A Medical Mess Created by the Anarchy of Capitalism

Aug 7, 2006

At least one and a half million people are injured or killed every year by medication errors in hospitals, nursing homes and clinics, according to a study issued July 20 by the Institute of Medicine. One panel member said they suspected these figures about medication errors are “serious under-estimates.” Another panel member said, “Everyone in the health care system knows this is a major problem, but there’s been very little action....”

More than four billion prescriptions are written in the U.S. each year. Drug errors can result from pharmacies not being able to read doctors’ handwriting. Errors also come from drug interactions, from lack of computerization of patients’ records, from dispensing errors by clinic staff and from mix-ups of similarly named drugs.

In previous reports, the Institute of Medicine noted that an electronic prescription system could prevent a large part of such errors. But so far fewer than 20% of hospitals use such a system. Only this year did the Food and Drug Administration (FDA) finally require all medications to carry a bar code. But it did not require all manufacturers to use the same system, so the manufacturers have come up with at least six different systems. And the FDA is still reviewing, as it has been for the last six years, how to make drug labels and drug inserts more readable–on the 100^th anniversary of regulating drugs!

In fact, there is one system that fills drug prescriptions with an error rate of less than one%. What is it? The VA–the Veterans Administration.

Certainly there are big problems with the VA, as every vet knows. But its system works better than the others. One way the VA solves some of these problems is to standardize practices in its 154 hospitals and 875 clinics. Another is the use of computerization in medical records–96% of prescriptions and medical orders are in the computer system. Another important factor is that it has one source of funding and no one is directly making a profit from it.

Compared to other health care systems, the VA ranks far higher than others on long-term care and follow-up care. And it saves money on drugs–a savings estimated at one third less than what those on Medicare Part D are paying.

The VA also faces a budget crisis. The government has cut its budget. At the VA the waits are too long and there are too few services for all those in need. But the fact that the VA system has done better than others, despite lack of funds, proves we could have decent quality health care throughout the U.S. at an affordable price. But it would require an entirely different health care policy.