This Site Has Moved
The posts found here are still available for archival purposes and to avoid broken links, but comments are now turned off and there will be no future updates. For all the latest from New America, please go to www.NewAmerica.net
Health Policy Facts
Upcoming Events
Recent Events:
To see a webcast of this event click here
The Wireless Future of Health IT
For a summary of this event click here
New Health Insurance Marketplace
For a summary of this event click here
To see a webcast of this event click here
For previous events click here
Health Policy Links
Topics
User login
QUALITY: A Reform Issue for all Americans
Quality is too often Jan in the Brady Bunch of health reform issues. The media and public tend to focus on the Marcias of cost and the Cindys of coverage. But New America's Health Policy Program has been dedicated to promoting an informed discussion of the entire family of issues. Today's event (video here) helpedto illustrate that improving quality must be central to any sustainable health reform.
Christine Bechtel, Vice President of the National Partnership for Women and Families, began the discussion with a broad overview about why we care about quality and what we can do about it. Bechtel noted that we spend nearly $1.3 trillion dollars a year on health care, of which nearly 30 percent is wasted on poor-quality care. Medical errors are the eighth leading cause of death in the U.S. and, in general, patients have only a 50 percent chance of receiving the right care. Bechtel stressed the fact that issues of cost, coverage and quality are fundamentally related and must be addressed as a package.
From system overview, the discussion turned to the view from our nation's emergency rooms. Brent Asplin, MD, head of the ED at Regions Hospital, described the ER as a bellwether for problems of quality and access seen across our health care system. An expert in managing and improving patient flow, Asplin suggested that it is costing more money to ignore the problem than it would to fix it. He advocated a "Willie Sutton" approach that would focus quality improvements on the where the money is such as the one percent of patients who make up 30 percent of the costs. (We found Asplin's comments on how the shortage of psychiatric beds contributes to ER boarding particularly intriguing and will write more on it next week).
Next, Marsha Regenstein, PhD, MCP, from George Washington's School of Public Health, examined the issue of disparities in health care, which she noted exist even after controlling for income and access. You can't manage what you don't measure, and so, Regenstein described the success of two programs using a quality collaborative model to address disparities in cardiac care and language services.
New America's Guy Clifton, MD closed the discussion by laying out a "roadmap to value" in health care. Clifton laid out the perverse incentives of fee-for-service medicine, noting that hospitals that "do that right thing" to improve patient care, end up losing money. He argued that fundamental change would require establishing benchmarks for quality, determining the best process of care, and sharing the savings from high value care with efficient providers.
Common to all presentations was a sense of how issues of quality relate to our health care system as a whole. Unlike TVLand, the real world of health reform isn't just about Marcia, Marcia, Marcia. It's about cost, coverage, and quality, and finding a solution that addresses all three issues in a comprehensive and sustainable manner.
- Login to post comments
Poor healthcare in America
I believe with All of my experience, that the quality of healthcare in the U. S. is much worse than your article depicts. I don't even believe as stated, that the chances of being diagnosed properly are the 'coin toss' of 50/50. In 2005 there was a study that indicated on the positive side, that there were 98,000, iatrogenic deaths in our country alone. These are deaths that were preventable, had there been skilled diognisticians and 'professional' healthcare. That is the figure for ONLY the U.S.! The estimates are, & these studies showed, on the low side. I had a preventable ,treatable illness, that was diagnosed finally in 2006, after 35 ye4ars of blatant symptoms! The diagnosis of primary parathyroid hyperplasia has become, due to the ineptness of the 'physicians' severe, with complications, that did NOT have to beI In 1987 at the age of 33 and after several fractures from the age of 29 to that date It was discovered that I had osteoporosis. In 2006 after reviewing the report that had been sent to the doctor in 1987, it said CHECK PARATHYROID. I never knew! I had asked repeatedly Why I had the disorder at such a young age? No one cared and instead passed me off from physician to psychiatrist, doing many ineffective CAT scans, MRIs etc. I also at the age 0f 19 while pregnant with mu first child had toxenia and thrush, My teeth began breaking off with NO decay. I had urinary retention, stomach pain and constipation, for the first time in my life. I suffered severe post partum depression and became a high risk pregnacy with ea. of the next4 live births and the eight interspersed misscarriages. At first they said it was'idiopathic'. They didn't know why I was swelling and why I had stomach pain, bone pain, kidney pain, ulcers multiple fracctures. My 4th child almost died.He was an abrution and a preemie with an APGAR of 2. I had several seizures during the delivery. I had 'nervous breakdowns' after each of the 13 pregnancies 5 of which produced my beloved offspring(they too have illnesses related to MENS1). I was sent to psychologist for the kidney pain. I was told that I was going through early menoppause with the 4th child. Actuality I was pregnant I discovered in my 5th month. Thank God, the doctor was off the day my physical therapist took me into the doctors office. He had not done any type of test to confirm I was, or was not pregnant, nor a test for menopause. I had been irregular and without menstral periods for most of the years following the birth of my first child. I was mislabled , maligned, lied about in records that too were falsified, After the birth of my 5th child it was discovered that I had 60 percent remaining function in my kidneys and that I had been born with a condition called sponge kidney( I am just giving a sm amt of my experiences). I was in my mid 30's by that time. Spokane Wa. was where I was born, it is also the place where this farce of 'medical rape of spirit and soul, along with severe abuse by apathetic medical personel took place, for over 35 years! I am now in 4th stage renal failure. My kidneys are so packed with calcium stones that they call them calcified. I have had 25 surgeries done on my pancreas alone. I had to go to Seattle to have these done! I did research in 2005 to discover why all these issues with calcium metabolism were affecting me! These 'piss poor' doctors, in Spokane, had the head of the nuclear medicine at Inland Imaging do my sestamibi. He assured me, it would be accurate, because he, the dept. head was doing the testing himself(scary isn't it). It wasn't accurate at all! They were ready to blame the disorder on my kidney failure. He said all 4 glands were fine! The residency program here, called a endocrine doctor and called a kidney doctor(curbside consultation). I never saw either of these Dr's! They concurred that I had secondary parathyroid problems caused by my kidney failure. I was pissed! I phoned the COMPETANT Doctor in Seattle whon was to see me for my 18th stone removal procedure for the inumerable stones he found in my pancreas, after the doctors here decided that I was a hard core alcoholic. Can You Begin to Imagine the pain I was in??? Kidney stones, Pancreatic stones and many(over 50) hospitalizations in Spokane since 1998 for pancreatic pain and renal colic, to include my kidney's failing from stone blockages, PLEASE IMAGINE!!! I went to Seattle and appx 6 weeks after the doctors here wrongly pushed me aside AGAIN without proper care, nor humanity, those Seattle doctors were removing ALL but 1/3 of my primary chief cell hyperplasiac parathyroids. I slept through a whole night for the first time in over 25 years! The Spokane doctors, are still treating me as though I am just a malingerer. They have since this past february put me on 4 different medications that caused 'insults', overdosage to my kidneys. The neph Dr. followed these with a medication that I have been shown to be allergic to since I was in my 20's. NOPE, Those numbers of 30 percent error and 50/50 are erroneous! I saw over 150 doctors in the Spokane area. I am a fighter ! I look up[ everything they tell me to do. I am my best advocate. I am being punished for my self advocacy! I will never give up!!!! I also suffered from psychosis after many years, in parrt from the heavy narcotics they pumped me full of in the hospitals. I have lost most of my function from RTHE ABUSE of power from bad doctors, whom I think meant to DO ME HARM. The psychosis was both drug induce and too a common complication of parathyroid disease called parathyroid psychosis, couple that with the drug induced pschisis that these doctors created in me and the calcium plaque that is throughout my CNS and everywher that my blood circulated. BAD MEDICAL(medicine) PRACTICE is what has made my life a 'living HELL'It is shortened by These evil, self regulating criminals. I absolutely am a Blessed woman that there are quality, conscienable doctors , even here. Thier being allowed the poiwer and the ability to ruin lives is indescribably evil and wrong. No, I have been blessed with a great , curious nature. How many have passed long since, that TRUSTED these doctors of Death? One on these physicians is in charge of a pilot program throughout the U.S. His program is being adopted as a 'model residency program' Be Afraid...Someone you LOVE will be affected!