Is Quality of US Health Care Deficient? Some Experts Disagree with Report

Room for Improvement

Although most ENToday sources commended the US health care system for its quality and access, others agreed with the Commonwealth Fund’s poor ranking. Carter Multz, MD, an internist/rheumatologist from San Jose, CA, who has been in practice for more than 40 years, said: Health care in America is too expensive because it is catawampus, askew, awry, and uncoordinated. But we can have universal health care, including pharmacy, improve quality, save lives, and save billions of dollars, easily and simply. Dr. Multz targeted wasteful administration as the culprit, noting that nearly 50% of our $1.9 trillion health care spending goes to administration, versus Canada’s 15%. He advocates a uniform PC-based system tracking authorization, utilization, quality control, claims management, and payments, with Congress eliminating antitrust laws that prevent efficient management.

Michael Jhin, MD, the former CEO of Houston’s St. Luke’s Episcopal Health System and a mechanical engineer, says that American health care providers might emulate Toyota Motors’ efficiencies to improve quality and efficiency. If our health care costs are not globally competitive, how can any of our industries compete in the global marketplace? How can we reduce costs, improve safety and reduce waste? he asked. Using Toyota’s emphasis on beachfront property-the area closest to employees to reduce waste and allow for more value-added services-Dr. Jhin improved his hospital system’s central supply area’s efficiencies by 40%. It completed more cases in less time, with fewer employees. Dr. Jhin added: American health care possesses enviable components for a world-class system. Yet we lack the system engineering to enjoy the full value of those hard-earned components.

Pennsylvania-based Geisinger Health System has followed a quality improvement program similar to those advocated by Dr. Jhin. Guaranteeing its workmanship, the health plan charges a flat fee for elective heart bypass surgery, plus 90 days of follow-up. Geisinger improved quality and efficiency by devising a consensus list of 40 best practice action items for bypass surgery. Its surgeons boosted adherence to the guidelines from 59% to 100% of the time, Now, if any preoperative measure is left undone, the procedure is scrapped. Efforts such as Geisinger’s may reduce the wide variations in treatment outcomes.

Several experts tied the poor US rankings on quality to other problems. Jim Goyjer, a native of the Netherlands who is now a Los Angeles-based public relations consultant, decried that health care is a for-profit business in the US. Everyone in this country does not share the burden of health care for all. It is a travesty that the richest country in the world cannot provide basic healthcare to its citizens. Richard Salluzzo, MD, CEO of Wellmont Health Systems, headquartered in Kingsport, TN, says that the US system wastes $17 billion annually in preventable medical errors. Multiple organizations and initiatives have addressed patient safety and quality piecemeal. No organization has taken a total solution approach to combat the growing epidemic of medical errors in hospitals. He hopes to address that through a Safest Hospital Initiative consortium involving Wellmont, Adventist, and Novant Health Systems.