THE Institute of Medicine (IOM) has been claiming for almost a decade that as many as 98,000 Americans are killed by medical errors every year. This is based on 173 deaths in the Harvard Medical Practice study and extrapolating to the entire U.S. population.

Bill Waters lll, M.D., writes, (Few) “people actually read the original 200-plus-page IOM report. I did. There were 45 references but they only used 3 studies all back in the 70s and 80s. One was done by librarians, another by administrative nurses and overseen by a medical student, and the third by clerical personnel, reviewed by two doctors. These deaths, dubiously attributed to errors, were then summarily extrapolated to the entire population and rushed to the headlines. Many people have detected this abrogation of scientific responsibility but only the original report has been touted.”

The IOM’s proposed solution was electronic records with constant surveillance of compliance with government-approved protocols. The IOM claimed that its methods could reduce errors by 50% over 5 years.

The IOM’s definition of error, the assumption that a death was a result of the error and would not have occurred anyway, and its guesstimate of the number of deaths all lack independent confirmation. The IOM number is three to seven times higher than a 1998 estimate by the National Safety Council.

Although the IOM analysis is uncritically accepted by the AMA and other influential bodies, there is no evidence at all that the proposed solutions would result in any improvement in mortality or other patient outcome measurements. More likely results are:

Choice of therapies not embraced by mainstream medicine would be much curtailed. Nutritional approaches, long-term antibiotics for Lyme disease, chelation, hyperbaric oxygenation, acupuncture, prolotherapy, treatment for multiple chemical sensitivities, and other innovative, nonstandard, or “alternative” modalities could become unavailable.

Intensified oversight and rigid protocols might make physicians even less likely to provide adequate relief for chronic pain. National electronic databases of prescription drugs would facilitate stigmatizing patients who use controlled substances whether for pain or mental health reasons.

Patients’ freedom to decline “recommended” therapy-such as vaccines and psychotropic drugs-would be threatened as doctors feared being penalized as “outliers.”

“Recommended” therapy has possibly done more harm than medical errors and more rapid and widespread adoption could amplify the harm resulting from a misdirected “guideline.” For example, more than 50,000 individuals are estimated to have died from encainide (Enkaid) and flecainide (Tambocor), used as directed to treat abnormal heart rhythms, before their adverse effects were recognized (Kilo CM, Larson EB. Exploring the harmful effects of health care. JAMA 2009;302:89-91). A trial of aggressive blood sugar control was stopped because the “common wisdom” was apparently wrong: more patients died from the “improved” treatment (Couzin J. Deaths in diabetes trial challenge a long-held theory. Science 2008;319:884-885).

Guidelines focused on cost control would deprive patients of newer, more effective drugs. Oncologist Karol Sikora states that thousands of premature deaths result from the British National Health Service’s restrictions on new drugs through its National Institute of Clinical Excellence (NICE) (Union Leader 5/12/09).

So lets not forget that the IOM was then, and is now, in bed with the government and their goals. The same pungent study done under the name of a rose would not smell so sweet to the media and not be immediately plucked by the press for sensational dissemination. As for the AMA – “ditto.”

http://www.jewishworldreview.com/0809/medicine.men082109.php3

Health Care Fit for Animals

A most interesting and insightful article and op ed by Nicholas Kristof of the New York Times

Is it accurate and insightful or just slighted propaganda ?
The analogy of the  lines and lines of would be ( or denied ) patients at a Tennessee fair grounds – waiting to be assessed or treated is certainly a stark monument to the tales of American private health care – certainly when one invokes the proof source of the Micheal Moore landmark film Sikko, yet one wonders as well at the rigid and self serving bureaucracies of the medical care systems of such countries with  “socialized “  or state run medical care systems – such as Canada or Britain who would downright deny and forbid these patients to have any alternative health care by any means.  Indeed “private ” operations might well be shut down , or worse their professionals chastised and punished by any of a number of means.

The expression in the former Communist Soviet Unions was “They pretend to pay us …. we pretend to work”  along with the maxim everyone had a job but no one could eat ( properly).   That was except for the Communist party bosses.

Opponents suggest that a “government takeover” of health care will be a milestone on the road to “socialized medicine,” and when he hears those terms, Wendell Potter cringes. He’s embarrassed that opponents are using a playbook that he helped devise.

“Over the years I helped craft this messaging and deliver it,” he noted.

Mr. Potter was an executive in the health insurance industry for nearly 20 years before his conscience got the better of him. He served as head of corporate communications for Humana and then for Cigna.

He flew in corporate jets to industry meetings to plan how to block health reform, he says. He rode in limousines to confabs to concoct messaging to scare the public about reform. But in his heart, he began to have doubts as the business model for insurance evolved in recent years from spreading risk to dumping the risky.

Then in 2007 Mr. Potter attended a premiere of “Sicko,” Michael Moore’s excoriating film about the American health care system. Mr. Potter was taking notes so that he could prepare a propaganda counterblast — but he found himself agreeing with a great deal of the film.

A month later, Mr. Potter was back home in Tennessee, visiting his parents, and dropped in on a three-day charity program at a county fairgrounds to provide medical care for patients who could not afford doctors. Long lines of people were waiting in the rain, and patients were being examined and treated in public in stalls intended for livestock.

“It was a life-changing event to witness that,” he remembered. Increasingly, he found himself despising himself for helping block health reforms. “It sounds hokey, but I would look in the mirror and think, how did I get into this?”

Mr. Potter loved his office, his executive salary, his bonus, his stock options. “How can I walk away from a job that pays me so well?” he wondered. But at the age of 56, he announced his retirement and left Cigna last year.

This year, he went public with his concerns, testifying before a Senate committee investigating the insurance industry.

“I knew that once I did that my life would be different,” he said. “I wouldn’t be getting any more calls from recruiters for the health industry. It was the scariest thing I have done in my life. But it was the right thing to do.”

Mr. Potter says he liked his colleagues and bosses in the insurance industry, and respected them. They are not evil. But he adds that they are removed from the consequences of their decisions, as he was, and are obsessed with sustaining the company’s stock price — which means paying fewer medical bills.

One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses.

Mr. Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.

All this is monstrous, and it negates the entire point of insurance, which is to spread risk.

The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.

Mr. Potter argues that much tougher regulation is essential. He also believes that a robust public option is an essential part of any health reform, to compete with for-profit insurers and keep them honest.

As a nation, we’re at a turning point. Universal health coverage has been proposed for nearly a century in the United States. It was in an early draft of Social Security.

Yet each time, it has been defeated in part by fear-mongering industry lobbyists. That may happen this time as well — unless the Obama administration and Congress defeat these manipulative special interests. What’s un-American isn’t a greater government role in health care but an existing system in which Americans without insurance get health care, if at all, in livestock pens.

http://www.nytimes.com/2009/08/27/opinion/27kristof.html?em=&pagewanted=print