From 2002 to 2003, about 101,000 Americans died from preventable causes ranging from diabetes to bacterial infections and surgical complications, so says a study releases this week.
The reports are based on results from a study undertaken by the Commonwealth Fund, a private New York City based health policy foundation. The study took place among 19 industrialized nations. The results were published in the journal, Health Affairs.
The US ended up at the bottom of the preventable death barrel. France, Japan and Australia were ranked at the top.
Researchers looked at deaths before age 75 from a variety of “amenable” causes which included heart disease, stroke, some cancers, diabetes, bacterial infections, surgical complications and others. They arrived at a death rate and numbers of patients who died before they might have if they had received “timely and effective healthcare.”
Among the countries reviewed, 64.8 of 100,000 French people died from preventable causes. And 109.7 of 100,00 Americans died from preventable causes during 2002 – 2003.
The same study was undertaken in 1997-1998, and the US came in 15th then — so it descended to the health system basement since then. Between the first study and the second study, all of the countries improved their preventable death rates by an average of 16 percent. Except the US — which improved by only 4 percent. (That may not be as bad as it sounds since the US’s rate was at a higher level to begin with.)
Why is the US in such bad shape? Those at the Commonwealth Fund blame access — the fact that 47 million Americans cannot afford insurance or healthcare. I have no doubt access is a big part of it. If you can’t afford healthcare, then you don’t seek it out. Who wants to spend a lot of money on a doctor appointment, only to be told you are sick, when you don’t have the money to treat the sickness anyway.
But I add my own two cents worth of reasons:
First, I believe that part of the answer lies in the way access is handled among those who DO seek help. We have symptoms, we go to the doctor, and the doctor spends so little time with us that too often, the problem assessment isn’t handled correctly to begin with. It’s a problem of misdiagnosis and missed diagnosis. I’d be curious about the correct diagnosis rates among those other industrialized countries. It only makes sense that people will die if their preventable disease isn’t diagnosed correctly to be begin with — even if it is eventually discovered, it may be too late to treat effectively. (Yes, I’ll admit, I’m not particularly objective about this part, based on my own experience.)
Second, I believe our American lifestyles lead to preventable death. We overeat, smoke, drink too much alcohol, drive too fast, live like couch potatoes — and then if we do go to the doctor, we expect the doctor to give us a pill that will fix our bad behaviors. Please! One pill won’t fix a lifetime of unhealthy habits. My curiosity expands to the lifestyles in the other countries that ranked higher than the US.
The Answers for Wise Patients:
A two-pronged attack. First, begin examining some of your own lifestyle habits to see if you can step up to the health plate yourself. Don’t blame your doctor or lack of access for your bad choices.
Second, knowing that your doctor will never (in our lifetime) have more time to spend with you, pick up the banner yourself, and begin empowering yourself. Take responsibility for your own healthcare. Seek out the doctor when you are prepared to do so.
The truth is — excellent care exists in the US for those who seek it out. I know the payment system is a barrier. There is no question about that. But that’s not going to change anytime soon. So we patients need to do what we can to improve our own chances.