Letters: Let’s keep humanity in discussions about patient safety

I found the Nov. 11 issue marking the 20th anniversary of the Institute of Medicine’s landmark report To Err is Human both thoughtful and thought-provoking.

The differences in language chosen by Dr. Don Berwick in his op-ed and in the editorial to address the persistent challenges to patient safety were telling, and perhaps indicative of some barriers to success.

While Berwick speaks of “human limits,” “guardrails around human frailties,” and “smart safety initiatives eschew blame,” the editorial chooses “requires admission of guilt,” “change in mentality of some providers who might see patients in the aggregate,” “retail-based customer service” and “inexcusable.”

As a retired critical-care surgeon, former chief medical officer, and quality committee board member at a midsize health system, it has been my experience that the language chosen to address patient-safety issues matters, and either promotes or hinders the collaborations necessary for progress. I believe Dr. Berwick’s characterizations to be not only the more humane and accurate, but more productive.

Dr. James Girardy
Rockford, Ill.

We agree with the Dec. 2 editorial that a pragmatic universal healthcare plan is critical. Medicare for More, or Obamacare with a public option, are steps in the right direction, however they are not really universal healthcare plans as currently discussed because they do not mandate employer participation.

All employers should be required to provide health insurance for their workers. We support a plan that would require them to do this in an environment where private insurance companies would have to compete with a public option for their current employer base of business. This requirement would expand coverage and lower costs, without raising taxes.

The competitive public option that we envision is based on Medicare, but it is designed to cover people under 65 and would cost approximately 30% less than the average cost of employer-based private insurance today. This new competitive pressure could drastically lower costs for both employers and employees without reducing benefits.

As a result, if all employers were required to provide health insurance in a market that included a highly competitive public option, the overall cost of employer-based insurance in America could be reduced by as much as $180 billion per year.

Edward Eichhorn
Dr. Michael Hutchinson
Partners at Eichhorn & Hutchinson
Hamilton, N.J.