This week, the Associated Press reported that Americans are not being informed when they’re being treated by drug-addled physicians:
Despite some unsettling cases, these arrangements have largely escaped public scrutiny until this summer, when California's medical board outraged physicians across the country by abolishing its 27-year-old program allowing doctors to get help without telling their patients.
A review concluded that the state-run program failed to protect patients - or help addicted doctors get better. But the medical community fiercely defends confidential treatment, saying it keeps patients safer.
Although Congress passed the Health Care Quality Improvement Act (
HCQIA) and National Practitioners Data Bank (
NPDB) to provide for reporting and disclosure, both fail because they rely on corporate hospital executives to report errors and complications that executives profit from. Drug-addicted physicians are a tiny symptom of a much greater problem.
When airplanes crash, the FAA investigates. If necessary, the FAA grounds airplanes and airlines until the causes are identified and fixed. When restaurants kill or injure consumers, the Health Department investigates. If necessary, they close down the restaurant.
So why should we expect hospital executives will report employees who generate huge profits from unnecessary errors and complications?
In 2005, Harvard University’s Adjunct Professor of Health Policy,
Dr. Lucien L. Leape, MD wrote:
In most industries, defects cost money and generate warrantee claims. In health care, perversely… physicians and hospitals can bill for the additional services that are needed when patients are injured by their mistakes. (JAMA, 18 May 05)
America's healthcare facilities spend billions each year because federal law requires them to treat uninsured, indigent, and illegal alien patients. To compensate for those losses, providers routinely subject patients to unnecessary procedures and inflated prices. Unnecessary errors and complications generate even more revenue for cash-strapped facilities. And when insurers raise their rates, employees and employers are forced to pay more, or drop out. Neither socialized schemes nor free-market forces will fix this problem. Costs will not drop until America takes out the profit for errors and complications.
For example, two physicians in one facility generated $40 million in annual revenues from patients they subjected to
unnecessary cardiac procedures. In another hospital, executives never informed physicians that their sterilization equipment was contaminating instruments that injured patients.
HCQIA fails because it relies on:
- Corporate hospital executives who profit financially from unnecessary procedures, errors and complications, and;
- The physicians who are responsible for such misconduct.
Failures to fulfill the HCQIA’s intent by corporate hospital executives were reported by
60 Minutes,
The Street,
Pittsburgh Post-Gazette, and the
AMA Voice.
Examples of failures to fulfill the HCQIA’s intent by physicians are found in
Medical Economics,
Pittsburgh Post-Gazette,
Time, and the
Journal of the American College of Cardiology.
HCQIA’s flaws stem from the fundamental conflict of interest between the bill’s co-authors, corporate hospital attorneys
Horty & Springer, and the patients they ostensibly protect. Predictably, Horty & Springer rendered HCQIA unenforceable by inserting the following subsection:
42 U.S.C. §11112(b) (3):
A professional review body's failure to meet the conditions described in this subsection shall not, in itself, constitute failure to meet the standards of subsection (a) (3) of this section. (bold added)
Although small businesses and entrepreneurs have been the driving force behind the growth of the US economy, the US healthcare system has regressed into one that
does not permit competition.
In testimony before the Small Business Administration in 2007,
Gil N. Mileikowsky, MD reported that prominent hospital law firms consider staff physicians who compete with hospitals, “problem physicians.”
Horty & Springer's hostility toward independent private physicians is demonstrated throughout their
seminars, courses, and audiotapes for healthcare executives.
Corporate hospital attorneys have also developed a methodology and vernacular for controlling physicians, patients, and other advocates who report incidents to outside agencies or agree to testify on behalf of patients-victims of medical negligence.
Their preferred strategy is to
discredit the individual as disruptive, crazy, impaired, incompetent, imminent danger, etc.
Horty & Springer also
teaches healthcare executives:
- How to protect themselves from whistleblowers
- How to avoid reporting a physician to the NPDB
- How to regain control of the hearing process
To understand the scope of HCQIA’s failure to protect patients, consider these studies:
- After reviewing 37 million Medicare patients' medical records (e.g. patients over 65 years old), HealthGrades reported that medical errors in hospitals kill 200,000 patients each year.*
- Harvard economist Kip Viscusi estimates that the value of one human life is somewhere between $4 million and $9 million. Multiplied by HealthGrade’s 200,000 annual patient deaths, the loss to the US economy can be estimated at somewhere between $800 billion and $1.8 trillion, annually.
- Based on 152 published peer review articles, the Nutrition Institute of America concluded that medical mistakes kill 784,000 people annually.*
* They did not report what happened to millions of patients under 65.
In 2006, the Association of American Physicians and Surgeons (
AAPS) unanimously
passed resolutions to correct the HCQIA, and the American Health Lawyers Association (
AHLA) recently published Dr. Mileikowsky’s
legal analysis (
2) in which he insists that changes must go beyond the HCQIA.
Based upon Dr. Mileikowsky’s analysis and over 100 other reports and anecdotal data, it’s clear that neither market forces nor socialized healthcare schemes will repair the HCQIA’s systemic failures. The quality of care will not improve until errors and complications become unprofitable for healthcare executives and their shareholders.
Last month, the Alliance for Patient Safety issued
this letter to
US Senator Tom Coburn, MD. Although many issues compete for legislative attention, I can’t think of a more compelling reason than 750,000 unnecessary annual fatalities.
***
If you agree, contact Senator Coburn HERE or call his office at 202-224-5754.