All we need is insurance…NOT

Within Article II, Section 3 of the Constitution it states that “he [the president] shall take care that the laws be faithfully executed.” It is safe to say that before Obama, no president in our history has purposely delayed implementing a law that was supposed to be his crowning achievement.

Yet, despite the original deadline of October 1, 2013, the employer mandate for health insurance has been delayed until 2015, and the individual mandate is under attack in the House, and may eventually be delayed, as well. These mandates are at the very heart of Obamacare, and are based on the quite absurd notion that lack of universal insurance coverage is the biggest problem facing American health care.

In reality, the biggest problem is that we are paying drastically more than any other country in the world for our care, but our outcomes on average are markedly inferior. This is largely because our system hugely favors procedural and acute medicine over cognitive and preventive medicine. As a telling example, infection control is a stepchild, even though there are at least 1.7 million healthcare-associated infections each year in the US, causing 99,000 deaths. Nearly all of these are preventable.

Here’s one that took place in New Brunswick, Canada. But make no mistake, similar incidents have occurred here in the US of A. I present this as a cautionary tale.

A few weeks ago, it was reported that “2,497 current and former patients who underwent biopsies in the Miramichi Regional Hospital’s colposcopy clinic may be at risk of HIV and other infections because standard sterilizing procedures weren’t followed over a 14-year period.” Colposcopy is a diagnostic procedure in which lady parts undergo examination, often as a follow-up to abnormal Pap results.

It would soon be revealed that forceps used during these tests–between May, 1999 and May 24, 2013–were not always sterilized in accordance with the best practices. In some cases, they were only high-level disinfected (HLD).

An instrument is considered “critical” if it penetrates sterile tissue, enters the vasculature, or contacts the patient’s blood. Sterilization is used primarily to prevent reusable critical instruments from transmitting disease during their reuse. Notably, forceps are considered critical. Thus, they must always be sterilized before use. HLD is not intended for critical instruments.

So, what happened? Prior to May, 1999, there were enough forceps on hand to assure that only those sterilized the night before would be utilized. At some point after that, though, there were not enough sterilized forceps to cover all the day’s cases, so HLD was performed during the day. That’s right, some genius decided to save a little money by not purchasing more forceps. Will this person be held accountable? Of course not, anymore than the cretin who hired the drug-addicted perp who caused last year’s Hep C breakout in New Hampshire and other states.

But, no worries. All the victims were covered by insurance.

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