I expect great shouts of it couldn't happen here from those across the pond, but here is an approach to fixing a problem and stopping federal/local squabbling.
D-Day for Rudd's hospitals overhaul - ABC News (Australian Broadcasting Corporation) (http://www.abc.net.au/news/stories/2010/03/03/2834814.htm)
In a milestone of demonstrating a concillatory approach to dealing with a severe problem, the Australian Federal Government has taken a big stick approach to dealing with the cronic mismanagement of public hospitals by Australian state governments proving once again that he who holds the purse strings holds the power. There is much to be said for action in an election year to endear you to the electorate and how much better to find a problem where everyone in affected is some small way.

What has caused this radical approach. It stems from states having a veiw that they can direct their funds into the holes that best suit their political purposes, ie; urban transit, roads, and leaving the public hospital inferstructure to molder away underfunded. This is a lesson not in why government is a poor medical administrator but in why it is undesirable to have a government of any political hue in office too long. The Federal government is actually of the same political hue as most of the states so the politics of this situation isn't a liberal/conservative divide or a public v private
Administration debate but a simple I made an election promise so I have a mandate declaration. We should be so lucky that all politicians actually mean what they say, but then that's Krudd

This is a lesson not in why government is a poor medical administrator but in why it is undesirable to have a government of any political hue in office too long.

But the problem isn't necessarily the politicians in charge. Rather it is the inherent inefficiency of the permanent bureaucracy that makes government control less than desirable.

But the problem isn't necessarily the politicians in charge. Rather it is the inherent inefficiency of the permanent bureaucracy that makes government control less than desirable.

Hey Tom I couldn't agree with you more it is the professionals who stuff it up, but you do realise these people are the puppets of those in power, the people who are responding to the policies put in place by the politicians, by manipulating the long term plans and so you get, in this case, funds diverted away from hospitals to other political objectives, overdue payments, botched hospital upgrades because of trying to minimise expenditure, hospital closures, people forced to travel long distances for treatment, understaffed emergency.

Where I live it is hard to find a public hospital which isn't the source of nightmare stores of inefficiency, under staffing, unnessessary deaths and incompetence. And to add insult to injury we learn that a private hospital will close for lack of patients. This means no surgery done locally in a reasonably sized regional centre. An incrediable scenario and all due to a state government which isn't interested in funding hospitals

By your measure we shouldn't place the blame on politicians who rule the state and direct the funding, we should blame a backroom bureaucrat. Well, yes, by all means fire the administrator, the incompetent bastard, but hold the politician accountable. In this case our politician-in-chief has decided to become accountable, a rare and refreshing stance for a politician.

No doubt the people who are supposed to be executives should be held responsible. But I find even the best of them have trouble reforming the entrenched rank and file.
I have mentioned this before .There is a prevailing attitude that administrations come and go ,but they in the permanent bureaucracy are the careerists.

The resistance to reform in the State Dept and to some extent the CIA made it difficult for President Bush to conduct policy in his term.

The best example I saw of a President dealling with it was when President Reagan fired the whole lot of the air traffic controllers.
The idea that decision would terribly disrupt the air traffic flow was quickly dispelled as there were plenty of people with the necessary skills willing to step into the position.

Nthere were plenty of people with the necessary skills willing to step into the position.

Okay I go along with your premise that we fire the administrators and even the state treasury bureaurcrats who are undoubtedly the problem, but how about a nice clean sweep of the State legislatures with it's seats full of party cronies and hacks. There is the real incompetence, people elected to direct the bureaurcrats who would have great difficulty directing traffic on an empty street.

As to the skills, aspirations maybe, but sadly lacking experience. Are we destined to repeat the mistakes of the past? To once again implement the pet projects only to find they fail dismally because we have lost our reference points. If you want change in the military you fire the General and maybe the Colonial, not the Sergeant. If you fire the Sergeant, nothing gets done.

Fortunately, we have a mechanism, however inefficient, for firing the politician, the sad part is, in a democracy, it isn't more effiecient. We have no mechanisn for firing the bureaurcrat short of revolution.

Tom, we have had some great thinkers here, instead of better hospitals what we got is a desalination plant that stands idle, instead of better urban transport what we got is a series of scrapped projects, one grand folly after another, instead of renewable power what we will get is more coal fired or is it gas fired, we can't even decide that, mainline generators. Incompetence abounds, there is a revolving door on the state premier's office, and the state elections are more than a year away.

https://www.askmehelpdesk.com/current-events/spirit-reagan-lives-447796-2.html

https://www.askmehelpdesk.com/current-events/spirit-reagan-lives-447796-2.html

What does that have to do with health care, different situation