to precede the free-for-all that will surely follow the Big O’s decision to jump start EMR utilization in health care, the JCHAO has issued a safety alert regarding their implementation.

The so-called Sentinel Event Alert warns that health IT implementation projects must begin by scrutinizing existing care processes and “be mindful of the safety risks and preventable adverse events that (they) can create or perpetuate.”

“Technology-related adverse events…may involve errors of either commission or omission. They typically stem from human-machine interfaces or organization/system design (flaws),” according to JCAHO.

The commission pointed to the US Pharmacopeia database which reports that 25% of the nation’s 176,000 medication errors in 2006 involved computer technology as either the cause or a contributing factor.

Of these, mislabeled barcodes on medications, and unclear or confusing computer screen displays were the most common problems.

New health IT can also create inefficiencies or decrease documentation speed if not carefully planned and integrated into existing workflow processes, according to the Alert.

“You have to understand what the worker is going through - whether that worker is a nurse, a doctor, (or) a pharmacist,” Ronald Paulus commented to HealthcareITNews.

“The interplay between technology and humans often gets short shrift,” added the chief technology officer at Geisinger Health System who co-authored the Alert.