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Congressional Testimony
February 10, 2000
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 1347 words
HEADLINE:
TESTIMONY February 10, 2000 PETE STARK CONGRESSMAN HOUSE WAYS
AND MEANS HEALTH MEDICAL ERRORS
BODY:
Committee on
Ways and Means Subcommittee on Health Hearing on Medical Errors Congressman Pete
Stark February 10, 1999 Statement Mr. Chairman, thank you for calling this
hearing today. As the Institute of Medicine report tells us, medical errors
result in injury and death to thousands of patients each year, and billions of
dollars in wasted costs. It is time for the health care industry to catch up
with other industries in preventing errors. While much of the information
reported by the IOM has been known for some time, the IOM report has focused our
attention on the issue and helped us realize that we need to take action now to
address this problem. Almost exactly two years ago, on February 26, 1998, you
had the foresight to call a hearing of this Subcommittee on "Assessing Health
Care Quality". At that hearing, Dr. Mark Chassin, Chairman of the Institute of
Medicine's National Roundtable on Health Care Quality, testified that research
on health care quality over 20 years is clear and compelling - "we have serious
and extensive problems in quality of care in American medicine." Dr. Chassin
said the need to act is urgent. The IOM report tells us that most errors occur
in health care due to poor systems design, just as errors occur in other
industries. Health care workers are placed into systems in which errors are
bound to occur. The way to reduce errors in health care is the same as in any
other industry - by changing and improving the systems design. However,
witnesses at our previous hearing and the IOM report have told us that
improvements in systems changes in health care have lagged far behind changes in
the commercial sector. According to the IOM report, health care is "a decade or
more behind other high-risk industries in its attention to ensuring basic
safety." The IOM report tells us the reason that health care has lagged behind
other industries is that reducing errors has not been a high priority in health
care, and not because the knowledge was lacking to make the improvements. Mr.
Chairman, I agree with those who tell us that we need to create a process in
Medicare that focuses on quality improvement in a collaborative way rather than
in a regulatory way. A collaborative quality improvement system would not
interfere in any way with the regulatory system now in place, nor the legal
system. Instead, it would be separate from those regulatory and legal processes,
and its information would be protected from those processes. We have had such a
confidential reporting system in Medicare since 1982 - the Peer Review
Organizations (PROs) - and it has worked well. I believe that we can build on
the PRO system, rather than creating a new process. Mr. Chairman, whatever we do
in quality, I hope we can pay special attention to the kidney disease program in
Medicare. In 1997, we called for quality standards. HCFA is still working on
these standards. It is way past time that a Continuous Quality Improvement
Program for ESRD was implemented. The fact is, some dialysis centers are
needlessly killing people, and we have the data to show it, and they should
either shape up or ship out. In addition, quality improvement legislation can
help us end treatment disparities that have been shown to exist, even in
Medicare - gender, income, and racial. It can also be a major help to employees
of providers by reducing the number of needless deaths and illnesses caused by
medical accidents, such as accidental needlesticks. Finally, I
am pleased to see that you have called a hearing on Medicare pharmaceutical
coverage for next Tuesday. The IOM report gives enormous emphasis to the number
of preventable errors in the dispensing of drugs in institutions. But the
problem is also severe in the outpatient side. I believe the single most
important step we can take to quickly reduce the number of deaths and injuries
is to pass a Medicare prescription drug program that will include computer
programs to detect and prevent inappropriate dispensing of prescription drugs. A
Medicare prescription drug program will not only help seniors afford their
prescriptions, it will help save them from adverse drug reactions and dangerous
combinations of prescriptions. Mr. Chairman, quality of care has never been a
priority in Medicare, and I believe the time has come for us to make it a
priority. Improving quality of care and preventing errors are not partisan
issues. We all want to improve quality and prevent errors. I look forward to
working with you on this important issue. Let's act on it this year. Thank you,
Mr. Chairman.
LOAD-DATE: February 14, 2000
