The president should make medical errors a priority -- to save both lives and money

The state of our health care

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Dear Mr. President:

I am writing with a suggestion for action on your part which I believe will vastly improve health care outcomes and reduce medical costs across the nation.

In your State of the Union message, announce that you have ordered each of the veterans' hospitals and U.S.-based military hospitals to connect with the Internet at 8 a.m. every day to post every hospital-acquired infection, every patient fall, every medication error and every injury to a caregiver that occurred during the previous 24-hour period. Announce that this will commence March 1, and that it is your intention to require all U.S. hospitals and nursing homes to start doing this on April 15.

To have the desired impact, it is important that this information be reported separately for each facility for each 24-hour period. That is because, every 24 hours across the nation there are, on average, 4,658 newly identified hospital-acquired infections, 1,369 patient falls and perhaps as many as 800,000 medication errors. Furthermore, injuries to caregivers are among the highest rates of any occupation, with as many as 950 injuries per day in the United States.

You might ask, "If we know these facts, what is the purpose of posting them every day?"

Here is the answer: We know these facts in an abstract, non-actionable way. It is not possible today for a citizen to go on the Internet to discover how safely, or how carelessly, a local provider is providing care. And it is not possible for care-giving institutions to gauge their own performance and compare it to others. By your action, you could enable individuals to choose where they go for service, based on the absence of error, not on the basis of proximity or advertising claims. And you would allow care-giving institutions to identify the best performers across the nation and learn how to improve their practices.

I, and others, have estimated the opportunity for cost reduction in American medical care at between $750 billion and $1 trillion per year. What could be better for our health care system than dramatically reducing these costs while improving outcomes?

As you do this, you should pledge that this information will not be used to penalize or criticize any individual or institution -- that its sole purpose is to provide the basis for everyone to improve together.

You have the executive power to do this. In the spirit of experimentation, you should announce that you will stop this process in three years it if does not produce significant results.

There will be many naysayers with many reasons why you should not do this. You should remind them that most 10-year-old children connect to the Internet every day and post a lot of less useful information, so adults should find this easy to do, with huge benefits to our society.

Mr. President, you have nothing to lose by taking this action, and it would allow We, the People, to live longer, stay healthier, spend less and find more of the happiness we pursue.


Paul H. O'Neill was secretary of the Treasury under President George W. Bush and is a former CEO of Alcoa Inc.


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