Health Care Reform and the Treatment of Heart Disease

There have been endless hours of discussion regarding “Health Care Reform.”  I once heard that you didn’t want to see sausage being made, but it sure tasted good.  That certainly holds true for our process in Washington.  Unfortunately, what the Congress and Senate are arguing about is not “Health Care Reform” but insurance reform and how we pay for our medical care, which as it is often pointed out, is very technical and expensive but it often doesn’t accomplish much.

Recently this phenomenon was again pointed out to me in an unsettling way.  An article was published in Circulation: Heart Failure on November 10, 2009, detailing our United States failure in the treatment of heart failure.

This article detailed the startling fact that 25% of heart failure patients discharged were back in the hospital within 30 days.  This was not occurring in isolated areas but was the figure across Medicare.  Since Medicare recipients have insurance and drugs as well as ancillary care, the figure for non Medicare patients is likely higher.

Further, this readmission rate figure is consistent from year to year.  It occurred in each of the years from 2004 to 2006.  So not only are we doing a poor job; but we don’t even know how to fix it.  This was documented by the statistic that half of the hospitals in the United States had risk standardized readmission rates within 1.5% of one another indicating that none of them had a better idea.

Part of the problem is that our present system rewards poor performance and stagnation.  I do not mean that doctors don’t try to make a patient truly better from their chronic condition but if they “fail” and the patient is readmitted, they get paid again.  If you had a car which didn’t work, how many times would you take it back to the same place to try again?

Although the problem can be identified in a blog, an entire book could be written on this issue.  This is a major issue as it accounts for the major expense to the Medicare system.  People do not realize that the mortality of patients with the diagnosis of congestive heart failure over five years is close to 100%.  As heart disease is the leading cause of death in the United States, the amount of money being spent is truly astounding.

This is a topic I will blog about continuously this year.  The medical system is moving on many fronts to confront and solve this problem and to define systems that work and can be put into place.  Technology is now available to help and I will detail much of this in coming blogs.

Tags: Health Care Reform, Heart Failure

This entry was posted on Thursday, January 21st, 2010 at 10:54 am and is filed under Heart Failure. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.