One might have thought that when considering health policy the safety of hospital patients would be just about everyone’s top priority – medical professionals and legislators (and, of course, patients themselves) alike. After all, there are few areas of our lives in which we base crucial decisions to the judgment of others more than in the realm of health care. Yet as it considers Governor John Kitzhaber’s health care reform bill Oregon’s legislature is not only ignoring simple remedies that could lower costs even as they improve the quality of care in our state, it is also threatening to leave the poor outside the system, with no way to obtain justice when doctors, hospitals and nurses fail to deliver the care patients deserve.
It is distressing to see Oregon’s legislature spending too little time addressing patient safety issues as it considers health reform. As a recent article in The Oregonian notes, the cost savings offered by the proposed legislation lie mostly in the future. Broadly speaking that is good – one of the few things that liberals and conservatives agree on these days is the fact that rising medical costs represent a significant long-term budget problem at both the federal and state levels (how that problem should be addressed is an issue that elicits far less agreement). But as nationwide surveys that have been around for quite some time have shown, there are a number of basic fixes that can be implemented more-or-less immediately which will both reduce costs and improve patient safety.
Even more distressing, however, are aspects of the proposed law that would make it difficult or impossible for patients injured by negligent doctors to defend themselves in court. Under the current version of the legislation, strict limits would be placed on the ability of patients covered under Medicaid or the Oregon Health Plan to seek justice for their injuries at the hands of negligent providers. The result would be to create a two-tiered system of responsibility and accountability, one in which – to use an extreme example – a doctor who amputated the wrong limb of a patient with private insurance would be held accountable for his horrific mistake, but would receive no sanction if the patient in question was too poor to afford private coverage.
This is not the first time I have addressed the issue of patients’ safety in Oregon hospitals. As I noted last summer, there is a significant amount of data out there to indicate that our hospitals can do better when it comes to reducing (or, better, eliminating) preventable errors. As The Oregonian reported last year, Portland-based Legacy Health was part of a much-noted national program in which patient safety increased significantly and costs were reduced simply by instituting rigorous use of checklists of basic procedures – hand washing, the double-checking that charts match patients, etc.
When it comes to health care everyone’s first focus should be on making sure that patients get the treatment they need, and that the people delivering the treatment do so in a safe and efficient manner. As The Oregonian notes, whatever cost savings might accrue from the governor’s proposed reforms would only be realized many years down the line. The Legacy study, however, has demonstrated simple, safe and effective measures that address our most immediate problem – patient safety – while also saving money now, not later. Shouldn’t implementing these reforms be the legislature’s top priority as it considers the health bill?