Just as Bad in Canada
I don't think healthcare and quality is a “Private vs. Public” debate. As we'll inevitably have debate during the 2008 U.S. Presidential election, I think it's important to keep quality in mind (not just cost and access). Side note, electing a President sure is a “long lead time” process, we've already started the process here in early 2007.
In Canada, they have a single-payer government healthcare system. Canada is suffering from the same types of medical mistakes and patient deaths that are commonplace here in the U.S.
Canadian Institute for Health Information (CIHI) statistics show that as many as 24,000 people die each year from avoidable events like surgical errors, wrong medications and hospital-acquired infections.
These types of estimates are often questioned. The number thrown around for the U.S. is 98,000 avoidable patient deaths (Institute of Medicine's “To Err is Human” report). Assuming the Canada numbers are accurate, keep in mind that Canada's population is about 1/9th that of the U.S. So, either the per-capita avoidable death rate is worse or it's roughly the same scale.
Glossing over the details of “unknowable numbers,” I think it's fair to assume that we have the same results from the very different systems in the U.S. and Canada. We shouldn't necessarily expect that a shift from one to the other would help, right?
The Canadian columnist I've linked to makes her case about standard work and quality:
A recent Auditor General's report estimated that one of every nine patients admitted to a Canadian hospital will become infected. Listening to hospital administrators doesn't exactly inspire hope. A televised response from the head of a Montreal hospital where patients died due to a particularly nasty C. difficile outbreak stated that he would “try harder” to get doctors and nurses to wash their hands between patients. And a B.C. regional health authority recently spent $130,000 on a campaign to “remind” staff about the importance of hand washing.
Try? Remind? If you were running an airline would you “try” to get the ground crew to properly service the aircraft, or “remind” the pilots to go through the final checklist just before they pushed the throttles forward? Of course not. You would require adherence to standardized safety procedures on a zero-tolerance basis.
The biggest difference is that pilots are employed by the airline, while doctors, in the U.S., are usually not employed by the hospital. I'm not sure if that's the case in Canada (does anyone know? please comment).
My question: Not that we want to lead with “firing people” as the first step, but has there ever been a case of a doctor getting fired or losing their privileges for bad hygiene?