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Wayne Post
  • RICHARD HERMANN: Unhealthy and unacceptable

  • Two recent studies of U.S. healthcare reveal a broken system that is rapidly going over its own cliff.

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  • Two recent studies of U.S. healthcare reveal a broken system that is rapidly going over its own cliff. Neither legislation nor provider nor consumer behavior is doing much of anything to reverse the decline. On the contrary, everyone involved appears to be making things worse, although simple fixes are available for some of the ills.
    Two key deficiencies among the hundreds revealed by both studies make the point:
    1. In 1846, Dr. Ignaz Semmelweis, a Hungarian physician serving as chief resident in the obstetrical clinic at Vienna’s primary hospital, was alarmed by the high mortality rate among new mothers at his clinic. Childbed fever, a virulent bacterial infection, was responsible for the deaths of thousands of young women each year worldwide. He observed that his clinic’s physicians often came directly into the delivery room after performing an autopsy. This prompted him to suggest a simple solution: that they wash their hands before delivering babies.
    Semmelweis’ advice was ignored, and he lost his job as a consequence. It was not until Louis Pasteur confirmed the germ theory of disease several decades later that hand-washing between medical procedures took hold. Meanwhile, women continued to die needlessly. Once hand-washing was implemented in Europe and America, the death rate from Childbed Fever plummeted to less than 1 percent.
    Recently, the National Academy of Sciences’ Institute of Medicine reported the results of an extensive study that shows that doctors, nurses and other caregivers have forgotten what Semmelweis advocated 170 years ago. The study found that up to 50 percent of healthcare professionals today do not wash their hands before beginning a medical procedure. The study attributes this shocking neglect to the pressures of time and work. That is, of course, a lame excuse and a condemnatory commentary on our broken healthcare system. Lives are still being lost due to failing to perform a simple task the omission of which amounts to something bordering on criminal negligence.
    2. The second study, by the Centers for Medicare and Medicaid Services, found that 25 percent of the $2.8 trillion Americans spend on healthcare each year is wasted. The waste results from a combination of unnecessary services ($210 billion), excessive insurance costs and bureaucracy ($190 billion), preventable errors ($130 billion), excessive prices ($105 billion), fraud ($75 billion) and missed prevention opportunities ($55 billion). The $765 billion total waste is more than likely understated. A slew of healthcare economists believe that this huge dollar amount actually understates the waste problem, and that Medicare fraud by itself amounts to more than $125 billion a year.
    With respect to Medicare fraud, the solution is of the “low-hanging fruit” variety. The federal government’s highly successful Medicare fraud program collects almost $3 billion a year at a very modest investment in investigative and prosecution personnel of only $165 million. Nevertheless, neither the timid administration nor congressional Republicans, whose only goal is to gut government regardless of the obvious benefits of any investment, will consider expanding this program.
    Page 2 of 2 - Solutions to the other waste components, while more complicated, are also not lacking. Unnecessary healthcare services, for example, is directly the result of our wrong-headed fee-for-service approach to healthcare combined with lawsuit risk avoidance by providers. There are provisions in the Affordable Care Act that partially address the fee-for-service lunacy, but they are too few to make a serious difference for years to come.
    Over time, healthcare costs (including avoidable deaths and disease from lack of hygiene), which have been rising at three times the rate of inflation for a generation, are one of the biggest threats to America’s future.
    “Rants” is a series of political and social observations written by part-time Canandaigua resident and Canandaigua Academy graduate Richard Hermann. Email him care of Messenger Post Media at messenger@messengerpostmedia.com.
     
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