Someone told me a long time ago that the secret to life was to make something good come from everything bad that happens to you
The recent problems with the extended VA Wait Times can be a case in point.
Even though the Congress has belatedly begun to take steps to rectify the VA problem it obviously is a very sad situation and we need to get to the bottom of what caused it and get it fixed very quickly.
But - and it is a very large But - We need to fix it ( and a related problem ) in such a way that the problems stays fixed and in fact can never recur again.
Only in that way will we truly be able to say that we have taken this terrible thing and made something good come out of it.
A suggested way to do this is discussed below the fold.
And here in my humble opinion is the way to do that and, as I alluded to earlier, fix the related problem as well.
Consider for a few moments the following statistics documented in the two web sites reproduced here
http://www.npr.org/...
and here
http://www.statisticbrain.com/...
According to the first link somewhere between 98,000 ( in a 1999 study ) and 440,000 people ( in a 2012 study ) die every year through mal-performance of one sort or another in the nations hospitals. At the high end of these numbers, which is where most investigators believe the real truth lies, this mal-performance in the nations hospitals would make it the third leading cause of death in America behind only heart attacks and cancer.
By contrast, according to the second link, there were in 2013 only 34,080 traffic fatalities due to the improper use of a motor vehicle ( and roughly half of these involved the offending driver himself ).
And yet every single highway death is investigated by law enforcement officials and essentially none of the hospital deaths are investigated at all.
And therein lies the solution to our joint problems.
If we want to get to the bottom of the VA problem, and more importantly to the bottom of the much larger private sector hospital problem, then the obvious solution is to subject both problems to the scrutiny of the Criminal Justice System.
Let those numbers sink in a little
Every day 89 people in the US die in traffic accidents and every single one of these incidents is investigated exhaustively by the Criminal Justice System and yet during that same 24 hour period over 13 times as many people ( 1205 ) die from mal-performance in the nations hospitals and not a single one of these latter incidents is investigated at all.
Is it any wonder why these hospital numbers are so staggering and is it any wonder how the VA problem could get so far along before someone noticed it?
When you think about it, it makes no sense at all. A sixteen year old kid getting behind the wheel of a car and then driving a little to fast for the conditions has no intention of harming any one and neither does the doctor who lets his "informed intuition" replace the running of one more medical test which might very well clarify his patients true situation more clearly and yet the result of both actions is a needless human death - a death which in one case is punished to the full extent of the law and which in the other case often does not even result in a civil malpractice lawsuit. Yet in both cases the action that results in death is caused by the same activity - both the driver and the doctor are going “ too fast for the conditions”. The doctor is trying to maximize the income from his profession and the 16 year old is simply trying to get to his destination a little faster than permitted by law but both are exercising poor judgment that results in a needless death of an innocent person.
Why should one activity be treated so much differently than the other?
The sixteen year olds actions are subjected to the extreme scrutiny of an experienced criminal justice system investigator and the actions of the medical personnel are very often not examined at all.
Who could possibly set up such a system -- except maybe the AMA?
And if you want a couple of real life examples that might make you see why this injustice bothers so me much read on.
My daughter suffered a serious fall in an industrial accident when she was 18 years old. This forced her to lead a sedentary life and compounding that problem she began to drink, smoke and eat too much so that by the time she was 40 years old she had become obese in addition to having three other health aggravating habits ( i.e. she was sedentary, smoked too much, and drank too much in addition to being very overweight ). All these things made her a prime candidate for a heart attack and yet when one December day in 2004 her husband drove her to a nearby Emergency Room with severe chest pains the doctor on duty decided she had bronchitis and sent her home where she died two hours later.
In the year 2004 the recommended examination technique for a someone possibly having a heart attack was to give them two Troponin I tests a few hours apart. If the second test was materially higher than the first this test this was a clear indication that heart damage had occurred and the patient should have been treated accordingly. Unfortunately the doctor never ordered the second test with disastrous results.
I say this is nothing less than criminally negligent homicide. The medical profession however considers it to be within the realm of “medical judgment” and in fact the doctor is not even subject to a civil mal practice suit.
I say take the case to a grand jury and then a regular trial jury and let the doctor or his lawyer explain to the second jury why he felt there was nothing reckless in his coming to this conclusion given all the facts of the case.
Even if the trial jury acquits ( which I seriously doubt would happen ) you can be sure this doctor and anyone else who hears of the case will never make the same mis-judgment again.
The second case involves the same hospital and the same emergency room only this time my wife is the patient and I have just taken her by ambulance to the emergency room telling the people there that she had been acting very unusually all day long.
The doctor on duty exercising his “medical judgment” prior to running any tests at all somehow came to the conclusion that she had a urinary tract infection and only needed an antibiotic.
I refused to accept this diagnosis and asked them to run more tests. I should probably mention here that my wife had chronically high blood pressure for which she was being treated by the very same hospital. As was also the case with my daughter my wife had excellent employer sponsored health insurance. Mine in fact was superb as I worked for a British Company.
Six hours later after the test for a urinary tract infection came back negative the doctor at my insistence requested a CT scan on her which showed conclusively that she had suffered a stroke and because so much time ( 6 hours ) had elapsed she was now in mortal danger of dying.
The emergency room personnel gave her some medicine to thin her blood and then had her shipped by ambulance to another hospital in their group which was equipped to perform brain surgery to reduce the pressure on her brain. This procedure was then performed the next afternoon and although the doctor told me and her sister that the operation had been a complete success she was literally smuggled out of the recovery room before my sister in law and myself could see her and she was taken to another room where the nurses informed me that they had had to sedate her prior to our arrival.
She never woke up from the sedation and died 5 days later which was three days after they had disconnected her from life support saying that the CT scan now showed that she was brain dead.
Once again I say let a jury decide. Or at the very least lets have someone in the criminal justice do an investigation and decide for him or herself if this level of medical attention was truly adequate or was once again an act, that outside of a hospital environment, would have been treated as reckless disregard for human life.
Let a Jury decide if these actions represented simple “Medical Judgment” or acting with depraved indifference for human life.
If we did the latter it well may be that we could greatly reduce the third leading cause of death in the United States.
Why do I think that treating these hospital and VA deaths through the criminal justice system will actually have a deterrent affect on the amount of deaths that are caused these truly criminal acts?
All we have to do is look at the highway mortality statistics.
The US started seriously treating bad driving practices through the criminal justice system in 1972.
At that time the number of annual deaths was 54,589 and the number of miles driven per year was 1.1 Trillion.
In the most recent year ( 2013 ) the number of miles driven has nearly tripled to 2.9 trillion and yet the number of fatalities has dropped to 34,080.
Adjusted to compensate for the increased exposure level this means the actual number of deaths per year has declined 76.3% simply because we began earnestly treating traffic deaths through the criminal justice system and not simply as unfortunate but “ inevitable accidents”.
Assuming we got the same kind of improvement in the hospital death rate this would amount to 335,720 human lives saved per year. Certainly this is a goal worth pursuing.
And finally just to make the pile complete. Isn't high time we started locking up criminal bankers for their crimes instead of fining their stockholders who have nothing to do with the criminality to begin with. And while we are at it we may want to consider a bill that will hold the state legislators that refuse to pass Medicaid expansion bills accountable for the deaths we know this action will cause. Right now it seems pretty clear that there are an awful lot of people who seem to have a natural immunity from the Criminal Justice System and this needs to be rectified.
And one final very important point.
Don't let “prosecutorial discretion” replace “medical judgment” in determining whether or not a crime has been committed.
It is after all, “prosecutorial discretion” that regularly allows criminal bankers to walk the streets freely while individual stock holders are asked to pay for their crimes in the form of heavy financial penalties.
The words “Justice for All” have been in this nation’s political advertising for a long, long time now and it is about time that we also made it part of our actual legal code. Not only will it be the right thing to do it will save hundreds of thousands of lives every year.
But we have to insist that this actually be done. We cannot simply write an angry Diary and then go on to other matters as we often do.
The elected District Attorneys of every Jurisdiction in this country need to be told by their electorates that they are not going to tolerate this double standard any longer and that if they do not begin investigating and prosecuting everyone of these atrocities just as they do with highway fatalities they will be recalled and replaced by someone who will take this kind of negligence seriously and then act accordingly.