Our nation is quick on the draw to close down an imperfectly assembled theme park ride or a business serving an E. coli–infused hamburger. Why do we tolerate the carnage inflicted by our hospitals? The hundred thousand deaths from infections are compounded by a litany of routine mistakes that create preventable blood clots, drug dosage and prescription errors, and any number of other oversights. All this adds up to an estimated two hundred thousand Americans killed each year by medical mistakes. ...from "Catastrophic Care" by David Goldhill
You may remember David Goldhill. He's something of a hero as a result of how his father died. Goldhill senior died from medical incompetence (infection) at one of New York's top hospitals. His son investigated and then wrote about this unnecessary death in a long article in 2009, a compelling, startling piece that caught the attention of many of us. Since then, there have been efforts to change some of the more outrageous -- medieval -- defects in American health care but certainly not all.
First: we pay out of pocket way more that we should, according to Goldhill in his new book, "Catastrophic Care." In an interview with NPR, Goldhill told the reporter that the true cost of our health care is massive and it is hidden.
He looks at a typical entry-level employee earning about $35,000 a year. He finds that over the course of her lifetime she will pay more than $1 million to support her and her family's health care. And that's if there is zero growth in costs and if she avoids major illness. ...NPR
So we need far greater accountability within the system and far greater respect for patients -- their standards, their choices, their safety. And that includes the new Affordable Care Act, says Goldhill.
In my own experience, accountability has to be accompanied by plenty of light and clarity about the treatment and its costs and plenty of opportunity to question each detail. The "boss" in our healthcare shouldn't be either the doctor or the insurer (government or corporate). If they're not prepared to simplify their records and account for each step in our care to us (or our families), then they're not doing their jobs. And we may be getting too accustomed to health care that provides neither health nor care.
"I'm a Democrat and I share what I think the administration's goal was of creating a national cradle-to-grave safety net. The problem is, I think the Affordable Care Act ... saw the big divide as being between the insured and the uninsured. And I think that's a very simplistic and probably inaccurate evaluation of what the key problems are in health care: ever greater price inflation, care that is more expensive over care that is less expensive, care that is wasteful and therefore harmful over that that is needed. ... What we have in this country is a system that is already hazardous to your health and to your pocketbook.
"I think we need a greater role for the patient as consumer. We're going to have to take more responsibility. It probably means taking some of the $2.7 trillion that we're flowing through an insurance system and flowing it back through us as individuals, so that we are the customers the system needs to chase." ..NPR