Envisioning 2.0

In a scathing report, Consumers Union estimates that more than 1 million people have died over the last decade due to preventable medical harm.  The newly released report, To Err is Human — To Delay is Deadly,” suggests that since the Institute of Medicine’s influential 1999 report on medical errors, “98,000 people die each year needlessly because of preventable medical harm, including health
care-acquired infections. Ten years after To Err is Human, we have no national entity comprehensively tracking patient safety events or progress.”

While some hospitals have made great strides in the effort to reduce medical errors and the U.S. government has taken steps to limit reimbursement for preventable medical events, the nation still has a long way to go.  Consumers Union is recommending that we develop a nationsl system for tracking medical errors.  The organization suggests that concerns about malpractice lawsuits due to reports of medical harm may be overstated.

To learn more about the Consumer Union report, please click here.

Over the past few months people on both sides of the ideological divide have been debating whether comparative effectiveness – relying on clinical studies to determine whether a medical intervention is more effective than another – is appropriate and can help reduce rising health expenditures.

This week’s edition of the Health Wonk Review features an article by BNet’s Ken Terry in which he says both sides are being disingenuous.  Using the example of virtual colonoscopies he writes:

“[M]edical ‘advances’ of lesser value will continue to be advocated by those who profit from them. When, as a result of comparative effectiveness research, payers have to decide whether to cover a particular type of back operation that has not helped patients any more than conservative therapy, they will undoubtedly find themselves locked in a political fight with surgeons who stand to lose income if nobody can afford the procedure. So we should not expect too much from comparative effectiveness research, as it’s now conceived.”

Terry has a very interesting perspective on the comparative effectiveness question.  When a procedure or medication is less painful or provides a better quality of life should that be considered when deciding which one is worth paying for?  In addition, as I discussed a few weeks ago, will comparative effectiveness research be doomed from the outset if we continue to conduct studies that do not include people from varying racial and ethnic backgrounds?

Clearly, there are no simple answers to this debate.  However, we are clearly benefiting from having a broad conversation about the benefits, drawbacks and scope of comparative effectiveness research.