Newtown, CT – October 12, 2012
In the 1960s and early 1970s, deaths from car accidents rose to a peak of about 54,000 per year. They've never been that high since – and there are far more drivers and cars today than there were then. So what happened? In short, two books. One by Ralph Nader, "Unsafe at Any Speed", and one by the National Academy of Sciences, "Accidental Death and Disability-The Neglected Disease of Modern Society". These prompted a national outcry which resulted in Congress passing legislation on seat belts and, later, instituting the precursors of today's National Highway Traffic Safety Administration. Today there are still 35,000 to 36,000 deaths from car accidents, but the rate has been halved from 20 per 100,000 people, to 10. And the laws that protect drivers are enforced (Click-it or Ticket!!), in much the same as the laws that protect workers in workplaces against preventable deaths. When President Nixon signed the law that put OSHA in place, there was an average of 14,000 deaths from workplace injury every year. Today, that number has been cut by two thirds, to about 4,700. In both instances, the regulatory agencies closely track and investigate incidents to learn from what happened, develop root cause analyses and propose fixes to avoid them from happening again. On the flip side, every year, a magnitude more of Americans die from preventable health care-related events . And that number hasn't budged much.
What this means to you – Let's start by understanding why the other rates went down. First, the institution of formal agencies led to complete transparency in the accounting and reporting of deaths. Anyone, at any point, can go on the website for the Bureau of Labor Statistics and view the rate of those who die from workplace related reasons. Ditto for transportation and foodborne illness. Where's the equivalent "death clock" for healthcare? Nowhere. Second, consumer activation and action. Ralph Nader's book caught the public's attention, and the NAS's report caught policymakers' attention. Many of us thought that the NAS's IOM's "To Err is Human" would similarly lead to action, but it didn't. Why? Because there was no equivalent consumer-oriented book to create activism. And then there was the usual pushback from the industry about how different healthcare is from other industries. So today, 100,000 more Americans die from preventable health events than in other developed countries. In total, about 200,000 lives are lost because young moms don't get the right care, older adults have little care coordination, underserved patients are ignored, and even the ones who have access die from lack of attention. The bottom line is that this plague is far far worse than deaths from car accidents, workplace injuries and foodborne illness combined. And yet there isn't one government agency, federal or local, that has taken on the same role as the one held by OSHA, the NHTSA, the NTSB, or the CDC. Maybe it's time for a healthcare death clock in addition to a debt clock. So far this year, the clock stands at 162,250 mothers and fathers, daughters and sons, sisters and brothers, grandparents and grandkids…and the clock keeps ticking.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.