In 2004, 63% of staph infections in the United States were caused by Methicillin-resistant Staphylococcus aureus, or MRSA, infamous for its mutation into a very drug resistant, and often deadly form. 19,000 die here every year due to MRSA, a number greater than those that die from complications due to AIDS.
In Norway, less than 1% of staph infections are MRSA after sweeping reforms were put in place nationwide aimed at stemmed the spread and deadliness of MRSA.
And, who would have guessed, it saves them money at the same time, which is probably the reason it'll take a ton of progressive effort to get such a system implemented here.
What has been such a success story for Norway was built on really quite simple thinking:
*Minimize the spread of infections by having the sick stay isolated.
*Over the long haul, drastically cut the use of antibiotics so bacteria cannot develop resistance.
Haug unlocks the dispensary, a small room lined with boxes of pills, bottles of syrups and tubes of ointment. What's here? Medicines considered obsolete in many developed countries. What's not? Some of the newest, most expensive antibiotics, which aren't even registered for use in Norway, "because if we have them here, doctors will use them," he says.
He points to an antibiotic. "If I treated someone with an infection in Spain with this penicillin I would probably be thrown in jail," he says, "and rightly so because it's useless there."
Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections.
"We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug.
This is basically what I've done my whole life. If I get sick, I'm sick, and as long as I'm still functional, there's no chance I'm going to take any drugs. Hot tea and chicken soup for me. Well, that and my parents were never like so many today, forcing hand sanitizer on their kids every 30 seconds, disinfecting every square inch of the house, and discouraging going outside and getting dirty. Never letting their kids build up an immune system.
We can move back in this direction, but it would go a lot more smoothly if we could make a few societal changes that have helped Norway fight infections:
Convenience stores in downtown Oslo are stocked with an amazing and colorful array — 42 different brands at one downtown 7-Eleven — of soothing, but non-medicated, lozenges, sprays and tablets. All workers are paid on days they, or their children, stay home sick. And drug makers aren't allowed to advertise, reducing patient demands for prescription drugs.
I think the last two are the real kickers, and would be hardest to adopt in the United States.
We already have a crisis in the workforce. People go to work sick, or send their children to school sick, because taking a day off could mean not being able to pay the electric bill, or getting fired for laziness. So the infections spread, any everyone pays. But only our government could mandate paid sick days, and I don't think we have progressive enough leadership to take that step.
Drug advertising reform might be even harder. in 2005, drug makers spent $4.2 billion on direct-to-consumer marketing (.pdf warning):
Studies GAO reviewed suggest that DTC advertising has contributed to increases in drug spending and utilization, for example, by prompting consumers to request the advertised drugs from their physicians, who are generally responsive to these requests. Evidence suggests that the effect of DTC advertising on consumers can be both positive, such as encouraging them to talk to their doctors, and negative, such as increased use of advertised drugs when alternatives may be more appropriate.
Commercial breaks are littered with drug ads. Birth control and Botox during female-oriented shows. Pills to help you get a boner and pee better during NFL games. The industry spends the money because the ads work. And as a society, we pay, and we suffer.
As Norway has banned drug makers from advertising, it truly is up the the doctor to decide what, if any, drugs are best for their patient. Which makes sense, because one party went to medical school, and the other simply watched TV and saw an ad targeted to them. We could put such a policy in place. There are already strict rules on how cigarette companies can advertise their product. We could put similar restrictions on the pharmaceutical industry.
The government of the United States implemented a test program modeled on a part of Norway's MRSA-fighting system, with great results:
In 2001, the CDC approached a Veterans Affairs hospital in Pittsburgh about conducting a small test program. It started in one unit, and within four years, the entire hospital was screening everyone who came through the door for MRSA. The result: an 80 percent decrease in MRSA infections. The program has now been expanded to all 153 VA hospitals, resulting in a 50 percent drop in MRSA bloodstream infections, said Dr. Robert Muder, chief of infectious diseases at the VA Pittsburgh Healthcare System.
"It's kind of a no-brainer," he said. "You save people pain, you save people the work of taking care of them, you save money, you save lives and you can export what you learn to other hospital-acquired infections."
Pittsburgh's program has prompted all other major hospital-acquired infections to plummet as well, saving roughly $1 million a year.
"So, how do you pay for it?" Muder asked. "Well, we just don't pay for MRSA infections, that's all."
Now isn't this the kind of project progressives and staunch conservatives could, in good faith, work together on? A pragmatic solution that provides better care while at the same time saving the taxpayer money.
So regardless of what may or may not happen with the health care bill as it becomes finalized and voted on, we should work hard to implement common sense solutions pioneered by in Norway and proven effective in Pittsburgh.