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Whatever Health Reform Plan is Adopted to Expand Access Must Address Medical Errors

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Richard T. Moore
December 16, 2019

Expanded access to healthcare appears to be a major concern for America’s voters and certainly among political candidates. A related issue, the rising cost of healthcare—especially prescription drugs and biologics—is also being debated in Congress and in the public forum. However, making healthcare more affordable and accessible to more people in the United States might only exacerbate another serious problem; medical errors. Of course, we should have a national goal of healthcare for all, whatever form the expansion of access takes. Whether it’s, “Medicare for All,” an improved version of the current Affordable Care Act or some yet to be designed formula, improving patient safety needs to be paramount.

Twenty years from the landmark patient safety report issued by the Institute of Medicine (IOM), “To Err is Human,” healthcare in America still contributes to preventable loss of life and injury and increases the cost of healthcare. The IOM report estimated between 44,000 and 99,000 people die from medical errors every year. It also estimated that medical errors add between $17 billion and $29 billion annually to the cost of healthcare through corrective action, loss of earning and disability. Any proposal to expand the number of people who have access to healthcare will contribute to an increase in medical errors unless steps are taken to promote patent safety.

Colby Strong, writing for Clinical Advisor, noted that medical errors are the third leading cause of death in the United States after heart disease and cancer. Medical error was defined in the report as an, “Unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient.”

Obviously, medical errors are a problem for patients and their families. They often cause serious issues for the healthcare staff who were responsible for the error. In addition, these errors, which are often preventable with better planning and training, increase the cost of healthcare by often requiring longer hospitalization, additional treatment and loss of income. A recent study by the Betsy Lehman Center for Patient Safety in Massachusetts also found that people who are harmed by medical error often lose trust in their doctor or the healthcare system in general. This can result in avoiding or delaying care and lead to more serious conditions and more expensive treatment.

While some experts blame the occurrence of medical errors on the complexity of modern healthcare, the problem has been with us throughout history. After all, it was the Ancient Greek physician, Hippocrates, who around 400 BC is reported to have warned aspiring doctors, “Practice two things in your dealings with disease: either help or do not harm the patient.” More recently, Oliver Wendell Holmes, Sr. and Ignaz Semmelweis were leaders in the 1850’s in advocating for hand-washing by physicians and nurses between patients to prevent spread of infection. Yet even today, only 71% of nurses and around 60% of physicians appear to be compliant with the hand-washing guidelines according to The Lancet Infectious Diseases report.

Despite all the media attention and academic research that has been devoted to reducing medical errors since the publication of the IOM report in 1999, a study reported in Modern Healthcare entitled, “Hospitals fall short of patient-safety goals 20 years after ‘To Err is Human’,” suggests that the healthcare profession still has a long way to go to improve patient safety. The report places much of the blame for lack of progress in reducing medical errors on lack of leadership by hospital CEO’s and chief medical officers. Kim Hollon, CEO of Signature Health states, “Patient safety is uniquely the responsibility of the C-suite, but CEO’s haven’t paid attention to it or acquired the necessary knowledge.

Policymakers at the national and state levels and academics in the health policy arena should watch what Massachusetts is developing in the form of a healthcare safety and quality consortium that includes all the stakeholders from government agencies, healthcare organizations, payers and the public. The new consortium represents an unprecedented statewide endeavor that recognizes the potential for major breakthroughs in reducing preventable harm through a sustained, multi-stakeholder initiative that leverages the expertise and leadership of the state’s healthcare community. The consortium will develop a statewide strategic plan—a, “Roadmap to healthcare safety and quality,”—and then oversee the plans implementation.  This model ought to be part of any national effort to reform healthcare.


Author: Richard T. Moore has served in both elective and appointed public office at local, state, and federal levels of government. He served for nearly two decades each in the Massachusetts House and Senate, as well as being chosen as President of the National Conference of State Legislatures. As a legislator, he led the effort to advance patient safety in Massachusetts and authored the legislation that established the Betsy Lehman Center for Patient Safety. He also served in Washington, DC as Associate Director of FEMA in the Clinton Administration and as a Presidential Elector in 1992. A former college administrator and adjunct assistant professor of government at Bentley University and Bridgewater State University, Mr. Moore is a long-time member of ASPA serving terms as Massachusetts Chapter President and National Council member. His email address is [email protected]

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One Response to Whatever Health Reform Plan is Adopted to Expand Access Must Address Medical Errors

  1. Richardeanea Theodore Reply

    December 27, 2019 at 12:41 am

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