I know what you’re thinking. With a headline like that, we have either, 1. turned into shills for the Obama care repealers; or, 2. created an awesome tease about this year’s PopTort Halloween costumes, where we all dress up as right-wing extremists (covered in, lets say, apoplectic Weekly Standard articles, like this one referencing new CBO scoring of the health care law, screaming about updated cost figures of “about $2 trillion over its real first decade (2014 through 2023).” Oh, the humanity.
Actually, it’s neither of the above. There’s another trillion-dollar figure, which is much scarier to us than $2 trillion over 10 years, or $1 trillion over five. That number is $1 trillion over one. And rather than anyone getting healthier, they end up sick, injured or dead. I wish this were some fake Halloween prank but it’s not.
According to a new study in the Journal of Health Care Finance by four professionals connected to the Loyola University Chicago’s Quinlan School of Business MBA in Healthcare Management program, the economic impact of this nations’ epidemic of medical errors is “perhaps nearly $1 trillion annually.” That's extraordinary. The problem is that except for a small number of hospitals that are really trying to address patient safety, hospitals have mostly refused to do so. The authors say it’s because,
The incentives were not substantial enough to overcome the inertia of many hospital cultures and the US payment system. However, those hospitals and health systems that overcame that inertia have experienced tremendous improvement in quality, financial performance, patient safety, and patient satisfaction. In a recent interview on PBS’s Nightly Business Report, Dr. Mark Chassin, The Joint Commission’s president and CEO, said that only about a quarter of the nation’s 6,000 hospitals are involved in some sort of quality improvement effort.
Here’s how they get to the trillion-dollar number:
[B]ased on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care, according to a study sponsored by the Society for Actuaries and conducted by Milliman in 2010. Additional costs of $1.4 billion were attributed to increased mortality rates with $1.1 billion or 10 million days of lost productivity from missed work based on short-term disability claims. The authors estimate that the economic impact is much higher, perhaps nearly $1 trillion annually when quality-adjusted life years (QALYs) are applied to those that die. Using the Institute of Medicine’s (IOM) estimate of 98,000 deaths due to preventable medical errors annually in its 1998 report, To Err Is Human, and an average of ten lost years of life at $75,000 to $100,000 per year, there is a loss of $73.5 billion to $98 billion in QALYs for those deaths― conservatively. These numbers are much greater than those we cite from studies that explore the direct costs of medical errors. And if the estimate of a recent Health Affairs article is correct― preventable death being ten times the IOM estimate―the cost is $735 billion to $980 billion. …
Quality care is less expensive care. It is better, more efficient, and by definition, less wasteful. It is the right care, at the right time, every time. It should mean that far fewer patients are harmed or injured. Obviously, quality care is not being delivered consistently throughout US hospitals. Whatever the measure, poor quality is costing payers and society a great deal. However, health care leaders and professionals are focusing on quality and patient safety in ways they never have before because the economics of quality have changed substantially.
Some in Congress are not, however. That’s something to really scream about.