Medical Mutual Insurance Company of Maine

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Commentary: Reducing Medical Errors is One Part of Healthcare Reform We Can All Impact

By Terrance J. Sheehan, MD
President & CEO

"Our job, as I see it, is to help as much as possible by providing leadership in controlling these costs... associated with medical errors."

President Obama has made healthcare reform one of his highest priorities, recognizing that our current system is too costly and unsustainable. Consider that in 2009, Medicare expenditures will exceed $400 billion representing 13% of the federal budget and about one-fifth of all United States’ expenditures on healthcare which totaled $2.2 trillion or 16% of the Gross Domestic Product (GDP) in 2007. It is predicted to rise to 25% of the GDP in 2025.

There is consensus from business, labor, consumer groups, and much of the healthcare industry that we are in need of fundamental change to reduce the costs, improve quality and patient safety, and extend coverage to the 45 million people without health insurance.

Providing coverage for all United States’ citizens could easily cost $1 trillion over the next 10 years. Obama’s health care reform plan calculates that twothirds of this cost would be covered by raising taxes on people who earn over $250,000 per year and by cuts to existing government healthcare spending, primarily Medicare. Part of this last initiative includes not paying for reasonably preventable medical errors and paying only for the most effective care and other payfor- performance initiatives.

Our job, as I see it, is to help as much as possible by providing leadership in controlling these costs. We have demonstrated we can decrease the costs associated with medical errors by developing and following guidelines designed to prevent such adverse outcomes. These efforts in patient safety and quality improvement are related, in part, to the significant decrease in Medical Mutual’s claims over the past five five years (2004-2008) leading to the payment of dividends and rate stabilization and rate decreases in some areas. This good news in claims frequency continued in January and February 2009.

The lead article in the February 26, 2009, New England Journal of Medicine by Elliot Fisher, et al, from Dartmouth Medical School discusses the significant variability in Medicare costs by service area throughout the United States for what appears to be similar outcomes. Small, realistic improvements by higher cost areas would lead to large overall savings. The authors suggest we focus on current areas of overspending which includes overuse of hospitals and unnecessary visits, consultations, tests and minor procedures to bend the cost curve.

With the enormous budget deficit and our current economic recession, it is doubtful universal healthcare will be accomplished in the near future. However, efforts by each hospital and each physician to slow the grow of healthcare costs can make a difference.