The new legislation, when it emerges from the Congressional sausage machine, will be an incoherent mess. Then come the administrative revisions, court challenges, and remedial legislation. Nonetheless this bill is a step in the massive reforms needed to contain the unaffordable growth of medical costs as the boomers retire — and to close the large gap in cost-effectiveness between our system and those of the better run european systems (e.g., France, Germany, Switzerland).
What might be the political repercussions of this bill? I suggest watching for these two developments during the next few years:
- Many conservatives made bizarre claims about the effects of the bill. The public might come to regard these as delusional or dishonest.
- People might look back on their propaganda and wonder if these conservatives were fools — or if they were smart people assuming that we are fools.
For an example of conservative debate about these issues we go to Glenn Reynold’s website, The Instapundit:
ANNALS OF GOVT. HEALTH CARE, CONT’D: Docs Removed Wrong Testicle. “Details of the error surfaced this week after the hospital was forced to confess all thanks to freedom of information laws. Care at the hospital had previously been rated ‘good’ by the Care Quality Commission.”
How many mistakes are made each day in US hospitals? Is the rate of medical errors (plus ill effects from lack of treatment due to inadequate or no insurance) higher in the US or UK? Don’t bother to ask Reynolds. He is an intelligent man, a law professor, using his skills to influence the debate with coarse propaganda.
How common is wrong-site surgery ?
Wrong-site surgery happens in the US. Even in our private sector hospitals. Even in operations untainted by government money. How often?
(1) “Incidence, patterns, and prevention of wrong-site surgery“, Mary R. Kwaan et al, Archives of Surgery, April 2006 — Abstract (red emphasis added):
This AHRQ-supported study analyzed information from nearly 3 million operations between 1985 and 2004, discovering a rate of 1 in 112,994 cases of wrong-site surgery. Investigators further evaluated cases with available medical records, all of which were among the malpractice claims. In doing so, they noted that the Joint Commission’s Universal Protocol might have prevented only 62% of the cases reviewed.
At the rates reported, the authors suggest that the average large hospital may be involved in such an event every 5 to 10 years, a rate 10 times less frequent than retained foreign bodies. They also point out that while wrong-site surgery is a devastating and unacceptable outcome, current efforts to implement protocols may not prevent every event and may, in turn, create inefficiency in related processes. The authors offer a series of recommendations for a model site-verification protocol. The American College of Surgeons offers a fact sheet on correct-site surgery geared toward patient education.
(2) “Wrong-Side/Wrong-Site, Wrong-Procedure, and Wrong-Patient Adverse Events – Are They Preventable?“, Samuel C. Seiden and Paul Barach, Archives of Surgery, September 2006 — Abstract:
Although instances of wrong-site, wrong-procedure, and wrong-patient adverse events (WSPEs) have been widely publicized, the true incidence of such errors remains unclear. A prior study indicated a rate of approximately 1 case per 112,000 surgeries, but WSPEs may occur in the outpatient setting or in ambulatory surgery as well. In this study, the authors reviewed four databases to determine the incidence of all WSPEs, including procedures performed outside the operating room. Data from both mandatory and voluntary reporting systems indicates that approximately 1300 to 2700 WSPEs occur yearly, with many occurring during outpatient procedures. The authors argue that all WSPEs should be considered preventable, and recommend reporting and prevention standards for reducing such errors.
For more information on the FM website
To read other articles about these things, see the FM reference page on the right side menu bar. Including About the FM website page. Of esp relevance to this topic:
- More attempts to control the climate science debate using smears and swarming, 19 October 2009
- About Wikipedia’s handling of controversial topics…like climate science, 20 December 2009
- Think-tanks bribe journalists to promote our wars, 24 December 2009
- Iran will have the bomb in 5 years (again), 20 January 2010
- Successful propaganda as a characteristic of 21st century America, 1 February 2010
- More propaganda: the eco-fable of Easter Island, 4 February 2010
- The hidden history of the global warming crusade, 19 February 2010
- Dumbest headline of the week, 1 March 2010 — More by Glenn Reynolds
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