A Perfect Storm in Medical Care

An Associated Press report reminds me of a poem that my father had hanging on the wall in his garage. The framed print said, “From the time you were born till you ride in a hearse, things are never so bad that they couldn’t get worse.” My Dad was a very wise man. The poem that inspired him many years ago says a lot about the health care system today in the United States.

On August 18, 2007, the AP reported:

…Medicare will stop paying the costs of treating infections, falls, objects left in surgical patients and other things that happen in hospitals that could have been prevented….The rule identifies eight conditions _ including three serious types of preventable incidents sometimes called “never events” _ that Medicare no longer will pay for. Those conditions are: objects left in a patient during surgery; blood incompatibility; air embolism; falls; mediastinitis, which is an infection after heart surgery; urinary tract infections from using catheters; pressure ulcers, or bed sores; and vascular infections from using catheters. The Centers for Medicare and Medicaid Services said it also would work to add three more conditions to the list next year….Last year, Mark McClellan, then director of the Medicare and Medicare programs, said the government could save hundreds of millions of dollars a year if the Medicare program stopped paying for medical errors such as operations on the wrong body part or mismatched blood transfusions. Medicare provides coverage for about 43 million elderly and disabled people…

The implications of this new rule will have disastrous effects for many — young and old. The scenario is this: you go to hospital for a minor surgical procedure — maybe an appendectomy. When you are wheeled out of surgery, you are minus one appendix and in its place you have a pair of surgical gloves, three sponges, and a spit sink. Weeks later the infection created by the foreign objects causes your temperature to approach the boiling point of tar. You return to your medical provider. X-rays diagnose the problem. Based on the new Medicare rules, the hospital denies care. The patient dies.

Conspiracy theorists might come to the conclusion that this new set of rules was planned a while back. The path was prepared. The propaganda campaign about the ease of filing and winning medical malpractice suits made way for these new Medicare rules. Tort reformists have poisoned not only the national jury pool, but also the national psyche. We now have a Perfect Storm in medical care. When a patient is the victim of medical malpractice he is on his own. There will be no medical coverage for alleviating medical errors. To make matters worse, the possibility of achieving justice in the courts is almost less than zero.

The continuing stream of bad news about health care could be sugarcoated by remembering that there are many excellent surgeons and other medical practitioners. That fact is not debated. Many years ago, after walking around with a ruptured appendix for a considerable length of time, my life was saved by a surgeon. I will never forget Dr. John Groblewski — a talented and dedicated doctor in Pennsylvania. He was loved by his many patients. Unfortunately, the new Medicare ruling will taint all doctors, even the good ones. Why are they silent?

Those who can afford it will join with many who leave the United States as medical tourists. They can have their surgery done in places like India, Thailand, South Africa, and Costa Rica. For those without money, medical care in the US will continue to be a crapshoot.

Rosemarie Jackowski is an advocacy journalist living in Vermont. Read other articles by Rosemarie.