America's Not So Best Healthcare System

After reading about Sweden's hospital system, where statistics about length of stay by disease (a direct indicator of health and recovery) by hospital are available to the people, I decided to try to find the same statistics for US Hospitals. Zip, zilch, nada. Oh, you can find averages for the US, averages for community hospitals, averages for non-federal hospitals, averages by year from 1950-1968, etc. etc. But try to find them for the hospitals in your city, so you can pick the best. No way.

Here is how it works: the longer you stay in a hospital for a given disease, the more likely you will either a. get another disease (generally a hospital-acquired infection) or b. die. Now, granted, individual cases of pneumonia or pancreatitis or liver transplant or whatever will vary by individual. But averaged over a patient population, the hospital that fixes 'em quicker will have better outcomes. So in Sweden, people can find out how their hospitals perform. And, not surprisingly, length of stay has gone down as the difference between the best and worst has decreased. Making the information available seems to stimulate improvement.

However, my goal of finding the corresponding statistics for US Hospitals was sidetracked by my investigation of the kinds of "improvements" that the US Hospitals/US Insurance companies/Health and Human Services are working on. America's not so best Healthcare System (#1 Switzerland, #8 Sweden, #24 USA; see is really a triumvirate, with the Medical Community saying what we need, the Insurance Companies saying what we can pay for and H&HS trying to regulate the other two. Our Healthcare System is sidetracked on trying to make sure that when we are struck by a turtle (either the initial encounter W59.21XA or subsequent encounters W59.21XD) or are burned due to water skis on fire (again, either the initial encounter V91.07XA or subsequent encounters V91.07XD) both the hospitals can properly code it (using the new ICD-10) so that the Insurance Companies will pay for it. And here's an interview, from PBS News Hour, with a consultant who can explain why that's a good thing.

Seriously, for the very small number of people who get bitten by a Diamondback and suffer tissue necrosis, it is very important that their medical records can distinguish them from the (equally) small number that get bitten by a Coral snake. And with the adoption of electronic medical records, it is no longer sufficient to rely on the physicians description of the disease. But having read Wendell Potter's Deadly Spin about the American medical insurance industry and its PR campaigns, I have to believe that some of the new codes were reactive to past payment fights, rather than attempts to improve patient care.

In today's information age, with the Internet providing us with so much of the information in the world, isn't it time that we get some information about how well our hospitals and doctors treat us? The American parents now know that American children perform about equally in math to Slovakian students at more than twice the cost. Naming and shaming needs to come to health care the way it has to education. And just like in education, with teacher's unions complaining about the comparison, hospitals and doctors will tell us that comparisons are "unhealthy". But it is not unreasonable for us consumers of health care to know how much a hospital costs, how quickly it heals, and what are the chances of surviving. Swedish health registries (open statistics) are no joke.