Monday, June 22, 2009

Check out the LA Times Editorial 6/22/09

This morning in the Los Angeles Times there was a good editorial about the problems behind healthcare reform and expenditures, that have arisen even before the ink on the drafts of the 5 healthcare bills have dried. Even though the problems have been widely discussed of late, the editorial does a great job of explaining each one, instead of trying to find answers.,0,3504596.story

As we’ve found in our own lives, as basic as it sounds, taking the time to identify the actual problem is a much better start than just jumping in and trying to solve them. As founders of the Next of Kin Education Project (, our attention was immediately drawn to the paragraphs on Quality of Care. According to the editorial:

“Dedicating so much of the economy to healthcare might be acceptable if the investment yielded the world's best results, but it doesn't. Despite spending far more per person and a far higher percentage of GDP than any other country, the U.S. lags behind other industrialized nations on most measurements of healthcare. These include higher death rates from medical errors and treatable diseases, and higher infant mortality, according to a 2006 study by the Commonwealth Fund. Defenders of the U.S. system often argue that patients in other countries face lengthy delays for care, especially from specialists or for elective surgeries. But the Commonwealth Fund study found that, compared with several other countries, "U.S. patients are notably less likely to have rapid (same- or next-day) access to physicians when sick or to find it easy to get care after hours without going to the emergency room."Even within the United States, there seems to be only a tenuous relationship between the amount of money spent on patients and the quality of care. Researchers at Dartmouth Medical School have looked at Medicare spending across the country, finding wide variation in the cost -- and, frequently, better results in regions where spending was lower. Nor have U.S. healthcare providers coordinated care for individual patients or helped them manage chronic diseases as well as their counterparts in other industrialized nations. Part of the problem is the slow, haphazard adoption of information technology, including digitized medical records, to guide patient care and prevent errors. Studies by the Rand Corp. in 2003 and 2006 found that U.S. patients receive the right care only about 55% of the time, and that the problem affects rich and poor, insured and uninsured alike.”

I’d like to add one more point to the discussion. Healthcare spending is often wasted on the repercussions of medical errors and simple mistakes that can easily be prevented. We had an experience in our family where my grandmother was hospitalized, yet the hospital didn’t call my mother and I, to tell us that she had fallen at home and had been admitted. By the time we found out, she'd been given drugs that interacted with those she was prescribed simply because they didn't call us to get a medical history.

Not only did that mistake end up costing Grandma her life, and us the chance to get to her bedside before her death, it cost the hospital itself unnecessary liability and the increased costs of intensive and cardiac care that would not have been necessary if one simple phone call had been made. In her memory, our solution was to create a next of kin notification training program that hospitals across the country are now adopting. But when problems that simple are identified, additional training, is a simple yet effective way of stemming unnecessary cost drains on our healthcare system.