Wednesday, April 15, 2009

Health care IQ – The results…

Thank you for filling out the survey from my April 13th blog entry. My source for this information came from a book titled, “Redefining Health Care” published in 2006 by authors Michael Porter and Elizabeth Teisberg. Michael Porter is a professor at Harvard Business School and Elizabeth Teisberg is a professor at the University of Virginia Business School. They specialize in competition, business strategy, and innovation. Michael has authored about 20 books and published 70 papers since the mid 1970s, many of them focused on health care.

Survey Q&A

Question #1

How many years does it take between the results of a successful clinical trial and that drug / process becoming a standard medical practice?
· 2 years
· 5 years
· 10 years
· 17 years

80% of survey respondents chose 5 and 10 years. 20% of respondents chose 17.

The answer is, 17 years. I don’t know about you, but this really blew me away. I watched the standard of care change for head and neck cancer patients over the past few years. 4 years ago the standard of care was radiation followed by surgery followed by wait and see. The current standard of care is concurrent radiation and chemotherapy followed by wait and see. I don’t often dwell on how my life could be different “if only” this or that happened. But I do focus on this one. What if the standard of care adaptation had been speedier? 17 years is just too long. And, here’s the sad part. My cancer hospital is probably an early adapter to change. There may still be great cancer hospitals out there treating head and neck cancer today with the old standard of care. I feel bad for the impact on the lives of those patients.

Question #2

Motor vehicle accidents cause more deaths per year than in-hospital medical errors (e.g., wrong drugs, preventable infections). True or False?

80% said false, 20% said true.

The answer is false. According to a study published by the Institute of Medicine (IOM) in 1999 (a little dated), there were an estimated 44,000 to 98,000 preventable in-hospital deaths per years. Motor vehicle deaths were about 45,000. My perspective on this is that preventable in hospital deaths have dropped dramatically since the 1999 study was published at the higher quality hospitals due to building quality, accountability, and transparency into the patient care process.

Question #3

There were (fill in the blank) Americans without health care insurance coverage in 2004. Possible answers were:
- 25 Million
- 45 Million
- 65 Million
- 85 Million

Survey participants were split evenly on the first three choices... 25, 45, and 65 million.

The book quotes a figure of 45.8 million Americans without health insurance in 2004. So, everyone was close to the right answer. The World Factbook puts our current population at 307 million. So, that boils down to about 1 out of every 7 people in the US is without health care insurance coverage. 45.8 million is a huge number. One issue with this is that for most of these people, their first line of health care is a trip to the emergency room. There, they are treated and admitted or sent on their way. Unfortunately, emergency room treatment is expensive and puts a drain on everyone else. One could write an entire book on this subject alone. There are no good quick fixes here.

Question #4

There is a high correlation between how much one spends for health care and how satisfied one is with their care. True or False?

Most survey participants chose false. False is the correct answer. I won’t get into the details of the book, but they measured health care costs in all 50 states. For a similar population set and type of services, costs ranged from a low of $3,500 per year in Hawaii to a high of over $8,000 per year in Louisiana. There was virtually no correlation between health care cost and satisfaction.

Question #5

Medical care spending in the US is 14% of our Gross Domestic Product (GDP). Medical spending in Mexico is less than half that of the US. Life expectancy in Mexico is higher than in the US. True or False?

About 40% of survey participants chose false, the rest chose true. The answer is false. Again, the data is a bit dated (from 1996), but the US life expectancy is 79 years and Mexico is a bit over 76 years. The highest life expectancy is in Japan at 83 years. They spend about half as much on health care as those in the US.


You all did pretty well with your health care IQ. What we need in this country is a health care system which is transparent, reports results (good and bad), looks at care holistically from the patients perspective (from prevention, to care, to rehabilitation), and allows free market competition among heath care providers. I hope you learned something from participating in the survey or at a minimum it gave you some good food for thought.

Thanks again for participating.

Enjoy, take care, and good health to you all.


Anonymous said...

Thanks Ed. I enjoyed your blog today. How true. Stay positive

Anonymous said...

Hi Ed, I missed taking the survey, but enjoyed learning from your results posting.