Letters at 3AM

Illustration By Jason Stout

The numbers stun. "Of every 20 people who go into a U.S. hospital, one of them picks up something extra: an infection. ... For 90,000 Americans a year, the infections are a death sentence. ... Two million patients get a hospital-acquired infection every year. ... Nationwide, hospital infections are the eighth-leading cause of death [my italics]. ... [And] in most parts of the country, it's virtually impossible to find out how well hospitals are doing at infection control overall" (AARP Bulletin, January, p.12). If 2 million were infected and 90,000 were dying from diseases contracted at movie theatres or sports arenas, those venues would be closed amid headlines and government investigations galore. If terrorists killed 90,000 Americans a year, we'd be living under marshal law. But hospitals are protected by powerful insurance and health-industry lobbies, so as yet no one in the federal government seems vitally interested.

In addition, "More than 2,000 patients are dying needlessly each year from the use of stents, the tiny medical devices that prop open heart arteries" (The New York Times, Oct. 12, 2006, p.22). And "46.6 million Americans, including 8.3 million children, had no health insurance in 2005, up 1.3 million from the previous year" (The Washington Post, May 25, 2006, p.12). "The National Academy of Sciences ... estimates that lack of health insurance leads to 18,000 unnecessary American deaths ... a year" (The New York Times, May 1, 2006, p.19).

Keeping count? The 2005 figures amount to 110,000 deaths a year caused by how we do (or don't do) health care. A decade of that, and it's as though terrorists nuked Chicago. Nuking Chicago (or Waco, for that matter) would drive us into a fit of national hysteria, but so far our 110,000-per-year needless "health care" deaths haven't tweaked our collective sentiment. We've been immune to news like "Medical Errors? Patients May Be the Last to Know" (The New York Times, Aug. 29, 2005, p.F7) and "Health Care Costs Rise Twice as Much as Inflation" (The New York Times, Sept. 27, 2006, p.C1).

The "average number of patients injured by medication errors of health professionals" is 1.5 million (Time, July 20, 2006, p.20). These errors "kill several thousand each year" and "are so widespread that hospital patients should expect to suffer one every day they remain hospitalized. ... Even simple medication safety recommendations – block-printing on hand-written prescription forms – are widely ignored" by care-providers (The New York Times, July 21, 2006, p.21, my italics). "Research suggests that more than half the time health care workers even fail to wash their hands as recommended" (AARP Bulletin, January, p.12). Imagine the state we'd be in if 1.5 million Americans were injured every year, and several thousand killed, by terrorists instead of health professionals.

We don't have to wait for bio-weapons to attack the United States. Doctors who overprescribe antibiotics in hospitals – which experts have warned against for years – are doing the terrorists' job for them. The technical term for this biological agent is "community-acquired methicillin-resistant Staphylococcus aureus," or MRSA. "Never heard of it? Neither have most doctors. ... It has spread rapidly through parts of California, Texas, Illinois, and Alaska, and is beginning to show up in Pennsylvania and New York. ... Those bacteria have escaped from the hospital and are now communally contagious, spread by contact. ... One of the difficulties in tracking MRSA is that doctors rarely check for it" (Time, June 26, 2006, p.52). MRSA "is infecting normal healthy people everywhere. ... Children that are healthy and playing with their toys in the morning get this infection and are dead that night" (The New York Times, Aug. 22, 2006, p.F7). That article reports the spread of MRSA in Atlanta, Baltimore, Vermont, and Montana. Why are doctors failing to test? The Time report quotes Elizabeth Bancroft, an epidemiologist: "HMOs aren't going to be paying you to do a culture on what they consider to be a [common] skin lesion."

There are no big bucks in prevention. Using fairly simple tests, some VA hospitals have reduced contagious infections by as much as 80%, "but the U.S. Centers for Disease Control and Prevention have thus far declined to recommend [this mode of] screening for non-VA hospitals" (AARP Bulletin, January, p.12). This administration rarely recommends anything that might cost any industry a little money.

Another way our "health" system is killing us: "Health-care costs are the number one reason Americans file for bankruptcy" (CNN, Nov. 2, 2006). CNN also noted that 41% of middle-income Americans had no health insurance for part of 2005.

"The More You Pay, the Better the Care? Think Twice. Several studies suggest that there is no relationship between the amount spent on treating a patient and the quality of care. ... There is mounting evidence that the zeal to treat and spend may actually hurt patients. ... The financial incentives in the health care system ... [don't reward prevention but] encourage hospitals and clinics to provide more services, hire more specialists and install more devices" (The New York Times, Dec. 17, 2006, p.BU4). This situation profits the health care industry hugely. "Since 2001, the health-care sector grew by 1.7 million jobs, while the number of private-sector jobs outside health care has not changed" (The Week, Sept. 29, 2006, p.36). The health care industry "constitutes about 14% of the gross domestic product" (The New York Times, Dec. 3, 2006, p.BU4). That's a ton of financial clout in Washington.

Who pays for that clout? The same people who are endangered by it. Us. But our money doesn't improve care. "We spend much more per person on health care than any other nation, and we have lower life expectancy and higher infant mortality than Canada, Japan, and most of Europe. ... Britain spends about 40% as much per person on health care as the United States" (The New York Times, May 5, 2006, p.23); yet "among U.S. citizens age 55 or over, the rates of cancer, diabetes, and heart disease are almost double that of Britain" (The Week, May 19, 2006, p.18). The British smoke and drink much more than we and eat lousy food, but their system, like most nationalized systems, attends to prevention.

Some states are tackling health insurance. Maine, Massachusetts, and Vermont have versions of "near" universal health care (The New York Times, Jan. 9, p.1). GOP Gov. Arnold Schwarzenegger has proposed a sweeping plan for California that includes "undocumented" children. (Who cares about a child's documents? Those who'd refuse care to any ailing child, for any reason, are not to be taken seriously as moral human beings.) We should insure everyone, by all means; however, the medical system that the uninsured will enter is itself unhealthy, yearly injuring 1.5 million and killing tens of thousands. Only New York has addressed this. "In 1989, when New York state started publishing hospitals' death rates after bypass surgery, the hospitals conducted reviews, hired new personnel and pushed out surgeons with the highest death figures. Statewide mortality dropped like a stone, by 41% in four years" (AARP Bulletin, January, p.12). Which proves these issues can be handled. But, nationwide, why aren't they?

Because of a sickness in the nature of how we perceive. With 110,000 dead and 1.5 million injured every year, the body count cries out that our health care system is a far greater threat to national security than Muslim terrorists. We don't want to hear that. We don't want to hear that we're endangered less by terrorism than by the passivity of health-care professionals toward managed care, by corrupt lobbying, by overemphasizing the profit motive where it doesn't belong, by insisting on the American medical system when there's ample proof that other systems work better. Most of all, we're being killed by our trancelike enthrallment with a theatrical good-guys/bad-guys threat (terrorism), rather than giving proper importance to prosaic dangers that threaten us far more: Our medical system yearly kills nearly 37 times the number of people who died on 9/11. We protest and e-mail like crazy about the war, and so we should, but what of our unjust and lethal medical system? We are being killed by our insistence that our greatest problems are caused by others rather than ourselves. We are dying needlessly by the tens of thousands because we refuse not only to face reality, but even to notice reality.

It's not just Bush. It's the U.S. of A. Both Iraq and our health care crisis are about not looking at ourselves. A disease we're killing for there, dying of here.