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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.