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Government Prestige Masks Scientific Incompetence

If “to err is human,” is being a member of the Institute of Medicine’s, “Committee on the Quality of Health Care,” really divine? We don’t think so!

Historian Daniel Boorstin once wrote of the “self-deceiving magic of prestige,” of using aura to cover inadequacy and other sins.

The prestigious Institute of Medicine, part of the prestigious National Academy of Sciences, is the kind of congressionally-chartered organization to which the word “prestigious” automatically attaches. Perhaps a bit too automatically. Among the Institute’s latest products: Two splendid examples of the kind of inadequacy that not even prestige can hide.

In June 1998, the Institute of Medicine established the “Committee on the Quality of Health Care in America,” with instructions to develop “a strategy that would result in a substantial improvement in the quality of health care over the next 10 years.”

In November 1999, this Committee (which includes professors, administrators, executives and, apparently, only one full-time practicing physician) issued its first report, “To Err Is Human: Building a Safer Health System.”

Their claim that somewhere between 44,000 and 120,000 patients — a rather large range — die each year because of human error, and hundreds of thousands (millions?) more suffer needlessly, brought them their first 15 seconds of fame. Needless to say, the Committee did not release between 44,000 and 120,000 names of individuals who’d met their end in this manner.

Soon, the Internet and every conceivable creation of the mass media was awash with chuckles that, if they’re right, you’re far more likely to die in a doctor’s office or hospital than from gunfire, stabbings, and extraterrestrial abductions combined.

Were they right? Around the same time, the National Safety Council, another bastion of prestige, concluded that less than 15,000 people died needlessly each year.

What the Committee did do, however, was get busy on its next report: “Crossing the Quality Chasm: A New Health System for the 21st Century”.

It’s a worthy successor to their first effort — 335 pages of rhetorical sound and visionary fury, in the end signifying nothing, save perhaps for an utterly misplaced faith in the curative powers of federal funding and the power of the Committee.

Since the Committee was established to recommend improvements to health care, its first mission must be to prove that things are bad. So bad, in fact, that there’s a “chasm” between the health care Americans now receive and the health care we “deserve.”

To read the report, you’d never know that America — in spite of the miseries of HMOs — has arguably the best health care system in the world, or that many of its problems are directly traceable to government regulation, interference and support for managed care.

Instead, you would find out that the all-purpose solution promoted by this government study is more studies, more bureaucracies, more government and, above all else, more money. Does anyone miss the irony?

Beyond that, it’s not often easy to tell what the Committee actually wants to do. Despite its length, the Report is more a “vision statement” (a popular Beltway genre nowadays) than a scientific investigation or medical agenda.

Their ideas are based on hopes that a radical transformation of the system will, in turn, transform human nature — especially the nature of the doctor-patient relationship. Information technology (admittedly under-utilized within the profession) and “evidence-based medicine” will eliminate human errors. To some extent, no doubt.

But when they use words like “monitoring,” “tracking,” and “transparency,” privacy alarm bells start going off. The Committee proposes “prioritizing” treatment, focusing on “a limited number of conditions.” Rationing, anyone? As for making “effective use” of “resources” — what could that mean?

Perhaps it is easy to tell what the Committee actually wants: It wants a health-care delivery system that is, in its words, “safe, effective, patient-centered, timely, efficient, equitable.” And centrally controlled — by a federal bureaucracy, of course.

But enough of wandering around in their verbiage. Let’s look at two things that really would improve health care:

Congress could return routine medical decisions and financial responsibility to patients and their families by simplifying the rules and expanding the limits on Medical Savings Account plans.

Congress could reprogram the $800 million currently spent each year ferreting out Medicare fraud and abuse under the Kennedy-Kassebaum Health Insurance Portability and Accountability Act (HIPAA) of 1996.
This mandated spending has established a virtual medical Inquisition. Further, the guilty-until-proven-innocent approach forces honest physicians and their assistants into wasting millions of hours trying to comply with 110,000 pages of ever-changing regulations.

The National Academy of Sciences should stick to science, not political prophecy based on an ideological vision of the future. We’re fed up with government studies that result in nothing more than conclusions that call for more government and more studies.

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Michael Arnold Glueck, M.D., of Newport Beach, Calif., writes extensively on medical, legal, disability and mental health reform. Robert J. Cihak, M.D., of Aberdeen, Wash., is president of the Association of American Physicians and Surgeons. Both doctors are Harvard trained diagnostic radiologists. Collaborating as The Medicine Men, they write a weekly column for WorldNetDaily as well as numerous articles and editorials for newspapers, newsletters, magazines and journals nationally and internationally.