A recent report from the National Committee for Quality Assurance (NCQA) shows that the nation’s health care system is riddled with “quality gaps” that end up in patient deaths that are completely preventable. NCQA uses the term “avoidable deaths” and reports on “estimated annual deaths attributable to failure to deliver recommended care.” They cite more than 57,000 deaths which could have been prevented by appropriate treatment (*see table).

High blood pressure

For example, the most rampant, yet simplest, health problem is high blood pressure. The successful monitoring of high blood pressure can yield dramatic results. Everyone knows that a person’s blood pressure can be taken in a few minutes. Yet, according to the NCQA report, only about 40 percent of the 31 million people in the U.S. with diagnosed high blood pressure have their blood pressure adequately controlled. By just increasing the 40 percent to 68 percent, an estimated 28,000 lives would be saved.

If you examine each of the conditions listed above, it is easy to make the case for the need to establish a preventive health program that would dramatically reduce death rates. Yet, all too often, those opposed to prevention programs cast doubt on how many people would be helped if money were to be spent to hire professionals and utilize physical facilities to establish the prevention program. Thanks to the NCQA report there are now actual figures that document the life-saving results of such programs.

*Preventable deaths in 2003
Beta-blocker treatment 1,700
Breast cancer screening 2,500
Cervical cancer screening 700
Cholesterol Management 6,500
Blood Pressure Control 28,300
Diabetes Care HbA1c 13,600
Prenatal Care 1,500
Smoking Cessation 2,700
Total 57,500

(To see the full report go to the NCQA web site: ncqa.org/index.asp)

Profits are the problem

The report does another great service by substantiating the assertions by labor, community health activists, and others that maintaining health care as a profit-making business places pressure on hospitals, physicians and other health providers to charge the most they can for their services. Making a profit in the U.S. health system has become a top goal of all administrators, including those in nonprofit hospitals and even hospitals that are publicly owned. Reversing the 1980s Reagan/Bush (and now the new Bush) ideological drive to make health care a market commodity will require a major political struggle.

The health policy struggles in the early part of the Clinton administration began the process of placing health care above profits. Now that every Democratic Party candidate for the White House is committing to a national health program, the pressure must be maintained. Every member of the House and Senate seeking to be re-elected should be asked the question: “How will you make universal health care a reality insuring that no one in the U.S. is denied all of the health services they require?”

For starters, greatly expanding the federally supported community health and mental health clinic system would make blood pressure screening a reality for those millions of Americans in need.

The author can be reached at pww@pww.org.