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The Best Science Writing Online 2012
Showcasing more than fifty of the most provocative, original, and significant online essays from 2011, The Best Science Writing Online 2012 will change the way...
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In all the talk about the Supreme Court's impending health care reform ruling, one question is often overlooked: What might happen to the many patient safety and quality of care provisions sprinkled through the Affordable Care Act?
They include a new Center for Quality Improvement and Patient Safety, more reporting of infections, injuries and mistakes in hospitals, and incentives for doctors and other providers to improve the care they provide. Those among the nation's 50 million uninsured who manage to get health coverage will also get better medical care than piecemeal or nonexistent version they now receive.
We've been talking about quality of care on Facebook with more than 700 users who've joined our discussion group on patient safety.
The Supreme Court could uphold the entire health care law or kill it, extinguishing its quality initiatives. Or the court could strike down the mandate to buy insurance alone 2014 a possibility that has long-time SCOTUS watchers on the edge of their seats. What then happens to the rest of the law no one really knows.
We asked some experts what's at stake for patients. Here's some of what they said:
Leaving uninsured Americans behind makes hospitals less safe 2014 Sharona Hoffman, professor of law and bioethics, Case Western Reserve University
"Emergency rooms are really stretched because they provide the only source of care for millions of uninsured, which affects the quality of care for everyone. Hospitals are a place that should be a last resort. There are risks of going to a hospital because infections have become so common, for example."
Provisions that prevent patient harm and unnecessary care will help out employers 2014 Helen Darling, CEO National Business Group on Health
"If the court throws out the whole act it would be stunning in its impact 2026 You have hundreds of millions of dollars spent on getting wrong treatment and sometimes harmful treatment. There's a long list of waste and harm in the U.S. health care system today and [employers] just think that's outrageous, because they spend so much money."
The act is a chance to learn how to keep patients safer 2014 David Howard, health policy professor Emory University
"The bill makes a number of potential changes and improvements to Medicare. So we lose the potential to learn from those pilot projects ways to improve the health care system."
Reform will give millions access to the same flawed, unsafe system 2014 Rosemary Gibson, author, patient advocate
"People will have access to the same system 2014 the good and the not so good. They will receive needed care that will save their life. They will also be exposed to harm: errors, infections and overtreatment."
The private sector will handle it, though slowly 2014 Robert Field, professor of law and health care policy at Drexel University
"There are private forces beyond the health care reform law that are promoting health care quality. The horse is out of the barn on patient safety, and things are going to change anyway 2014 but they may change slower without the Affordable Care Act."
Culturally competent care can reduce errors 2013 Jennifer Ng'andu, National Council of La Raza
"One of the exciting things about the Affordable Care Act is that it really challenges the paradigm of how [providers] approach culturally and ethnically appropriate health care 2026 We know there are preventable errors because of health inequality in the health care system and it's costing us."
From ProPublica.org (find the original story here); reprinted with permission.
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11 Comments
Add CommentAnd Chicken Little came running and told everyone, the sky is falling, the sky is falling. The misleading half truths in this article have no business in a science magazine. Are infections rampant in hospitals, yep, but not in ER's. In-patients especially with IV's and catheters are at risk. Show me the data that ER pts are dropping like flies. And if ER's are stretched, it is due to the laws that force ER's to see anyone for any condition that walks through the door, and more laws are fixing this how? 100's of millions on wrong and dangerous treatment, and how is the law fixing this? And why has nothing been done until now? So this group is saying there is no way to prevent errors and wrong treatment with out spending trillions (or at least lots of billions) on far reaching programs that have never been studied for efficacy? No answer, just conjecture and fear mongering. Here's the thing, technology drives health care costs, access to technology due to health insurance makes them easy to access, so they get overused. If a pt has insurance, many docs spend no time at all deciding how much the test is actually needed and order it. If the pt has no insurance, there is a long discussion between the doc and pt about the need and alternatives and perhaps a cheaper way.
Reply | Report Abuse | Link to thisThis whole thing will be a farce if it continues. Politicians and administrators making huge changes in health care when they have never actually done it is ludicrous. Imagine congress passing a law telling mechanics how to reform their business so oil changes will be cheaper-they've never done, can't conceive of it, and it will fail. Medicine is vastly more complicated and you all think it will end well?
The republicans could care less if health care is out of control and so expensive that only the 1% can afford it, and the hospitals are so dangerous that not even God would walk into one, and the health care act would correct it all...their only concern is that they want the health care act gone because a black democratic president implemented it and it is making them look stupid and racist and out of touch with the other 99% of Americans.
Reply | Report Abuse | Link to thisI think the court will only take out what is unconstitutional like the republican's insert where the law will force you to buy health insurance from a private insurer where they will continue to put your premium and deductible so high that the middle class and the poor will never be able to afford it. ...that's the republican's goal.
Where is the proof that anything in the bill will actually "fix" what some of the respondents have indicated is a problem? Because we passed a bill? If the trial lawyers have not forced out infections and mistakes, do we really believe passing a bill will do so?
Reply | Report Abuse | Link to thisLook everyone, we outlawed having "hundreds of millions of dollars spent on getting wrong treatment and sometimes harmful treatment".
Sure. That will work just fine. Now on to more important things scientific. Let's pass a law that keeps experiments from ever failing. And let's go ahead and include a provision that will make scientists finally determine the origin of the universe. After all, we are spending hundreds of millions of dollars on that quest when we could be funding other endeavors such as giving more money to planned parenthood so we can thin out the potential crop of future politicians.
Why in the world is this liberal whine in a science magazine? It’s just another attempt at fear mongering to push an unconstitutional political agenda.
Reply | Report Abuse | Link to thisFor those of us who have actually read the Constitution, we find that it transfers specific, limited, enumerated powers from "the people" to each of the three branches of government. It also reserves certain God-given Rights to the people and to the States. Nowhere in the Constitution is Congress empowered to make laws regarding healthcare. Nowhere in the Constitution is the federal government empowered to force a person to buy a product under threat of fine or imprisonment. Nowhere in the Constitution is the federal government empowered to steal from Peter to pay Paul, which is what this onerous legislation does. Make no mistake about it; the underlying purpose of this law is to take total control of our daily lives. Even if there may be some beneficial aspects in the law, it is seriously flawed and totally beyond the powers granted by the Constitution. The Supreme Court should and must overturn it in its entirety.
On another note, nowhere in the Constitution is the President given the power to unilaterally make law, ignore the law or even issue executive orders. Our founders did not create a dictatorship but a Representative Republic, governed by the Constitution. It is high time that Congress began impeachment hearings.
Yes, and they should've started impeachment proceedings against Bush his first two months in office when he overrode Congress and started two wars and infringed on our 1st Amendment right of Free Speech by collecting every ones e-mails and reading them and taking away our 2nd Amendment Right to bare arms. Or did you conveniently forget about that?
Reply | Report Abuse | Link to thisI agree!
Reply | Report Abuse | Link to this"taking away our 2nd Amendment Right to bare(sic) arms." - When did that happen?
Reply | Report Abuse | Link to thisThe most interesting thing about the Republican agenda to "Repeal and Replace" the Affordable Care Act is that they would replace it with the exact same legislation. First, it's a Republican (conservative) plan to begin with (i.e. the mandate). Second, everything the Republicans want to keep (e.g. pre-existing conditions --> denial of coverage, charging higher premiums due to PECs) requires a mandate or the health insurance companies will go out of business.
Reply | Report Abuse | Link to thisIt's a sad day for America that one party has been radicalized into a 100%-politicized propaganda machine rather than working to pass legitimate legislation to move our country forward. That is, they reject their own ideas just because the other guy (Obama) agrees to them. Sad. And it is even more sad that so many American voters can not see through this. Have you ever seen Jay Leno's Jaywalking segment?
All I've heard from Republicans is various schemes allowing people to buy insurance across state lines.
Reply | Report Abuse | Link to thisThis amounts to putting lipstick on a pig.
The costs and practices of health care should be corrected before we try and tackle nationwide healthcare. Congress needs to beat back the AMA and insurance companies and get a multi-tiered system of specialists and care. Along with finally forcing everyone to have a health care card, something long overdue and only hasn't been done because of paranoia. The whole system needs streamlining with computers to eliminate the 3-4 people at each office who handle that crap along with the 5-6 at every insurance company. It is a FUBAR of inefficiency that rivals many of the worst government organizations, so no, capitalism doesn't always work. It fails here because "we have to have health care" and they all know it. It is the same for college tuition costs. This is a terrible problem in the US and Congress is just a bunch of 4 years olds pointing fingers. So stop the rep/dem rhetoric and realize that they are all responsible for this mess and that we are also responsible because we let them trick us into stupid arguments that get us to keep voting for the next rep/dem in a suit they throw our way.
Reply | Report Abuse | Link to thisThe rationale in the opposition of some to what they consider an intermission in their private affairs is not difficult to understand, for example, in Switzerland, one of the most liberal countries in the world, they accepted that people can travel in a car without fasting the seat belts if they don't want having seat belts fastened, even when it was shown that this increases the risk for deaths and lesions in automobile crashes whose costs will go on the whole society, but if having an insurance for a car is mandatory for using the car in public streets, roads or ways, it would be hard to justify a total opposition against rules that may reinforce that everybody contracts some kind of a healthcare insurance policy. At short, middle and long term, health insurance saves lives and reduces sufferings.
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