4. The Leading Cause of Death in the United States
This idea involves an accounting of many of the ways in which lapses in the management and execution of health care cause fatalities.
This calculation does not include fatalities that would have occurred even with appropriate care. It includes only fatalities that result from a specific identifiable failure to provide reasonable care. For example, doctors or nurses fail to clean their hands before performing an invasive procedure. The wrong drug is administered, or the dose is multiples of what it was intended to be. Blood clots or bed sores (pressure ulcers) lead to death, when following standard procedures to prevent them, identify them promptly, and/or treat them appropriately would have avoided death. And so on.
If one does the accounting carefully and compares the numbers to other causes of death, one is led to the conclusion that failures in health care delivery are the leading cause of death in the United States.
What follows is a quotation from a five-page end note in Elizabeth L. Bewley's book When Health Care Hurts. The conclusion of the detailed analysis is that the leading cause of death in the United States of America is its health care system.
The summary version follows:
The Summary Data for Medical Causes of Death
|Medical Errors in Hospitals||200,000|
|Blood Clots in Hospitals||190,000|
|Infections in Hospitals||75,000|
|Drug Side Effects in Hospitals||106,000|
|Less Possible Double Counts||-38,000|
Net Total Deaths
By comparison, heart disease causes 596,000 deaths annually. Cancer causes 575,000 deaths annually. Other causes are materially less than these.
If one reads the notes very carefully, one might conclude that the "Net Total Deaths" probably leaves out quite a number of deaths that are at least partly attributable to certain lapses in medical care. Maybe tens of thousands who die as a result of being misdiagnosed at a doctor's office, as just one example. The endnote discusses several other potentially large but unreported causes of death in health care not included in the above numbers.