Medical Errors Are Number 3 Cause of US Deaths, Researchers Say (npr.org) 247
An anonymous reader quotes a report from NPR: A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third-leading cause of death in the United States -- and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye. The authors, led by Johns Hopkins surgeon Dr. Martin Makary, call for changes in death certificates to better tabulate fatal lapses in care. In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death. Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. On the CDC's official list, that would rank just behind heart disease and cancer, which each took about 600,000 lives in 2014, and in front of respiratory disease, which caused about 150,000 deaths. Medical mistakes that can lead to death range from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive. The study was published Tuesday in The BMJ, formerly the British Medical Journal.
Best Care in the World! (Score:5, Insightful)
We spend so much money for so little.
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We have so much faith in our medical system, but not every doctor is great and our health care system gives little incentive for meaningful results. The best medical results I hear about are from docs who take responsibility for their own care.
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The plague doesn't avoid doctors, you idiot.
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One of the problems with healthcare is, the average doctor is mediocre. Half of them are below average!
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Which is why he put in the line about being banned from all insurance providers.
If you can't get coverage then they can't tax you for it. Yes, it's a tax.
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The emergency department is efficient because that's where people without insurance get their care.
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Lots of people like to point to the numbers instead of actually looking at the reasons and being honest. The medical professionals are also more willing to try riskier and newer things than they are in other countries. We also report our medical data differently than other countries.
That is not to say that it is good, that it is better, or that it is ideal but it is to say that it's a bit disingenuous to ignore the reality and just point to the numbers as if they alone are significant. Juxtaposition is also
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And why? Because of greedy pharma, hospitals and lawyers. This monopoly needs to be busted.
Re:Best Care in the World! (Score:5, Insightful)
You missed the cause of all of this: no nationalized healthcare.
A single-buyer can negotiate prices from Big Pharma and limit their meddling with doctors and practices. Government-run hospitals don't have to spend money on marketing and all sorts of things traditionally associated with car dealerships rather than treating people. Government-run healthcare can include a reasonable arbitration system for dealing with claims of medical malpractice, etc. Plus if people aren't paying out of pocket for treatment, there are far fewer financial issues relating to needing extra/different treatment. No more government picking up the massively-inflated bill for someone who wandered in to an ER with holes in them.
This is hardly esoteric - just look at the other developed countries with comparable/better healthcare systems, and see how much they actually cost. This experiment has been running for decades, and the outcome is staggering.
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You missed the cause of all of this: no nationalized healthcare
There is that - I agree wholeheartedly. There is also some incompetency involved. Some years back my mother in law had a TIA - a mini stroke. At the hospital she noted that she was peeing a lot. While talking with the doctor, the doctor expressed concern that my MIL's potassium level was low. I noted that they probably administered a powerful diuretic, because she was urinating a lot, and that was likely the cause of the low potassium level. The number of expressions that flew across the doctor's face were
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So, you want to bring the best parts of the DMV and the IRS to health care. That should turn out great.
Instead of having to choose between Android and Apple, maybe we need a nationalized smart phone designed by a committee.
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No, he wants to bring the best part of Medicaid to the rest of healthcare. You know, the most efficiently run insurance system in the country (seriously, they are head-and-shoulders above any private organization by any metric). This is not about replacing who controls hospitals, or makes the drugs. It is about who pays, and thus negotiates, for these things. If you look just at drug pricing, comparing the U.S. prices to anywhere else in the world (Canada is an easy example, and hard to argue that it is a m
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Well said, and you are entirely correct.
Single-payer has advantages that private, for-profit hospitals cannot compete with. No marketing, tremendous bargaining power, and more standardized care make a huge difference. Other countries have been doing it successfully for decades, and the VA here shows it can be done.
Some things should NOT be run for profit, including health care, education, and prisons.
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"There aren't any. England? Walk into a hospital with a million euro's and say "I want a new kidney, now!" and see if you get one."
Obviously not, they'll send you to a bank getting British pounds for your Euros and even then, there's no place to pay for anything, only a counter where you _get_ money back for your transport to the hospital.
Re:Best Care in the World! (Score:5, Interesting)
My grandmother (on my mother's side) passed away about a decade ago after 'routine' heart surgery (no double or triple bipass). However it wasn't the heart surgery that got her, it was the infection after. The doctor's however had been 'confused' by her lack of progress and didn't believe she had an infection. At the same time I picked up on her having an infection after one visit and with no tests. She was never treated for an infection, though the autopsy proved that was the cause of death in the end. After that I truly understood why the US has such a high malpractice rate. The Doctor's had continued to rely on tests which told them the wrong answers and had so little time to actually see a patient that she was never treated properly.
In my own personal experience I had a diseased gall bladder since I was a teenager, however it went misdiagnosed for a decade and a half as IBS. However it finally got so bad that I couldn't function normally and for about the fifth time in my life I returned to the hospital to finally get a real explanation of what was wrong with me. When they removed my gal bladder the doctor who had performed the surgery had said it was the most diseased gal bladder he'd ever seen in a living patient.
All that money we pay for medical care seems utterly wasted between the insurance companies and the hospitals.
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And the government wants us to buy more!
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I have to admit, the credentials of the researchers notwithstanding, I find the notion that medical errors are the "third-leading cause of death" in the US is hard to swallow.
Alcohol, car accidents, heart disease, smoking, stroke, cancer....all those things kill millions. The idea that improper diagnosis and/or treatment outweighs those things just seems unrealistic to me.
US healthcare (Score:3)
Is the worst in the world. Cuba is the best, by far.
Re:US healthcare (Score:4, Informative)
Nope, Cuba is behind us.
http://thepatientfactor.com/ca... [thepatientfactor.com]
Re:US healthcare (Score:5, Insightful)
37th rank vs. 38th is hardly much to boast about though.
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Sorry typo: 37th vs. 39th. Still nothing to boast about.
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"Medical Errors" (Score:2)
Are they grouping inherent risks with medical errors?
Medicine definitely falls into the Rocket Science category of difficult.
Perspective (Score:5, Insightful)
"250,000 Americans die each year from medical errors"
Fuck fighting terrorism. This deserves more attention.
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and yet doctors sneer at you when you tell them you looked something up on the internet.
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I just give mine a fist-full of antibiotics and enough opiates to make them settle down and not worry about anything.
Yes, yes I really am a doctor.
No, I'm not a medical doctor. I prescribe four quadratic equations and tell 'em to call me in the morning.
Maybe more opiates is the answer (Score:5, Interesting)
A friend's wife is senior management with a hospital system and we were talking about some of the impossible challenges of medical care and cost.
I kind of wondered if more opiates, doled out in small doses & quantities, wasn't actually partly the answer.
1) Pacifies the hypochondriacs and people with vague and poorly defined "symptoms" who end up getting a bunch of expensive tests to rule out rare conditions they don't have. They go home, feel better from the opiates and maybe find something else to be distracted about because they feel better. Eliminates a lot of doctor time, lab time and expensive time on limited access equipment like MRIs.
2) Masks symptoms in people who have chronic conditions and have no actual cure. These people may have expensive and marginally effective therapies for what actually ails them, but quite often these are expensive drugs, demanding physical therapies or other treatments that don't much improve their actual condition or how they feel and won't cure them anyway. A lot of the time is strikes me that these people are on expensive medications with weird side effects and marginal primary effects whose principal value seems to be they aren't opiates.
OK, there would be downsides, some of these people would develop low-level habits, but that's where the small doses and quantities part comes in. Given opiates under managed conditions, most would not spiral into raging junkies and many may actually experience an improved quality of life because they *feel* better. Even if they did have low-level, maintenance habits they could be on opiates for years without any significant side effects, and as drugs they are dirt cheap.
The up side is that a lot of people who clog the medical system with non-problems and conditions that mainly need to be managed to keep them living functional lives, probably saving a bunch of money and resources for people with treatable or more life-threatening conditions.
In a way, it's kind of a rationing of medical resources but with potential state-of-mind improvement for those rationed out of the system.
Re:Perspective (Score:5, Interesting)
Not to judge, but when I was having an appendicitis and thinking it was food poison searching on the internet gave me better control of the situation than the ED Doctor. He was so excited after the CAT Scan that it actually was an appendicitis and I was going to need surgery, rather than discharging me.
Point being we all have access to different information. As a patient, I didn't know how to filter relevant from non-relevant information. My pain was somewhat asymptomatic due to another problem that I didn't fit neatly into the right box.
I have know three other people who were discharged from the ED, only to be back an hour or three later when their appendix bursts. As a patient, you need to be your own advocate. The "guess what's wrong with me"game just doesn't work.
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and yet doctors sneer at you when you tell them you looked something up on the internet.
Because the vast majority will do a simple Google search, and not do any serious homework. That doesn't mean that others won't do some significant reading, but the likelihood of you picking up more knowledge with your internet search than someone who does this fulltime with a medical degree is slim. And either way, they shouldn't sneer.
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and yet doctors sneer at you when you tell them you looked something up on the internet.
Because the vast majority will do a simple Google search, and not do any serious homework. That doesn't mean that others won't do some significant reading
Are you talking about doctors or patients here?
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Re:Perspective (Score:5, Funny)
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To be fair, many of the people dying from these medical errors are really sick, and would have soon died from something else anyway. Also, killing off old people helps keep Social Security and Medicare from going bankrupt. I am not saying killing them is a good thing, just that it is not all bad.
Some hospitals have dramatically cut medical errors using a very simple tool: Checklists [amazon.com].
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One magazine (might have been the Economist) called medical care the "least innovative industry" a few years ago. Not medical technology or medicine, both of which are making tremendous strides, but the way we organize and administer that care.
Re:Perspective (Score:4, Insightful)
What took doctors so long to follow suit?
Same reason it took pilots a long time to adopt them : Ego.
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Also the the realization that people are not built to nor adhere here the engineering specifications of an airplane. Every patient's anatomy, symptoms, disease processes etc..are relatively unique to them. There are several thing that work for checklists, but they aren't going to save the day.
Also, in some ways we are spoiled by modern medicine - what exactly is "routine" heart surgery. You have 1 pump in a system that has no backup or redundancy. How is altering that or taking it offline for repairs ever r
Re:Perspective (Score:5, Insightful)
What took doctors so long to follow suit?
Same reason it took pilots a long time to adopt them : Ego.
Most pilots I know put their ego aside when it comes to flying.
Unlike doctors, they put their own life on the line and self-conservation instincts keep them in check.
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Unfortunately, the errors often drive up costs rather than down, forcing more time in an ICU etc.
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In the sense that people should be aware of it, yes. Every trip to the doctor is a risk. Prevention is much better than any kind of medical intervention.
In the sense that these errors are avoidable, no. Medicine is intrinsically inexact and difficult.
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Burnout, Depression, Anxiety in Em Dept staff (Score:5, Informative)
When you look up the rates for problems, you see huge % of the staff have problems.
The non-stop pressure from management to work faster coupled with major decisions being made with often not enough diagnostics or time means burnout is high and part of that is the recognition they make mistakes.
A friend who works the ED noted he had an inconclusive diagnosis of a new patient and took extra time to get other tests done. He got the results and the patient was moved into the hospital and he was on to his next patient when a 'bean counter' shows up and says "We noticed you took an extra 20 minutes on your last patient. You are slowing down. etc. etc."
Then to counter the stress and sometimes double shifts, they start taking drugs.
Re:Burnout, Depression, Anxiety in Em Dept staff (Score:5, Interesting)
This is the reality of medicine in the United States these days. A doctor who must appease every patient (paying or non-paying thanks to EMTALA) as a waiter must his or her tables so that our patient satisfaction scores do not drop appreciably or else the bean counters will not be happy. if the bean counters are not happy, then you will be looking for another job.
If you want to be treated as a real patient, you better start looking for direct primary care physicians who take your money on a monthly or annual basis. In exchange they will give you their undivided attention in the form of hour long visits, communication via email, and your ability to reach them 24/7 as needed.
http://epmonthly.com/article/2... [epmonthly.com]
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I am a physician who practices in the U.S. as well, and I mirror your sentiment.
Things have really gone from bad to worse in the last five years. The number of patients we each have to see has dramatically increased, and the level of staffing is either the same as or worse than five years ago. Certainly staffing is worse than ten years ago.
I'm hoping that more money gets put into the system for physician extenders and that society as a whole realizes that the extenders are 'good enough' for the vast major
Re:Burnout, Depression, Anxiety in Em Dept staff (Score:4, Interesting)
Trax, correct me if I'm mistaken, but I think you're referring to concierge style service, no? My wife and I signed up for this kind of service about a year ago, at a cost of $2k each. It's been night and day better than my old primary care. We get same day appointments, email responses (from our doctor) to medical questions, and it included the most complete (4-5 hour) physical I've ever been through, and additional time with a personal trainer and dietitian. For me, it's been well worth the cost.
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I think that is exactly the point. It's a fixed bid type thing as opposed to T&M.
Re:Burnout, Depression, Anxiety in Em Dept staff (Score:5, Interesting)
Do you want treatment by a stressed out doctor, or no treatment at all?
False dichotomy.
There is more need than can be met by the supply of doctors.
Many other countries deal with this by having PAs and nurses handle routine cases, and only get a doctor involved if symptoms are unusual. Oh, and these countries have far lower costs and better health outcomes than America.
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Why do people keep confusing single payer with all-government medicine? The two concepts are not necessarily related.
Being able to buy medicine and contract for care in bulk saves a lot of money on marketing and distribution costs. This should be available to any mass buyer, public or private.
Not really that surprising (Score:4, Interesting)
About 7.3% of the population [cdc.gov] were hospitalized overnight or longer (23 million people).
If 250,000 of them died, then fatality rate due to medical errors is about 1.1%. Which is in line with the average error rate compounded over multiple ways in which errors could kill a hospital patient.
If you want to reduce the fatality rate, you either need to get people out of the system (e.g. autonomous cars - but they make people uncomfortable even though they're statistically safer), or implement automated checks to supplement people's work. We're already doing the latter with prescriptions - computers now automatically check for dangerous interactions between medications prescribed to the same person. More operating rooms scan all equipment used during surgery, and re-scans at the end to make sure it's all accounted for, and nothing has accidentally been left inside the patient. And some hospitals are starting to use barcode and RFID scanners to double-check that the medication being administered is the proper one for that particular patient.
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Assistive tech in the medical setting is something that really can have a positive impact. And there are so many opportunities going forward. My slight concern is that we end up pitching a clinician's opinion against some algorithm.
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An error that favours the patient would have to be something like a billing error, or perhaps a one-in-a-million case where providing the wrong treatment per our current knowledge was actually better / running the wrong test found something more important than you would have found by running the right test.
Neutral errors are, I expect, dominant. And of the negative errors, I expect many of them are not all that severe, eg. dentist's hand slips and he drops a mirror on your chin vs. dentist's hand slips and
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WTF? Do you think hospitalization is like Monopoly? "Medical Error in Your Favor, Collect 50 Hit Points!"
I was almost one of them (Score:3)
I was almost one of these statistics.
A 'pain physician' providing after-care for a skull fracture prescribed me 80 mg of straight oxycodone every three to four hours, as needed. That is over HALF A GRAM of oxycodone per day! Talk about a pain roller-coaster... My fiancee would spend the entire day watching me, just to make sure that my chest was moving. It was a deadly dose.
I went back to this bad MD, once, and she tried to place all the blame on me. "You follow what's on the label". I replied, "YOU wrote the scrip, which determined what was on the label!" This idiot was blaming me for her near-deadly error, trying to escape the risk of losing her medical license. Well, she soon got fired from a third institution within a year...
I immediately found an actual Pain Management Physician. He prescribed a 24-hour time-release oxycodone, plus a few on the side for pain-spikes. I got off of that crap in less than three months with no withdrawal issues at all.
This is just an example of how physician errors kill people.
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Oh, I forgot to mention that she was lecturing me like a school-child.
So, I had to remind her several times of my PhD in Chemistry & Physics. I also corrected her a couple of times on points of chemistry, after she lied to my face regarding basic chemistry that every physician should know---She did not enjoy that. But I did.
I told her to just write a scrip for a bucket of oxycodone -- to hold me over until I found the Real Pain Management Physician, or I would talk to her supervisor immediately. She
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Indeed. One book you may be interested in is "A leg to stand on" by the recently late Dr Oliver Sachs. He was a world leader in his field of medicine and even had a movie made about his achievements (with Robin Williams playing his role) but when he was in hospital with a broken leg he was lectured like a school-child. The bits where he got to see the doctor-patient relationship from the other side and how ridiculous it can be sometimes
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You asked her to write you a provisional certificate of money subscribed to a bank or company, entitling the holder to a formal certificate and dividends? No wonder she was confused!
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That is over HALF A GRAM of oxycodone per day! Talk about a pain roller-coaster... My fiancee would spend the entire day watching me, just to make sure that my chest was moving. It was a deadly dose.
OK, so you knew that the subscription was for a ridiculously huge amount and that it would almost certainly kill you if you took that much, and yet you took it anyways? Ya, I am with the doctor on this one. The pharmacist should of caught that, and if they did not, you should have. If you found a razor blade in a candy bard would you just assume that the candy bar makers know what they are doing, and swallow it?
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Clearly enough to get his wife to stand over his bed for the entire day. Even if he was too dazed to understand the concept that taking so much medication that your lungs will likely stop functioning is bad, than you think his wife could of figured that aspect out.
Straw meet camel's back (Score:2)
Facing facts (Score:5, Insightful)
I work for the single payer health care system of Finland on the administrative side (IT & stats related) and partly because of that, health care has always been one of my favorite subjects to discuss. However something I've noticed when talking with Americans about it is a certain type of illusion/fallacy that many seem to be under, which is that because you pay so much for it, it must be the best system out there.
Just yesterday I had a lengthy conversation on fb about the problems with a purely insurance based model, and even though I tried linking a couple of studies as to the amount of deaths caused by lack of access due to costs, I was labeled a liar because apparently 'everyone in the US now has the opportunity to get health insurance" (a direct quote from him) despite the fact that it's known that there are people who do not meet the criteria under the ACA to qualify for the cheaper/low income insurances whilist also not being able to afford a private one AND that there are also still issues with insurances not covering certain operations. Don't get me wrong, the ACA was a small step in a better direction but the gutting of the public option for all sort of killed the best potential about it. Yet my counterpart in said discussion was adamantly of the opinion that anyone who dies in the US for not getting treatment dies purely because he/she didn't bother to get insurance and hence the system is not to blame.
You've plenty of things where you lead the world, and the medical R & D and high level expertise in the US is unparalleled. However I do wish that more Americans would realize how much you're paying for simple base level health care. I've seen hospital invoices from the states where simple over the counter ibuprofen pills are billed at several dollars a piece. That's a a margin of several thousand percentages. The fact that this is allowed is unfathomable to me. Even if one is of the opinion that a life-saving basic service should be allowed to remain a profit-driven business, having no controls on pricing combined with the insurance lobby has created a gigantic price bubble. This is why the US spends combined (private and tax spending) the most money on the planet per capita on health care, and still the results are far from the top. (Source [wikipedia.org] (wiki))
The profit motive needs to be either removed or curtailed heavily, so that more of the money that's spent can actually be used to improve the level of care and oversight, instead of just increasing the profits of the insurance giants and private hospitals.
We get comparable treatment results and universal coverage (at about 3500 dollars a year per capita) than the US does when it comes to life expectancy, cancer survival rates (in fact, with certain types of cancers we're ahead of the US even) and so on. You spend more than DOUBLE that (8700 dollars according to OECD when totaling private and public spending, though interestingly, the CDC [cdc.gov] puts this figure even higher at 9500) and the massive increase in spending doesn't get you the kind of results that such an investment should.
You could and should easily be able to arrange for the hands down best universal health care system without spending a dime more than you already are. Don't spend more, spend smarter.
Just my 2 cents, feel free to mod me down for being a socialist scum now.
Re:Facing facts (Score:5, Insightful)
America doesn't understand that certain things everyone has to pay for, and then everyone benefits from.
Police and other emergency services
Street lighting and road maintenance.
Healthcare.
Why anyone would want to involve a third-party insurance company into their payment of such things, or be able to "opt-out" of any of those, I can't fathom. You can't just say "Oh, I'll save a few dollars and the police won't be available to me". That's ridiculous and dangerous and burdensome.
Same with healthcare. Provide basic healthcare for everyone. If you want, provide "above-and-beyond" healthcare that can be insured for. Like almost every other first-world country that provide "state" and "private" healthcare side by side.
But if you need to pay into a fund just to ensure that if you accidentally break your leg you're not going to be put out on the streets because you can't work and/or pay the medical bills, then that fund needs to be centralised, non-profit and available to all. Not some private stash.
You honestly might as well not have any healthcare at all, and just pay for the operations YOU need. It's honestly how it works out, but with a 50% profit for the insurers thrown in for good measure. At least without the insurers the poor would still die, the sick would still have to fund an unfair proportion according to how sick they are, but the insurers wouldn't be taking their cut.
The biggest problem with America is that it doesn't see outside its own borders. The next is that, because of that, it thinks it's the best at everything. Sure, you're the best. If you never look at anyone else, ever. But the second you start to compare, it all falls apart.
Maybe that's why they never do that comparison.
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There was an article in the New England Journal of Medicine back in 2003 that showed that the difference in spending between Canada and the US came down basically to the additional admin costs in the US:
http://www.nejm.org/doi/full/1... [nejm.org]
In fact it's unbelievable how much the admin costs are. It's interesting looking at those numbers and the ones you quoted, which if accurate surely show costs are increasing far faster than the rate of inflation.
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Depends on how you look at it. While the average household income in the US is significantly higher, it is top-biased. The average income for the bottom 20% is higher in Finland at $13253/year vs $11194/year in the US [oecdbetterlifeindex.org]. Suffice it to say that it is not the top 20% who need universal health care.
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We're talking about medians; they are not "top biased".
I'm sorry, but you don't understand the numbers you're quoting: that's not "average income", it's "disposable income", and it excludes "in-kind benefits".
In any ca
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Of course the spending is massive, because currently the cost of procedures is massively inflated. My whole point is that in the current american model the pricing of standard procedures is way high precisely because the hospitals are in it to make profit and they have fairly free reign to set the prices as the mone
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You aren't listening. The US has a public system, a system that already has eliminated insurance companies, and that already has controlled prices. And that public system is horrifically expensive. The fact that the massive public health care system in the US is unable to achieve the kind of price controls that the Finnish
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If you look at the numbers spent per patient, both Medicare and Medicaid are cheaper than private alternatives already. So your point is wrong: the costs of the system to the state have increased as people enrolled in these programs have increased, but the cost per member when compared to private insurers is still cheaper.
Point being, if you replaced medicare and medicaid with some type of single public insurance that would still be free/cheap for people of l
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You're thinking of healthcare prices as cost+profit, and assume that if you deliver health care via a non-profit entity, prices will drop to cost. That's not how economics works. The difference between the Finnish and the US system isn't profits. In fact, most of the differences are simply cons
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Healthcare scales with population size nicely, as the people it serves pay for it. You can't pull the usual "but we so biiiig!" argument we see when discussing shitty broadband, as it simply does not apply. And "monoculture"? What's that supposed to mean? Can you elucidate as to: a. what that is, and b. how it matters? Not to mention "ass end of Europe" - what does that have to do with anything, apart from you showing your emotional side and trying to stave off this attack on your beloved, sacred homel
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Small, ethnically homogeneous countries are quite different on many dimensions from larger and more ethnically diverse countries.
It refers to the fact that Finland's geographic situation and history is rather exceptional and very different from the US. It's also expresses a certain disapproval for how Finland has used its position in the past.
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Erm... the policies of the last three cabinets have been far from socialistic. They've sold of core infrastructure as you mentioned to foreign capital investment firms (not a socialist policy), they've cut the corporate tax rate by quite a huge chunk in the false hope that that would have created more jobs, (which it didn't) and now they're cutting fr
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The US still has the material wealth to pretend to be able to pay it - we've loads of national resources and the military might to silence critics if need be. Finland hasn't got that. I do seem to recall that Finland now has an oil industry but that it's not actually their oil - it's just getting refined there and it comes from Norway and Russia. So, there's that but they tell me oil's going to keep having production issues and the usage will continue to decrease.
Maybe that's what they're suggesting?
But yea
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There are problems in the current system here as well, but this is not representative of them for several reasons. If you have acute symptoms you do not go to a health centre, you go directly to an ER. Something like a blood clot which causes clear and immediate symptoms like possible slurring of speech, impeded movement ie. these are things for which you cal
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If I may...
While it's great that you're close and can give personal anecdotes and even cite select figures, has it occurred to you that you're incapable of being objective? I'll also add that the news is generally only going to show you the bad because the normal, every-day, fairly standard stuff isn't really that interesting. It doesn't get eyeballs, excitement, or result in charged emotions.
Get out, travel the world. Most of all, visit America - if you want. Spend some time and actually meet some people.
L
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Yes and I'm very aware that obviously I have certain biases, as do most people, I try my best to control them, albeit not always successfully.
Oh I know, and I wasn't saying that it's bad. It's quite good, even top class in many ways, my gripe is just that from my perspective as someone who knows something about the cost-structure of health care the system is just inefficient at produc
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Yes, but I wasn't talking about eliminating profit motives from manufacturers of medical tech. We still buy and use american medical tech here, and the companies manufacturing those make profit on them.
The point is, if you install something like a pacer on someone of course the pacer has a margin on it and is sold for profit. In the US however, on top of this the hospital then adds its own margin and finally after the
Doctors think they're smart (Score:3)
And hey, they're right, but they're not infallible.
Neither are computers, but they're closer.
Right now, expert systems are ALREADY better than doctors at making diagnoses. The only part they can't handle is doing the actual inspection and questioning of the patient, and that part is coming fast.
What will prevent us from using them? The AMA. They lobby to make it harder to become a doctor, in order to keep down the supply of health care professionals. The AMA is evil, and must be destroyed.
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And hey, they're right, but they're not infallible.
Yes and no. I've dated two doctors and a PA. One doctor was a surgeon and the other handled critical care at an ICU. About half of the doctors I met during that time were idiots - I would feel more comfortable making my own medical choices over having them make any. I'd let the nurse make decisions over some of those doctors. The PA knew her shit better than a lot of the doctors I met during the time I dated those three women. All of her doctor friends were geniuses. In my experience there are a lot
Just another line item... (Score:2)
Statistics (Score:2)
If medicine could treat any condition ... (Score:2)
Sooooooo.. where do I pick up my ammo? (Score:2)
So statistically speaking, I'm safer around guns than doctors?
Oblig Redd Foxx quote (Score:3)
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Yes, but that something shouldn't be medical errors, especially in the most expensive healthcare system in the world.
It also shouldn't be choking on unpeeled pineapples.
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One should ask where is all the money going. It isn't going to the doctors. It is going to the parasitic medical establishment. e.g. the lawyers, the administrators, the FDA, the AMA, the insurance companies, etc.
If you want to solve the health care crisis:
1) eliminate the health care companies. We need direct pay!
2) eliminate the AMA. There are not enough doctors. Patients are dying in the emergency room waiting to be seen.
3) kill all malpractice lawyers. A doctor practising in good faith should nev
Simple but wrong ideas (Score:5, Insightful)
1) eliminate the health care companies. We need direct pay!
The costs are too large to not have either insurance companies or the government involved. The majority of Americans would be bankrupted by a single major surgery and that would be true even if healthcare costs weren't completely out of hand.
2) eliminate the AMA. There are not enough doctors. Patients are dying in the emergency room waiting to be seen.
First off, the AMA has nothing to do with the quantity of doctors. They do not directly control the supply of doctors and in fact the number of medical schools has been increasing in the last decade. Second, there is no epidemic of patients "dying in the ER waiting to be seen". Emergency Departments (they aren't typically called Emergency Rooms because - well, they're not a room) are actually quite good at triaging patients and taking care of those in greatest need first. There is however the problem of people coming to the Emergency Department for conditions that clearly are NOT emergencies because our screwed up system gives them no other options.
3) kill all malpractice lawyers. A doctor practising in good faith should never ever be sued
And exactly how do you plan to distinguish between doctors acting in good faith and those that aren't? While the vast majority of doctors are good, hard working people who care greatly about their patients, there are exceptions. Furthermore there sometimes are doctors of questionable competence. An incompetent person acting in good faith is just as dangerous as a competent person acting in bad faith. Either one is dangerous and there has to be a mechanism for dealing with them.
4) curtail the power of the FDA. The FDA does more harm than good.
Spare me. While nobody would argue that the FDA is without problems, the FDA is one of the most successful and vital government organizations we have. Their prime directive is to actually make sure that medical treatments actually work before they can be sold to the public. Without the FDA you would have absurd levels of quackery and fake "treatments" being sold to people who don't know any better. One merely has to look at the market for "alternative medicine" (particularly homeopathy) to see what would happen. You know what they call alternative medicine that is proven to work? Medicine.
There is no difference between big government and big corporations. You do not want you health care being run by the insurance companies or the government.
If you think there is no difference between government and business you don't understand either one adequately. There are no other payment options available without involving either insurance or government. Most countries have (sensibly) picked the government option since EVERYONE needs health care at some point but insurance can be made to work. But unless you are privately wealthy there aren't any third options. Your notion of everyone paying directly is pure fantasy because the costs are and will remain too high to be feasible.
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I'm mostly with you on the malpractice lawyers, but tell me, should my mother pay for her own care, when she got her cervix perforated in a doctor's office? What about her lost time at work, and any pain & suffering, or should she just suck it up?
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"3) kill all malpractice lawyers. A doctor practising in good faith should never ever be sued"
Until you come across that one flagrant case of malpractice that you really want to pursue.
Malpractice actions are civil suits, and reform of this whole area of law would be a better solution. My reform would be to eliminate the procedural advantages to the lawyer lobby that civil procedure has over the much stiffer standards of criminal procedure. Require a unanimous jury vote for the plaintiff in civil trials, ra
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"4) curtail the power of the FDA. The FDA does more harm than good."
The FDA performs the vital function of getting new compounds and devices tested, but I would strip it of the power to keep products off the market. Let "FDA Approved" be taken as a gold standard of quality for those who insist on it, while allowing patients to try drugs that are still in the testing process if they and their doctors want to take the risk. And for approved medications, putting an end to the FDA's ability to support the pharm
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Fully on-board with 1,2, and 4. 3 is more complicated. First, not all doctors are practicing in good faith and those who aren't should be sued. Second, we need to solve the lack of a proper social safety net that leads patients left with a disability to sue out of desperation for a way to live. It's notable that states that imposed limits on malpractice settlements as part of tort reform have seen no improvements in the cost or quality of healthcare. Cover those issues somehow and I'll sign off on 3 as well
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It's after eliminating cancer and coronary disease. It's beating respiratory disease.
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No, that's not even remotely what this is about. It doesn't sound like you've even read the title on the summary, let alone the story itself.
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Bernie wants to make all of US health care as efficient as the VA and Medicare, meaning he will about triple the cost per patient. And doctors and hospitals will love him for it.
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Nobody is going to incriminate themselves when they know that doing so is likely going to result in a malpractice suit, or higher payout if one was already started.
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> Until patient outcome has as much influence on medical practitioner compensation as mere throughput there will be no incentive for clinicians to up their game.
Then no doctors will undertake the riskier surgeries that are difficult and have a lower chance of success. Yup... Sounds like a good plan to me. Let's run with it!
(That's also a part of why the numbers are as high as they are. Yeah, you make more mistakes when you try difficult and new things. Imagine that.)
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we do have the worlds best doctors.. we just happen to have some of the worlds worst too :D