The money paragraphs for me were:
”
With all the tools available to modern medicine — the blood tests and M.R.I.’s and endoscopes — you might think that misdiagnosis has become a rare thing. But you would be wrong. Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.

As shocking as that is, the more astonishing fact may be that the rate has not really changed since the 1930′s. “No improvement!” was how an article in the normally exclamation-free Journal of the American Medical Association summarized the situation.
”

Wow.

I have to say I disagree totally with the idea in the article of tying doctors’ jobs to outcomes. There are just too many things involved besides the skill of the doctors for that to be a smart thing to do. Every doctor who could get away with it would have to start treating nothing but colds in healthy teenagers. (Actual malpractice, of course, is a different matter.)

(BTW, I love your blog. Go read, folks: Blue Collar Politics Blog. I just found it a couple of weeks ago. I think I don’t get around enough….)

Medical errors and mistakes happen everywhere. The doctors in Germany are no better or worse than the doctors in america.

The difference is the LEVEL OF EXPECTATION of american patients vs other patients around the world.

In the US, if a doctor misses a “zebra” (i.e. a rare cause of illness) then the doc faces a very high risk of lawsuit. In other nations with socialized med systems, they dont expend resources to hunt out zebras. If you came in with your eye infection, they wouldnt run all those fancy tests to rule out zebras, they’d limit their discovery to the 1 or 2 most common causes and forget about the other stuff.

Socialized med nations are much better at providing BASIC lower cost care to everyone because there is a tradeoff involved. Its understood that with socialized medicine we are not going to spend resources chasing zebras. If your illness isnt caused by what statistics dictates as the 2 most likely causes, then we arent going to explore it any further and thats that.

The problem with implementing that in america is that in america the individual, not the community is of primary importance. Too many americans would put up resistance against the tradeoff of not catching the zebras. They want “better” healthcare than what exists in Germany, or France, or Canada.

America epitomizes the Burger King mentality. They want it “your way, right away” whereas other nations make a conscious tradeoff. Americans arent interested in tradeoffs, so although the current healthcare system is troubled, they refuse to switch because they want to believe in the illusion of the current system.

Comic Project-
A friend of mine from India had a complicated problem with the small bones in her ear that needed surgery. She had to make the decision whether to have it done in India for about $10,000, or US for about $80,000. She went to India. (Everything worked out fine.) I’ve heard of many people in the US who go on medical “vacations” to Mexico for the same reason.

Most of the doctors and nurses seem to be good everywhere. It’s all the other stuff that needs work….

Well, here in india, I trust my doctor not to screw up, do my bit of praying to god and everything works out fine. Don’t have the best healthcare in this country, but the best doctors, not much health insurance, but treatment is neither too expensive nor inexpensive. Given a similar situation like yours, I would have gone to my “family doctor” and come back with a eye-drop, and resumed normal life and vision in a couple of days. But things are changing, sadly.

“Semi-socialist” is right: We’ve socialized the risk, and privatized the profit. This is Not a Good Thing….

To Joan: best of luck becoming an amateur patient again! (I hope that’s a possibility!)

Kash at AngryBear A very thorough look at the economics and statistics of the whole sorry business, in several posts, by a professional economist.

Kevin Drum’s posts are scattered, mainly through the April archive, and have links to several other sources of information:

Health care in France
Health care in America
Health care around the world
Health care in America [not a duplicate of above]
Health care in France, part 2
Health Care Top Ten
Health care. (“I’ve long thought that the spectre of “socialized medicine” is the greatest con ever perpetrated on the American public.” ‘Nuff said.)
Health care woes

I have to say you kind of went off-track for a bit there, especially in your quoting of the US’s infant mortality statistical rating in decrying the quality of our health care. Live births are accounted for differently here than elsewhere, and that does a lot to explain the low ranking.

Sad to say there’s nothing really unusual about your experience.

Americans want the best care. They want to be seen right away when they go to the ER, to have a specialist available, to have plenty of people on staff when they are hospitalized so that they get good personal attention, and to sue for millions if anyone makes a mistake. They want the insurance to cost less but to cover the costs for all this, but they don’t want doctors or themselves to have to deal with the insurance companies or all the little restrictions the companies impose on coverage to keep costs down.

I’m convinced that basic care for everyone will do people more good than first class care for some. But to get the former people will have to agree to give up ready access to the latter.

Best of luck getting Americans to accept the trade off.

And having an advocate in the hospital is fine, but remember that there’s a point where whipping a horse harder will not make it go any faster.

I think that all of us as patients are prone to going onto childish rants about “the system.” Not that those rants are without justification. But there are all sorts of imperfect human beings and flawed processes in the world.

The processes will gradually improve, if there is enough flexibility and accountability in the system. However, once government takes over as a single payer, you will see at best a one-time gain in efficiency. From then on, the system will ossify into a stagnant state, frozen by the political process.

By way of example, take a look at Lasic eye surgery. It’s typically not covered by insurance, so patients have to pay for it out of pocket. Patients therefore look at costs and effectiveness rates, and doctors compete with each other to attract more customers. Costs have gone from thousands of dollers per eye to hunders per eye, while effectiveness and safety have improved.

With insurance companies mandating what doctor you can see, and how much (s)he’ll be paid, and with the bulk of the cost invisible to the patient, there’s no market incentives anywhere in the entire system….

I’m glad you’re ok, home safe and sound and healing up well. I live in Canada. You’ve likely heard all about our healthcare system. I can say that the entire situation is similar to what we endure EXCEPT no financial hardship to deal with at the end of it.

Like you, I avoid the hospitals and hope to never need one again (foot surgery experience in 93 very similar in many ways to your experience). But I have a chronic illness now, similar to lupus, so chances of that are slim. Still, I feel as you do, I think I’d rather die than endure the nightmare again.

This was truly a great post.

I hate to say it, but my first thought in reading the beginning of your blog was “is she in rural Oklahoma?”

I about spit my water out when you said you had to go to OKC!

I live in Tulsa, sitting in waiting rooms here, the stories you hear about ER’s in rural hospitals (like ENT’s being called in for eyes) is amazing!