Journalism in the Public Interest

Could The Supreme Court’s Health Care Ruling Kill Patient Safety Reforms?

In all the talk about the Supreme Court’s impending health care reform ruling, one question is often overlooked: What might happen to the many patient safety and quality of care provisions sprinkled through the Affordable Care Act?

In all the talk about the Supreme Court’s impending health care reform ruling, one question is often overlooked: What might happen to the many patient safety and quality of care provisions sprinkled through the Affordable Care Act?

They include a new Center for Quality Improvement and Patient Safety, more reporting of infections, injuries and mistakes in hospitals, and incentives for doctors and other providers to improve the care they provide. Those among the nation’s 50 million uninsured who manage to get health coverage will also get better medical care than piecemeal or nonexistent version they now receive.

We’ve been talking about quality of care on Facebook with more than 700 users who’ve joined our discussion group on patient safety.

The Supreme Court could uphold the entire health care law or kill it, extinguishing its quality initiatives. Or the court could strike down the mandate to buy insurance alone — a possibility that has long-time SCOTUS watchers on the edge of their seats. What then happens to the rest of the law no one really knows.

We asked some experts what’s at stake for patients. Here’s some of what they said:

Leaving uninsured Americans behind makes hospitals less safe — Sharona Hoffman, professor of law and bioethics, Case Western Reserve University

“Emergency rooms are really stretched because they provide the only source of care for millions of uninsured, which affects the quality of care for everyone. Hospitals are a place that should be a last resort. There are risks of going to a hospital because infections have become so common, for example.”

Provisions that prevent patient harm and unnecessary care will help out employers — Helen Darling, CEO National Business Group on Health

“If the court throws out the whole act it would be stunning in its impact … You have hundreds of millions of dollars spent on getting wrong treatment and sometimes harmful treatment. There’s a long list of waste and harm in the U.S. health care system today and [employers] just think that’s outrageous, because they spend so much money.”

The act is a chance to learn how to keep patients safer — David Howard, health policy professor Emory University

“The bill makes a number of potential changes and improvements to Medicare. So we lose the potential to learn from those pilot projects ways to improve the health care system.”

Reform will give millions access to the same flawed, unsafe system — Rosemary Gibson, author, patient advocate

“People will have access to the same system — the good and the not so good. They will receive needed care that will save their life. They will also be exposed to harm: errors, infections and overtreatment.”

The private sector will handle it, though slowly Robert Field, professor of law and health care policy at Drexel University

“There are private forces beyond the health care reform law that are promoting health care quality. The horse is out of the barn on patient safety, and things are going to change anyway — but they may change slower without the Affordable Care Act.”

Culturally competent care can reduce errors Jennifer Ng’andu, National Council of La Raza

“One of the exciting things about the Affordable Care Act is that it really challenges the paradigm of how [providers] approach culturally and ethnically appropriate health care … We know there are preventable errors because of health inequality in the health care system and it’s costing us.”

The US has the best medical care but, that’s not saying much. Medical care is terrible with the industry in the US killing over 1 Million people a year. In 5 years that’s over 5 million or Hitler’s pace. The reason that this happens is because of government intervention and the shortages that it creates. Because of the shortages, we are forced to keep incompetent doctors and other personnel plus ineffective treatments and medications. Government intervention only makes things worse and more expensive. We will be better off if the government starts following the Constitution and stays out of it. The price will go down and the quality will go up.

You are uninformed. Socialized medicine is the only way to go. Just go to world health organization and lookup where the USA stands as far as quality of health care
All the other socialized countries are ahead of us and at half the cost.
And no none of the rumors are correct as you can go to any doctor like in Canada

Talking about Canada, a lot of American people with diabetes are having to import natural pork and beef insulin from Canada and England for survival and quality of life, because it is no longer available in America. That is just wrong.


You are definitely misinformed. Government intervention is actually saving your tax dollars from healthcare fraud. I am working in a Compliance program which teaching doctors to bill correctly. This is saving tax payer money. Government also makes sure that hospitals do the same thing. I have also worked in Intensive Care Units and I have seen the uninsured increase, which actually increases tax payer costs. What really increases healthcare costs are the hospitals NEEDING to buy expensive equipment and doctors have been found performing unnecessary procedures on patients, like open heart surgery. Really, open heart surgery on patients that don’t need it , just because they wanted to make more money. Government is cracking down on medically unnecessary procedures and testing. I am glad that you are intelligent enough to pursue non-corporate owned news media, which are not biased compared to MSM. Pam, I agree, pharmaceutical cos. are financially raping the American citizens, with their pricing structure and Medicare Part D did not have better pricing restrictions.


Even Justice ACLU said his “masterpiece” is a mess.

You want to die, waiting for a BUREAUCRAT to rule on your case, go ahead.

Those with common sense will DEFEAT OWEbama on Nov. 6 and get rid of his MESSES.


If Candian medicine is so good—why does its leaders get treated in the USA?

Hmm .. they do not want to DIE??

Get rid of OWEbama on Nov. 6. Your life depends on it.

The problem with healthcare isn’t that it’s private.  Socializing it might create some improvements, but it could also drive it off a cliff, as people from many socialist countries will attest.

The problem is that it’s a monopoly.  The AMA (and groups like it) is union, corporate boss, and legislative body (partly via heavy lobbying) rolled into one.  Your doctor will lose his license if he competes by, say, advertising his rates in the newspaper.  He won’t lose his license if he amputates the wrong leg.  That’s not because your doctor wants to maximize his profit, it’s because the AMA wants to maximize ITS profit.

So, Emmett’s close.  Why do you not have enough doctors in your neighborhood.  It’s not because of the government.  It’s because the AMA refused to license doctors who wanted to move there.

If you break an arm, it’ll cost you twelve thousand dollars for something most Boy Scouts will do for you for free just as well:  Set the arm with a splint and tell you to buy some aspirin.

(Speaking of which, don’t forget the pharmaceutical industry, who brands imported drugs as “counterfeit” to hide the fact that patients in India get for a dollar the same pill that costs you fifty.)

Now, what’s worst of all is that Obamacare isn’t even socialized medicine.  It’s just more of the same!  Rather than be under the exclusive thumb of the AMA, you’ll be progressively under the thumb of an insurance company that’s under the thumb of the AMA.  If you read through the law, what you see more than anything else is that it’s hundreds of pages that say, “you citizens need to buy health insurance from companies we recommend.  You can buy more, if you want.”

Here’s my challenge to the government or anybody who wants socialized healthcare:  You drive the price of routine care down to what it actually costs (I have ideas of how), and I’ll happily support as high a tax as you want to care for the critically ill.  I will not, however, support any plan that maintains and enforces the status quo of the AMA, insurance companies, and pharmaceutical companies abusing patients.  That’s the worst of all worlds, and will not improve healthcare in the slightest.

Notice that no proposal on the table, no politician, is interested in solving the problem.  They only want to “do something,” especially if it involves siphoning more money out of the economy and tracking and monitoring more Americans.

As to the actual topic of the article, those “enticements” weren’t going to work anyway.  They never do.  If you swore to “do no harm” and still sawed off the wrong leg or left a dirty sponge in your patient’s heart, it’s not going to stop because Washington offers you a tax break.  We know this, because malpractice insurance costs more if you screw up more, so there are already strong incentives in place.

At best, they’ll fudge the numbers, just like many big government contractors do.

You know what would work?  Suspend them, just like you would a cop.  Partly as punishment, sure, and partly to keep a dangerous doctor away from patients.  But most importantly, these mistakes probably happen (based on every other field and every study I’ve seen) due to fatigue.  Six months away from the practice, in many cases, would work wonders for both the doctor and his patients.

Joleen Chambers

June 18, 2012, 4:39 p.m.

What I have learned as a patient advocate for a harmed family member:
1. FDA approves implanted devices that are not clinically tested
2. The public trusts the government/FDA
3. If an implanted medical device fails, the only accountable entity is the patient who discovers medical and legal purgatory
4. The medical device industry is very profitable and purchases lobbyists and celebrity spokespeople
5. Congress folds under pressure/greed and marketing/advertising drives sales.
6. The more we talk about this openly, the more people avoid/postpone medical implants.

This is an article? No. It is once again and advertisment for obamacare. Propublica has become CNN or Fox so predictable in their spin. So bias in their editorials, you can’t call them news articles, they must be editorials.
John from yesterday at 11:46,  great comment, thank you.

Mother of Diabetic

June 19, 2012, 7:38 a.m.

This is why we need freedom on the internet. Importing insulin now, but shouldn’t have to.
I left this comment on the internet:
I just read that George H.W.Bush & Dan Quayle with ties to Eli Lilly encouraged the fast track of the rDNA synthetic insulin through the FDA & then the Bush administration tried to limit the public’s ability to sue drug companies. The profits from rDNA synthetic insulin affords the powerful to purchase new cars for their children, while we parents of diabetic children are left to purchase coffins or worse for our children, because of the defective insulin that we are forced to buy in America.

This was the reply to that comment:

She is right. Cloned insulin is a defective product. In Eli Lilly’s cloned insulin’s phase 2 clinical trials in England in 1982, there was a 30% adverse reaction rate. But Eli Lilly covered that percentage up and had their own doctors report a 2 to 3% adverse reaction rate. Again, Eli Lilly wanted to raise the price of insulin and couldn’t do so unless they “improved” it. But cloned insulin IS NOT an improvement, just another defective product from Eli Lilly. End of their reply.

rDNA synthetic human ( not human ) insulin is the only insulin that you can get in America now, even though Eli Lilly stated that rDNA synthetic insulin wouldn’t work for many diabetics. On and Diabetes International Foundation websites, they talk about how the death rate went up with rDNA synthetic human ( not human ) insulin, with dead in bed, car crash deaths and unexplained deaths. I’m sure the sites will be affected if this should pass, because the drug companies don’t want the truth out there.

If you go to ” Dollars for Docs ” you will find that many doctors are paid by drug companies which is a conflict of interest to say the least. Many doctors have gone from healers to short-sighted business people. Many doctors, for a few shiny beads from the drug companies, will throw their patients under the bus.

Any drug company that can knowingly profit from a drug that they know will cause death or worse is in my book a sociopath. These sociopaths become wealthy and use their wealth to shape this country for their benefit. They are not out of touch with the working class, they are mentally ill. The irony is, that if they seek psychological help from many American psychologist who accept shiny beads from the drug companies, they will find themselves under a bus.

I donʻt trust our government. If health care is run by the government, it will cover-up the atrocities it causes. All of a sudden, recommendations for screening times will double and triple. You wonʻt get good health care from the US government. If the government canʻt run the government, how do you think it will run health care?

I can’t believe the insurance company did this. The phone rang and I turned the oven off and ran to the phone in case it was a family emergency. It was an automated phone call from the insurance compamy leaving a message on my phone stating that according to their records that I had not had an annual mammogram this year and needed to set up an appointment with my gynecologist. If they had my medical records, then they should have known that I have never had a mammogram and never will, but that’s beside the point. Since it was the last call, I star 69’d it and the number was 866-308-4778, so I called the number and a recording said that it was BlueCross BlueShield and they wanted my identification number, so I hung up and called the service number on my insurance card.

When I called the service number a really helpful man answered and I told him what had happened. I told him that I was on the no call list and I wanted my phone number removed from their list. He said,” Oh no, the insurance company would never make a call like that and asked me for the phone number and would I hold while he called the number.” When he got back on the line, he said that they had made the call and he told them to take my number off their list. I see two big problems here, number one is they are a business and I’m on the no call list and number two is medical information is supposed to be confidential and the phone they called on is not in a private area.

Most people think that they have to go in for these test or lose their insurance. I don’t know why true it is, but I’ve read on the internet that insurance companies own these mammogram machine.

This article is part of an ongoing investigation:
Patient Safety

Patient Safety: Exploring Quality of Care in the U.S.

More than 1 million patients suffer harm each year while being treated in the U.S. health care system. Even more receive substandard care or costly overtreatment.

The Story So Far

Too many patients suffer harm instead of healing in U.S. medicine. That’s why ProPublica’s reporters have investigated everything from deadly dialysis centers and dangerous hospitals to the failure of state boards to discipline incompetent nurses.

This page allows patients, providers and readers to join the patient safety conversation. Our goal is to find out why so many patients are suffering harm and highlight the best ways to solve the problem. Here you’ll find regular updates, and places to share your stories, views or expertise.

Read all of our posts on patient safety, and find out how to get involved.

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