Thread: Counting the Blessings of American Medicine

Guest columnist

Counting the blessings of American medicine

American medicine has been taking a beating in the health-care-reform debate. Here, guest columnist John Olsen, M.D., counts the blessings of an industry that leads the world in innovation.

By John Olsen

Special to The Times

WE keep reading the same old statistics about the poor quality of health care in the United States as a justification for how it needs to be fundamentally changed. We hear that the U.S. ranks 37th in infant mortality, has lower life expectancy than that of many developed countries in the Western world, and that there are 90,000 deaths per year because of medical errors — all despite higher costs per capita. These notions have been cited so frequently that they seem to gain traction simply from their repetition.

Of course, once quoted, scant attention is paid to any analysis of their validity. Several reasons should make us pause before accepting such numbers. Different reported outcomes might have to do with different methods for gathering results from country to country. Filling out a death certificate or coding a medical outcome, usually the basis for our "vital statistics," is surprisingly inexact. In addition, we assume that patients are alike around the world, but it is clear this is not the case and skews the data. (Certainly there are genetic differences at the very least).

Often, health care is not the primary cause of the outcome: poverty, nutrition, alcohol and drug use come to mind, problems that are societal in nature and that vary from culture to culture. And since we respect patient autonomy, if someone does not make the effort to sign up for health-care benefits, or take the time to come in for prenatal care, or have the willingness to follow simple advice, should their outcomes be charged to medicine's account? Mark Twain admonished us to beware of "lies, damn lies, and statistics."

How robust is medicine in the United States? One historical root traces back to a caring physician driving a horse-drawn carriage to the bedside of a sick patient in the middle of the night, for little recompense and at a time when little could be offered beyond holding a hand. That compassion is still alive today.

We followed pioneers like Abraham Flexner in making medical education rigorous and based on an exacting science. William Stewart Halsted's legacy has given us gifted and creative surgeons, while the disciples of Sir William Osler have illuminated the paths of critical thinking. And when science isn't enough, we can fall back on the quiet words of poet William Carlos Williams, M.D.

Our students are the product of intense competition, providing promise for future generations. Outstanding medical centers have arisen in most major cities in the country, attracting talent from around the world, places where knowledge about both arcane and common ailments grows through fundamental inquisitiveness, limited only by intellectual capability and hard work.

Our national conferences routinely attract thousands who seek to validate their ideas on the most competitive stage. The best journals, the most publications, and the most scientific accolades are garnered by physicians working in this country.

We have deciphered the genome and developed dialysis, bone-marrow transplantation and catheter-based cardiac interventions. Our population can get advanced imaging studies or virtually any laboratory test performed promptly and reliably. A simple call to 911 provides instant access to a remarkable countrywide system of emergency care. We have many reasons to be proud, and I am disappointed in my colleagues who are too modest to defend vociferously what is good in our system.

The 2002 Institute of Medicine report (which actually estimated not 90,000, but between 44,000 and 98,000 deaths per year attributable to medical error) is old hat. We have long since internalized its message and taken it to the floors of hospitals to improve care at the bedside. We work hard to surpass standards and reach error rates below 1 in 100,000.

Our medicine is not static. But amid all the turbulence, let us pause and give thanks for the bedrock of American medicine that is the envy of all the world.

Dr. John Olsen is the past president of the King County Medical Society and past governor for the American College of Cardiology.

http://seattletimes.nwsource.com/html/o ... olsen.html

This confirms what most of us already know. It also explains why Michael Moore did not have bariatric surgery which he needs while up there.

http://news.therecord.com/News/article/635108

Should Ontarians have to use a passport to get health care?
TheRecord.com - News -
By Melinda Dalton, Joe Fantauzzi and Matthew Strader

Record numbers of Ontarians are being sent to the U.S. by their government for routine health care that should be available at home. A Metroland Special Report shows thousands of others are funding their own medical treatments south of the border, at high personal cost.

The numbers have been rising for the last 10 years. Government approvals for out-of-country health care funding are up 450 per cent. Should Ontarians have to use a passport to get health care?

WATERLOO REGION — Dany Mercado of Kitchener had a choice to make: travel to Michigan for a risky mismatch marrow transplant or watch his time tick down on a transplant list in Ontario.

Tyler Agnew’s options were just as limited. The genetic evaluation that could shed light on cause of the Cambridge man’s frequent lung collapses is widely available south of the border, but not in Canada.

Both families turned to the U.S. for care when they ran out of options in the Ontario system.

Agnew and Mercado are not alone.

Long waits, unavailable procedures and poor physician access are driving record numbers of Ontarians to seek treatment south of the border and sometimes, overseas.

A Metroland Special Report on Cross-Border Care shows:

A 450 per cent increase in OHIP approvals for out-of-country care since the beginning of this decade, a period of explosive growth in new technologies and therapies not covered or available here. The province agreed to fund 2,110 procedures or treatments in 2001, and 11,775 last year.

Patient demand has created a new breed of health-system navigators, known as medical brokers, who find U.S. options for the growing number of Ontario patients who elect to pay for medical services south of the border themselves.

Medical brokers negotiate discount rates with U.S. centres to get Ontarians faster diagnostics, second opinions and surgery.

Brokers say that for every patient sent south by the Ontario government, there may be up to 10 others who go — and pay — on their own.

Ontario’s spending on out-of-Canada medical services has tripled in the last five years. Payments in 2010 will balloon to $164.3 million, from $56.3 million in 2005. The province said in last month’s economic forecast that it needs to increase health spending by $700 million to cover “higher than anticipatedâ€

No doubt about it, America has been far superior to the world in medical testing, advanced procedures and technology and overall quality of medical care.........and now the Fascists want to take this from us.

I am really concerned for our seniors.