ReThinking Patient Safety

Is Iatrogenic Injury Inevitable?

No Progress

Sadly, yet another study shows that many patients are harmed by their medical care, iatrogenic injury. Worse, significant effort over the past decade by leading minds in medicine, state and federal governments,  professional medical associations and thousands of advocates have produced little impact. The most recent study indicates that the rate of patient harm produced by medical error remains relatively constant. (See http://www.nejm.org/doi/full/10.1056/NEJMsa1004404#t=article. The abstract appears at http://www.ncbi.nlm.nih.gov/pubmed/21105794.)

The Study: Respected Researchers Review 588 Cases

Despite some criticism of the methodology, the study cannot be lightly dismissed. The authors reviewed 588 cases randomly selected from 10 hospitals in North Carolina, a state generally respected in the medical community for its attempts to promote safe patient care. The authors are well published and respected. A search of Pubmed identifies over 350 articles by these authors dating back to 1973 (http://tinyurl.com/356-articles-by-Landrigan-etc) 39 of which are review articles (http://tinyurl.com/39-reviews-by-Landrigan-etc). (Note: they have published 11 articles in both JAMA and the New England Journal of Medicine. ) Landrigan and his co-authors hold prominent positions in medicine. 

• Landrigan: http://sleep.med.harvard.edu/people/faculty/226/Christopher+Paul+Landrigan+MD+MPH
• Parry: http://connects.catalyst.harvard.edu/profiles/profile/person/51398   
• Sharek:  http://fsi.stanford.edu/people/pauljsharek
• Goldmann:  http://www.ihi.org/ihi/aboutus/people.aspx#DonGoldmann

Conclusion Consistent with Prior Studies

These findings are consistent with what other studies have been showing in the past decade:

          little if any measurable progress. 

• 2005 Leape & Berwick in JAMA  -  http://www.ncbi.nlm.nih.gov/pubmed/15900009

 

• 2006  Stelfox, Palmisani, Scurlock, Orav, & Bates in Qual Saf Health Care. - http://www.ncbi.nlm.nih.gov/pubmed/16751466 - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464859/pdf/174.pdf

 

• 2006 Pronovost, Miller, & Wachter  in JAMA -  http://www.ncbi.nlm.nih.gov/pubmed/16896113

 

• 2009 McGiffert, McCauley, & Levin  Consumers Union Report: "To Err is Human, To Delay is Deadly" - http://www.consumersunion.org/pub/core_health_care/011324.html - http://www.safepatientproject.org/safepatientproject.org/pdf/safepatientproject.org-ToDelayIsDeadly.pdf

 

• 2010 Wachter in Health Affairs  - http://www.ncbi.nlm.nih.gov/pubmed/19952010

It is time to re-think the approach being taken to patient safety. The approach we are using has not worked, is not working, and cannot reasonably be expected to work in the future. 

In the coming weeks, lessons from successful attempts to reduce injuries will be discussed. 

_______

Government Citations

• Women's Health  http://womenshealth.gov/news/english/646530.htm
• Minority Health   http://minorityhealth.hhs.gov/templates/news.aspx?ID=646530
• Healthfinder  http://healthfinder.gov/news/newsstory.aspx?docID=646530
• Medline Plus  http://www.nlm.nih.gov/medlineplus/news/fullstory_105958.html

News References

• The Examiner  http://www.examiner.com/children-s-health-in-providence/medical-errors-and-patient-safety-protecting-your-family
• Google News  http://news.google.com/news/story?pz=1&cf=all&ned=us&hl=en&ncl=dxCT0QHL_FmRUfMYPGFr94AfApH1M
• More Google News  http://news.google.com/news/more?pz=1&cf=all&as_qdr=w&as_drrb=q&cf=all&ncl=dxCT0QHL_FmRUfMYPGFr94AfApH1M
• Globe and Mail  http://www.theglobeandmail.com/life/health/paul-taylor/safety-measures-havent-reduced-hospital-errors-study-shows/article1813618/
• Reuters  http://uk.reuters.com/article/idUKTRE6AO0C220101125
• Business Week  http://www.businessweek.com/lifestyle/content/healthday/646530.html
• Web MD  http://www.webmd.com/news/20101124/study-no-improvement-in-hospital-safety
• Bloomberg  http://www.bloomberg.com/news/2010-11-24/medical-injuries-harm-18-of-hospital-patients-in-n-c-researchers-find.html
• MSNBC  http://www.msnbc.msn.com/id/40361672/ns/health/
• Boston Globe  http://www.boston.com/news/health/blog/2010/11/_soon_after_the.html
• New York Times  http://www.nytimes.com/2010/11/25/health/research/25patient.html?_r=1&partner=rss&emc=rss
• UPI  http://www.upi.com/Health_News/2010/11/26/Despite-efforts-medical-errors-persist/UPI-53461290815556/
• Medical News  http://www.news-medical.net/news/20101125/Hospital-errors-in-US-continue-despite-efforts-Study.aspx
• Med City News  http://www.medcitynews.com/2010/11/1-in-5-hospital-patients-injured-during-care-morning-read/
• Mother Jones  http://motherjones.com/kevin-drum/2010/11/hospitals-still-bad-your-health
• Doctors Lounge  http://www.doctorslounge.com/index.php/news/pb/15913
• All Headline News  http://www.allheadlinenews.com/articles/7020634517?Medical%20Mistakes%20Still%20Common%20In%20U.S.%20Hospitals
• Physorg  http://www.physorg.com/news/2010-11-hospitals-reduction-adverse-medical-events.html

 

Change the Senate Rules: 41 / 100 is Not a Majority - 1 / 100 is Not a Majority

One of the lessons from my college years was a principle derived from Robert MacIver's book: The Web of Government. 

Government exists to serve the needs of the people. 

At this point, I confess that I do not recall whether this conclusion was articulated in the book, or at the end of a path to which the book led me. The principle seems reasonable if not obvious. 

Recently, the Republican leadership in the Senate made it clear that it was willing to use its block of 41 Republican Senators to block progress in healthcare reform. The Republican leadership was not willing to do anything but "start over" going "step by step." Any other approach was unacceptable, including: 

          Starting with the points on which the Republicans agree with the Democrats, 

          Proposing amendments to the existing legislation, 

          Forwarding a Republican bill for consideration.

Senator Mitch McConnell insisted that we must start over with a blank piece of paper.  

I expressed some dismay that this is the posture in which we find ourselves after a year of hard work by all involved.  This call to "start over" comes after more than 70 years of hard work by numerous Congresses and Presidents. This blank piece of paper is all we have to show for over 450 Congressional hearings. Insisting that we "start over" throws all the hard work into the wastebasket. 

(See Links to information about the 451 hearings here. )

The Senate became even more absurd when Kentucky Senator James Bunning insisted on blocking extension of unemployment benefits all by himself. One senator. One lone senator. A filibuster of one. How is this possible? How can it be that 59 of 100 Senators cannot vote to provide healthcare for Americans? How can it be that one lone senator can deprive millions of Americans of what they need to survive? 

The Constitution provides that each house of Congress may "determine the Rules of its Proceedings." (See Article I Section 3 and Article I Section 5. Additional sources of information: 1   2  3)

When the Senate rules allow one, count 'em one, Kentucky Senator James Bunning the ability to singlehandedly block extension of unemployment benefits and knock thousands of Americans out of work, the rules need to be changed. 

The principle is: 

Government exists to serve the needs of the people. 

Since the Senate rules prevent the Senate 

from serving the needs of the people, 

the rules must be changed. 

How can we accomplish that? 

What do you think? 

Let me hear from you. 

Q: "Are Filibusters OK?" George Will's A: Yes AND No!

Thanks to Peter Hart of FAIR.org for

George Will's Perfectly Consistent Filibuster Position

George Will answers the question: 

Question: "Are US Senate Filibusters OK or NOT OK?"

Answer:  "Yes, indeed they are."

Source:

http://tinyurl.com/George-Will-on-Filibusters

http://www.fair.org/blog/2010/02/25/george-wills-perfectly-consistent-filibuster-position/

George Will on February 25, 2010, Filibusters OK 

http://tinyurl.com/George-Will-2-25-10-OK

George Will on February 27, 2003, Filibusters NOT OK 

http://tinyurl.com/George-Will-2-27-03-NOT-OK

George Will on April 29, 1993, Filibusters OK 

http://tinyurl.com/George-Will-4-29-93-OK

41 > 51 - When 41 Senators Have More Power Than 51 Senators

Senate filibusters allow 41 of 100 Senators to determine policy. Senate reconciliation allows 51 of 100 Senators to determine policy. Some Senators who are perfectly comfortable making policy by filibuster loudly decry reconciliation. 

It is bizarre for those who regularly use filibuster to criticize the use of reconciliation. It is better for public policy to be determined by 51 votes than by 41. This is especially true in the case of healthcare reform. Congress has been working on healthcare reform for 70 years through 451 hearings. I believe that 70 years and 451 healthcare reform hearings are enough.

Filibusters used to be rare. The first one I remember was the filibuster in which Strom Thurmond participated in the 1960's to block enactment of civil rights laws. That relatively brief filibuster brought clarity and made the civil rights issue simple. Can a small handful of Senators block progress? The effort of Sen. Thurmond and his allies significantly damaged his credibility. Thankfully, the majority of the Senate was willing to sit, and force the Thurmond and friends to expose themselves to the public for what they were: obstructionists. 

We are now over 70 years and 451 hearings into the lifelong struggle for healthcare reform.Healthcare reform has been in front of Congress for over 70 years. Over 450 hearings have been held. Senators opposing healthcare reform employ the same strategy every time. Raise money to run ads decrying "socialized medicine" and "government run healthcare" to demonize the idea that people receive healthcare as a right. 

If the Senators opposing healthcare reform want to filibuster this issue, let them. Make them. Call their bluff. Let all of America see how desperate they are to block progress. The opponents of healthcare reform are not willing to begin with the areas of reform they support, are not willing to offer amendments to the existing bills, and have not forwarded their own proposals undermines their credibility. 

 "Start over." is the battle cry. "Start over." After 70 years and 451 hearings they want to "start over." What would we have told Strom Thurmond had he said that? When is enough enough? 70 years and 451 healthcare reform hearings are enough.

Senate filibusters allow 41 Senators to determine policy. Senate Reconciliation allows 51 Senators to determine policy. It is better to determine policy with 51 Senators than with 41 Senators.  Filibusters may have their place, but the current minority party in the Senate is abusing the process. 

70 years and 451 healthcare reform hearings are enough.

Information Links:

Healthcare Reform

Hearings on Healthcare Reform

The Inventors of the 10 Day Legislation Costing a $ Trillion Criticize 70 Years as "Rushing"

       Healthcare: 451 Hearings over 70 years is not rushing

Starting Over again on Healthcare Reform again and again and again, after 451 hearings over 70 years

http://tinyurl.com/start-over-on-health-reform

Republicans want to "start over" on healthcare reform. 

http://thehill.com/blogs/blog-briefing-room/news/83841-gop-leaders-disappointed-in-health-summit-call-for-dems-to-start-over-on-health-bill

 Lamar Alexander wants to "start over" on healthcare reform. 

http://www.washingtonpost.com/wp-dyn/content/article/2010/02/25/AR2010022502364.html

Mitch McConnell wants to "start over." 

http://www.kansascity.com/2010/02/25/1773885/senate-gop-leader-mcconnell-gets.html

We cannot afford to start over. Congress has held over 451 hearings over seventy years on healthcare reform. Despite lengthy hearings and debate, these senators are not willing to use points of agreement as a starting point. They insist on a blank piece of paper. 

We have been starting over for seventy years and 451 hearings. That is quite enough starting over. 

If you want to count the hearings yourself, they are listed in earlier blog posts here:

Healthcare Reform

Hearings on Healthcare Reform

The Inventors of the 10 Day Legislation Costing a $ Trillion Criticize 70 Years as "Rushing"

       Healthcare: 451 Hearings over 70 years is not rushing

What If?

What If?

By Sam Stark

Reposted with permission - see links below.

What if this is 1935 and Congress is getting ready to vote on the Social Security Act?

As political progressives, union activists, or whatever, do you support the bill or oppose it?

No brainer, right?

So what if I told you that by supporting the 1935 Social Security Act you would be selling out the working-class and capitulating to right-wing interests who wrote half the bill?

Didn’t see that one coming didja?

To get Social Security passed, progressives had to agree to exclude nearly ½ of the working class, including 2/3 of African Americans and more than ½ of all women.

Yep, that’s the deal you had to agree to in 1935 to pass what we now know as one of the most successful and progressive government programs of all time. Bur in 1935, it didn’t look that way when progressives had to accept the deal racist, reactionary Southern democrats laid down in exchange for their votes.

These backward elements held power over key committees that could have scuttled Social Security and even prevented a vote. Their deal? Exclude al domestic workers, agricultural labor, state and local government employees, and many teachers, nurses, hospital workers, librarians, and social workers. Their special interest? Keeping power by keeping intact the American-styled apartheid system they presided over.

So what do we do? Kill the bill and try to come back later or take what you can get now?

Remember this deal was made during the Left’s Glory Days. That’s when we had one of the most progressive presidents ever in the White House, the most progressives ever in Congress and the biggest mass movement ever out in the streets. And progressives still had to cut a deal with the devil.

Protesting is easy. Governing is a b*tch.

So let’s bring this What If game to the present

What if you are a member of Congress in 2009, do you vote for the deal cun in the Senate or vote to kill the bill?

Not so easy anymore, is it?

We know the flawed Social Security bill was strengthened over the years, adding household workers in 1950 and agricultural, hotel, laundry, and state and local government workers in 1954. What we don’t know is the future of our flawed health care bill?

The nice thing we do know is that improving it will be a lot easier than passing the original bill. As New York Times columnist Paul Krugman pointed out, many of the future improvements can be through reconciliation with simple majority vote as opposed to the anti-democratic, super-majority 60-vote process that gave sociopath Joe Lieberman the power to kill the public option and prevent lowering the enrollment age for Medicare to 55.

So what do we do now?

We still have to figure that one out. But one thing we can’t afford to do is make single-payer a dogma. Such rigidity in strategy ties our hands and limits our options. Looking at the world we see that more nations have accomplished the goal of health care for all through a multi-payer system. Only Canada, Taiwan, and South Korea have chosen to go single-payer.

France is considered to be the world’s best health care system while Japan has the longest healthy life expectancy. Single payer systems? Hardly. French citizens are covered by 14 private insurance companies. The Japanese have about 3,500 private health insurance plans. These multi-payer systems succeed because private insurers there are not allowed to make a profit selling health insurance.

Every nation that has committed itself to providing health insurance for all its citizens has followed its own unique path to get there. It’s a sure bet that the United States will never adopt the socialized medicine system of Great Britain, even though the Veteran’s Administration is already a socialized system with government-owned, government-run hospitals and government-hired doctors.

We could build on this flawed health care bill by expanding Medicare to all Americans of all ages. That would be the most direct route to single-payer since the structure already exists, is quote popular (Even Tea Baggers love their Medicare) and operates way more efficiently than private insurance with it’s 3% administrative costs verses 20-30 percent for private insurers.

But it’s not certain most Americans are prepared to kill a whole industry even if many of the clerical workers are absorbed by Medicare to serve the new enrollees.

The private sector has always had a role in our government-run health care. Most of the Medicare workers who process sand pay claims are employees of private insurance companies. That was the result of deal struck in 1965 to help win support for passage of Medicare.

With the creation of health insurance exchanges under both the House and Senate bills and the Senate’s provision that private insurance companies must reduce their administrative costs to 10% could move us in the direction of a French-German-Japanese-Swiss model. In these and other multi-payer countries, private insurers collect premiums set by government regulation, pay all claims immediately under rates set by government negotiations with doctors and hospitals, and cannot deny coverage for any reason under strict government regulation.

So what if it turns out that most Americans decide they prefer a multi-payer over a single-payer health care system?

Protesting is easy. Governing is a b*tch.

Author: Sam Stark

http://michuhcanblog.org/index.php?blog=2&title=what_if&more=1&c=1&tb=1&pb=1

60 Senate Votes Guarantee Universal Access to Health Insurance

60 Senate Votes

Guarantee Universal Access to Health Care Insurance

Obama's Stunning Accomplishment

Succeeding where FDR, Truman (x 3), Eisenhower, 

Nixon, Carter, Clinton, Dingell, et. al. failed

By securing the recent passage of health care bills by both houses of Congress, Obama has accomplished more on health care reform than any president in history. He is the first to overcome threatened filibusters blocking Congressional action for 70 years. Obama has succeeded where strenuous efforts by FDR, Truman, Eisenhower, Nixon, Carter, Clinton, Kennedy, and Dingell failed.

70 Years, 

450 Hearings, 

30 Million Uninsured, 

45,000 Unnecessary Deaths per Year

Enormous energies have been poured into the more than 450 hearings on the issue. (175  hearings occurred in Democratic administrations and 276 hearings during Repubican administrations . (See: tinyurl.com/hearings-on-health-care). By assembling the 60 votes necessary to overcome a Senate filibuster, Obama offers access to health care for 30 million uninsured Americans, preventing 45,000 deaths annually.

Chorus: "Dump the Bills and Start Over"

Citing shortcomings of the bills, many suggest that we dump them and “start over.” The bills are, admittedly, less than most of the reformers wanted. Thorny issues remain. Should we listen to the chorus that demands that we "dump the bills and start over"?

"Dumping the bills and starting over" discards access to health care insurance for 30 million Americans. What does the this chorus offer in its place? The chorus has laudable goals. But is there any reasonable expectation that the chorus can provide access to health care for 30 million uninsured?

No Strategy to get to 60 Senate Votes to Override Filibuster

Where is a strategy for assembling filibuster proof majorities in Congress? What is the basis for believing that we can provide health care for the uninsured? As much as I agree with the goals of the chorus, they do not have 60 Senate votes for passing a better bill. At this point, access to health care for the uninsured depends on the fate of those problematic bills. Perhaps understandably, the "dump the bill and start over" chorus does not include representatives for the uninsured. 

Universal Health Care has been harder than Flying to the Moon

Universal access to health care for uninsured Americans has been an elusive goal. That goal has frustrated seven decades of presidents who defeated Hitler, created Social Security and Medicare, started the United Nations, launched NASA to the moon and preserved a free Berlin. Assuming those "dump the bills and start over" chorus will succeed where eight accomplished presidents have failed is unreasonable. 

Dumping the bills = 30 Million Americans with no Health Care

We must resist the call to dump the bills. "Dumping the bills" means "no health care" for 30 million Americans. "Starting over" means "waiting another70 years." We must not turn our backs on the only citizens in western civilization lacking access to health care. 

Lee Tilson

The Inventors of the 10 Day Legislation Costing a $ Trillion Criticize 70 Years as "Rushing"

What is "rushing"?

10 days (Republican Congress on Iraq and Tax Cuts)




vs


70 years (Democrats on Health Care)

________________________

http://tinyurl.com/Rushing-10-days-vs-70-years

copyright Lee Tilson 2009

The Republican creators of the "10 Day Standard" for Congressional action criticize reformers who finally get change after 451 hearings over 70 years as "rushing. LINK Where is the press? 

The Republican criticism is absurd. How is holding 451 hearings over 70 years "rushing"? Why does the media let them get away with this? 

Congress has spent over 70 years holding 451 hearings on health care reform, http://tinyurl.com/hearings-on-health-care

175 hearings during Democratic administrations (Roosevelt: 8 hearings, Truman: 71, Carter: 11, and Clinton 85) and 

276 during Republican administrations (Eisenhower: 19, Nixon: 73, Ford: 56, Reagan: 22, Bush 1st: 77, Bush 2nd: 29). The Republicans call this "rushing." http://tinyurl.com/McConnell-Misinforms 

Why is the press giving the Republicans a free pass on the claim that healthcare is being "rushed" through Congress? 

The Republicans set a 10 day standard for important legislation: 

Decision to Invade Iraq: H.J.Res.114 9 days from Oct. 2 to 11, 2002; 

First Bush Tax Cut: H.R. 1836 11 days from May 15 to 26, 2001; 

Second Bush Tax Cut: H.R. 2 10 days 
(after Sen. Grassley's May 15, 2003 amendment gutted the first version of the bill). 

In fact, in 1912, it was Republican Theodore Roosevelt who introduced health care reform to the national debate. The first true champion of health care reform was Republican Secretary of the Interior and AMA President Dr Ray Lyman Wilbur. (See the 1928-32 publications of 28 volumes by Wilbur's Committee on the Costs of Medical Care). 

The authors of the 10 day standard criticize those who finally achieve change after 450+ hearings over 70 years as "rushing." Where is the press? 

 Lee Tilson
Detroit

Michigan

451 Hearings over 70 Years is not "rushing."

December 17, 2009

http://tinyurl.com/McConnell-Misinforms

Sen. McConnell Misinforms

Earlier today, Senator Mitch McConnell's office posted a press release criticizing the attempt to "rush" through the Health Care Reform Bill, arguing that Congress has not spent sufficient time on this legislation in comparison with other important bills. (http://mcconnell.senate.gov/print_record.cfm?id=320943)

Republicans average 10 days on “big ticket” legislation.


McConnell overlooks the fact that when the Republicans were in charge, the entire Congress averaged 10 days on critical trillion dollar items of legislation: 9 days spent on H.J.Res.114, the bill authorizing the invasion of Iraq, considered from Oct. 2 to 11, 2002; 11 days spent on H.R. 1836, the First Bush Tax Cut, considered from May 15 to 26, 2001; and 10 days spent on H.R. 2, the Second Bush Tax Cut (after Sen. Grassley's amendment gutted the first version on May 15, 2003), considered from Feb. 27/ May 15 to May 23, 2003. 


Why aren't over 400 hearings spanning 70 years enough?

In contrast to this 10 day average for Republican consideration of “big ticket” items of legislation, Congress has spent over 70 years on health care reform, holding 451 hearings, 175 hearings during Democratic administrations (Roosevelt: 8 hearings, Truman: 71, Carter: 11, and Clinton 85), and 276 hearings during Repubican adminstrations (Eisenhower: 19, Nixon: 73, Ford: 56, Reagan: 22, Bush 1st: 77, Bush 2nd: 29) . (See: http://tinyurl.com/hearings-on-health-care )


McConnell ignores the fact that Republicans introduced health care reform (Theodore Roosevelt in 1912), and championed it nearly a century ago (See the 1928-32 publications of 28 volumes by Committee on the Costs of Medical Care chaired by Republican AMA Pres. Dr. Ray Lyman Wilbur).

Do not let McConnell's misinformation further delay our long overdue health care reform.

Lee Tilson
Detroit, Michigan



70 Years of Congressional Health Care Hearings by Presidential Administration

President

Year
Number of Hearings

Roosevelt
1938 - 8 hearings

Truman
1946 - 36 hearings
1947--1948 - 11 hearings
1949 - 24 hearings

Eisenhower
1954 - 19 hearings

(I have yet to find the dates for hearings on Medicare from 1960-68)

Nixon
1970 - 2 hearings
1971 - 46 hearings
1972 - 1 hearings
1973 - 7 hearings
1974 - 17 hearings

Ford
1975 - 35 hearings
1976 - 21 hearings

Carter
1977 - 1 hearings
1978 - 3 hearings
1979 - 4 hearings
1980 - 3 hearings

Reagan
1983 - 6 hearings
1985 - 1 hearings
1986 - 4 hearings
1987 - 8 hearings
1988 - 3 hearings

Bush (GHW)
1989 - 12 hearings
1990 - 10 hearings
1991 - 24 hearings
1992 - 31 hearings

Clinton
1993 - 41 hearings
1994 - 34 hearings
1995 - 3 hearings
1996 - 1 hearings
1997 - 2 hearings
1999 - 2 hearings
2000 - 2 hearings

Bush (GW)
2001 - 5 hearings
2002 - 7 hearings
2003 - 3 hearings
2004 - 2 hearings
2005 - 1 hearings
2006 - 1 hearings
2007 - 6 hearings
2008 - 4 hearings

This list does not include hearings after Obama's election.

Health Care Reform Hearings: A Partisan Issue?

Copyright  2009  Lee Tilson  lee.tilson@gmail.com

In an effort to contribute to the discussion of health care reform, I have been working to compile information about the Congressional hearings held by Congress. 

Please note: This is a work in progress. It will be supplemented. This is only a partial listing. Please let me know of any corrections or additions that need to be made. 

Arguments are being made that the effort to enact health care reform are partisan. I am compiling dates of hearings on health care reform since the Committee on the Costs of Medical Care issued its 28th and last report in 1933. This list was compiled from various other partial lists. It is not yet complete. It does not include any hearings on Johnson's proposals for Medicare. 

Hopefully, this will, in some small way, contribute to the discussion. 

History proves that this issue is not partisan. Before FDR and Truman fought for reform, the issue was introduced by a Republican. Theodore Roosevelt first proposed providing health care for all United States citizens in 1912. Next, AMA President and Republican Secretary of the Interior Dr. Ray Lyman Wilbur chaired the Committee on the Costs of Medical Care. Dr. Wilbur led its five year (1927-32), twenty eight volume, study that supported health care reform. Health care reform has been advanced by Republican presidents as well as Democratic presidents. Many Congressional hearings have been held during Republican administrations as well as Democratic administrations. 

Let's look beyond today's heated rhetoric.  What are the facts?

So far, I have identified 175 hearings on health care reform held during Democratic administrations:

8 (FDR) + 71 (Truman) + 11 (Carter) + 85 (Clinton) = 175 hearings

(See below.) I am still trying to locate any hearings under JFK and Johnson. 

I have identified 276 hearings on health care reform held during Republican administrations:

19(Eisenhower) + 73(Nixon) + 56(Ford) + 22(Reagan) + 77(GHW Bush) + 29 (GW Bush) = 276 hearings

(See below.)

Is it a pattern for the Republican Party to abandon its great causes? 

Lincoln freed the slaves. A century later, the Republican Party abandoned the cause of Civil Rights, one of the great moral causes of the twentieth century. Credit for advancing that cause went to the Democrats. 

Health care reform was introduced into the public debate by Republican Theodore Roosevelt. Reform was initially championed by AMA President and Republican Secretary of the Interior Dr. Ray Lyman Wilbur. More hearings have been held on health care reform during Republican administrations than during Democratic administrations. The Republican Party seems determined to see that the Democrats get credit for advancing this cause just as the Democrats received credit for advancing Civil Rights.  

President Franklin D. Roosevelt:  8 Hearings in 1939

1939     Hearings: 8     To Establish a National Health Program

4/27/39, 5/4/39, 5/5/39, 5/11/39, 5/12/39, 6/2/39, 6/29/39, 7/13/39

President Harry S. Truman:  71 Hearings 1946 - 1949

1946     Hearings: 36     National Health Program

4/2/46, 4/3/46, 4/4/46, 4/5/46, 4/9/46, 4/10/46, 4/11/46, 4/16/46, 4/17/46, 4/18/46, 4/19/46, 4/22/46, 4/23/46, 4/24/46, 4/25/46, 4/26/46, 4/30/46, 5/1/46, 5/2/46, 5/3/46, 5/6/46, 5/7/46, 5/22/46, 5/23/46, 5/24/46, 5/28/46, 5/29/46, 5/31/46, 6/18/46, 6/20/46, 6/21/46, 6/24/46, 6/25/46, 6/26/46, 6/27/46, 7/10/46

1947-48     Hearings: 11     National Health Program / Plan

5/21/47, 5/22/47, 5/23/47, 5/28/47, 5/29/47, 6/4/47,  6/5/47,  6/6/47,  7/23/47, 1/27/48, 1/29/48

1949     Hearings: 24     National Health Program / Plan

5/20/49, 5/23/49, 5/24/49, 5/25/49, 5/31/49, 6/1/49,  6/2/49,  6/6/49,  6/7/49, 6/8/49,  6/9/49,  6/10/49, 6/16/49, 6/17/49, 6/20/49, 6/21/49, 6/22/49, 6/23/49, 6/24/49, 6/27/49, 6/28/49, 6/29/49, 6/30/49, 7/6/49

President Dwight Eisenhower:  19 Hearings 1953–60

1954     Hearings: 19     Health ReInsurance Legislation, President's Health Recommendations and Related Matters

3/24/54, 3/25/54, 3/26/54, 3/30/54, 3/31/54, 4/1/54, 4/2/54, 4/5/54, 4/8//54, 4/13/54, 4/14/54, 4/15/54, 4/20/54, 4/21/54, 4/22/54, 4/23/54, 5/5/54, 5/6/54, 5/7/54

President Richard M. Nixon:  73 Hearings 1970 – 74

1970     Hearings: 2     National Health Insurance

9/23/70, 9/24/70

1971     Hearings: 46     National Health Insurance / Health Care Crisis in America

2/22/71,  2/23/71,  2/25/71,  3/1/71,   3/3/71,   3/4/71,   3/15/71,  3/16/71, 3/23/71,  3/24/71,  3/31/71,  4/6/71,   4/7/71,   4/14/71,  4/15/71,  4/19/71, 4/20/71,  4/26/71,  4/27/71,  4/28/71,  5/4/71,   5/5/71,   5/13/71,  5/14/71, 5/17/71,  5/18/71,  10/19/71, 10/20/71, 10/26/71, 10/27/71, 10/28/71, 10/29/71, 11/1/71,  11/2/71,  11/3/71,  11/4/71,  11/5/71,  11/8/71,  11/9/71,  11/11/71, 11/12/71, 11/15/71, 11/16/71, 11/17/71, 11/18/71, 11/19/71

1972    Hearings: 1     National Health Insurance Proposals

3/10/72  

1973     Hearings: 7      National Health Insurance Implications

12/10/73, 12/11/73, 12/12/73, 12/13/73, 12/14/73

1974     Hearings: 17     National Health Insurance & Implications

2/1/74. 2/2/74, 4/24/74, 4/25/74, 4/26/74, 5/3/74,  5/10/74, 5/17/74, 5/21/74, 5/22/74, 5/23/74, 5/31/74, 6/7/74,  6/14/74, 6/21/74, 6/28/74, 7/1/74,  7/2/74,  7/9/74

President Gerald Ford:  56 Hearings 1975 – 76

1975     Hearings: 35      Health Insurance for the Unemployed, National Health Insurance, Getting Ready for National Health Insurance 

3/3/75,   3/4/75,   3/5/75,   3/6/75,   3/10/75,  3/11/75,  3/12/75,  7/10/75,  7/11/75,  7/15/75,  7/17/75, 7/17/75,  7/18/75,  7/24/75,  9/3/75,   9/12/75,  11/5/75,  11/6/75,  11/7/75,  11/10/75, 11/11/75, 11/12/75, 11/13/75, 11/14/75, 11/17/75, 11/18/75, 11/19/75, 11/20/75, 12/2/75,  12/3/75,  12/4/75,  12/5/75,  12/8/75, 12/9/75,  12/10/75

1976     Hearings: 21     National Health Insurance

2/3/76,  2/4/76,  2/5/76,  2/9/76,  2/10/76, 2/11/76, 2/17/76, 2/18/76, 2/19/76, 2/23/76, 2/24/76, 2/25/76, 2/26/76, 2/27/76, 3/18/76, 3/19/76, 5/6/76,  5/7/76, 5/20/76, 5/21/76, 7/23/76

President Jimmy Carter: 11 Hearings 1977-1980

1977     Hearings: 1     Urban Health Crisis  

11/12/77

1978     Hearings: 3     National Health Insurance

10/9/78, 10/10/78, 10/13/78

1979     Hearings: 4     Presentation of Major Health Insurance Proposals

6/19/79, 6/21/79, 11/19/79, 11/29/79

1980     Hearings: 3     National Health Insurance

2/11/80, 2/12/80, 2/21/80

President Ronald Reagan:  22 Hearings 1983-1988

1983     Hearings: 6     Health Benefits: Loss Due to Unemployment, Health Insurance for the Unemployed, Health Care for Displaced Workers Act

1/24/83, 4/21/83, 4/22/83, 4/27/83, 5/3/83,  5/9/83

1985     Hearings: 1     Americans at Risk: The Case of the Medically Uninsured 

6/27/85

1986     Hearings: 4     Health Care for Older Americans: Insuring Against Catastrophic Loss,  Catastrophe of Uninsured  and Underinsured Americans: In Search of a US Health Plan, Health Care for the Homeless

8/27/86, 8/28/86, 9/12/86, 12/15/86

1987     Hearings: 8     Catastrophic Health Costs, Reauthorization of the Older Americans Act, Essential Health Care, Catastrophic and LongTerm Health Care

1/28/87, 3/25/87, 5/19/87, 6/1/87,  6/22/87, 6/29/87, 8/28/87, 11/11/87

1988     Hearings: 3     Lack of Health Insurance Coverage in the US , Young Children in Crisis: Today's Problems and Tomorrow's Promises

4/15/88, 6/30/88, 7/25/88

President George H. W. Bush:  77 Hearings 1989-92

1989     Hearings: 12     Health Insurance Coverage and Reform, Health Insurance and the Uninsured, Basic Health Benefits for All Americans Act, Health Care for the Uninsured, On the Growing Crisis in Health Care: The Basic Health Benefits for All Americans Act and Other National Health Care Policy Options, American Health Care Crisis: A View from Four Communities, Changing Face of Health Care: The Movement Toward Universal Access

3/9/89,   4/6/89,   5/1/89,   6/19/89,  6/23/89,  6/28/89,  10/11/89, 10/12/89, 12/11/89, 12/12/89, 12/13/89, 12/14/89

1990     Hearings: 10      Health Care for the Uninsured, Pepper Commission Recommendations on Universal Health Care, Uncompensated Health Care Costs for the Uninsured, Health Care Crisis: Problems of Cost and Access

2/15/90,  4/6/90,   4/18/90,  6/2/90,   7/23/90,  8/23/90,  8/24/90,  10/31/90, 11/5/90,  11/19/90

1991     Hearings: 24     Health Care Crisis and the American Family, Reform of the Health Care System, Health Insurance for the Unemployed, Need for National Health Reform, Health Insurance Options: Reform of Private Health Insurance, Health Care Reform, Comprehensive Reform of the Health Care System Comprehensive Health Insurance Legislation Including HR  the "Health Insurance Coverage and Cost Containment Act, Nation's Health Care Crisis, Health Care Reform

1/10/91,  2/25/91,  3/21/91,  4/4/91,   5/2/91,   5/23/91,  7/10/91,  7/29/91, 9/6/91,   9/23/91,  9/30/91, 10/8/91,  10/9/91,  10/10/91, 10/22/91, 10/23/91, 10/24/91, 10/25/91, 10/28/91, 10/31/91, 12/10/91, 12/11/91, 12/12/91, 12/13/91

1992     Hearings: 31     Health Care Reform, President's Proposals on Health Care Reform and the FY Health and Human Services Budget, Need for US Health Reform: Uninsured and Chronically Ill Americans, Health Care Reform: The Time Has Come, Nation's LongTerm Health Care Crisis, Comprehensive Health Care Reform  and Cost Containment , Health Care Crisis: Human Impact of Insurance Company Abuse, America's Growing Crisis: Access to Affordable Health Care

1/14/92,  1/27/92,  2/6/92,   2/10/92,  2/11/92,  2/12/92,  2/20/92,  3/3/92, 3/4/92,   3/5/92,   3/9/92,   3/12/92,  4/13/92,  4/23/92,  4/24/92,  5/5/92, 5/6/92,   5/7/92,   5/14/92,  6/8/92,   6/9/92,   6/11/92,  6/15/92,  6/17/92, 6/18/92,  6/24/92,  9/4/92,   10/22/92, 12/9/92,  12/16/92, 12/17/92, 

President Bill Clinton:  85 Hearings 1993 - 2000

1993     Hearings: 41     Health Care Reform, Rural Health and Health Reform, Primary Care Services for the Underserved, , President's Health Care Plan, Oversight on the Administration's Health Care Proposal, Single Payer Health Care Systems: Issues and Options, Health Security Act

2/2/93,   3/15/93,  3/30/93,  4/19/93,  4/20/93,  4/22/93,  5/3/93,   5/20/93,  5/25/93,  5/27/93,  6/8/93, 6/9/93,   6/22/93,  6/24/93,  7/13/93,  9/14/93,  9/15/93,  9/30/93,  10/5/93,  10/12/93, 10/14/93, 10/15/93, 10/19/93, 10/21/93, 10/26/93, 10/28/93, 11/2/93,  11/3/93,  11/4/93,  11/5/93,  11/8/93,  11/9/93,  11/10/93, 11/15/93, 11/16/93, 11/17/93, 11/18/93, 11/19/93, 11/30/93, 12/8/93,  12/16/93

1994     Hearings: 34     Health Security Act, Health Care Reform, Small Business and Health Care , Health Reform and US Business Competitiveness, Will Patients and Doctors Be Protected Under Health Care Reform, Women's Health Care in the President's Health Care Plan, Hearing on HR  the Affordable Health Care Now Act, Consumer Protection and Quality Assurance Under Health Care Reform, Health Care Reform: Implications for Seniors

1/8/94,   1/10/94,  1/12/94,  1/24/94,  1/25/94,  1/26/94,  1/31/94,  2/1/94,   2/2/94,   2/3/94,   2/4/94,   2/7/94,   2/8/94,   2/9/94,   2/10/94,  2/14/94,  2/21/94,  2/22/94,  2/28/94,  3/2/94,   3/3/94,   3/8/94,   3/9/94,   3/10/94,  3/16/94,  3/17/94,  4/21/94,  4/29/94,  5/18/94,  6/9/94,   6/15/94,  8/4/94,   8/5/94,   11/15/94

1995     Hearings: 3     Hearing on Health Care Reform, Effective Health Care Reform  in a Changing Marketplace  

2/14/95, 3/14/95, 3/15/95

1996     Hearings: 1     Health Care Reform: Reforming the Small Business Marketplace and the Individual Health Insurance Market

3/7/96

1997     Hearings: 2     Universal Service

3/12/97, 6/3/97

1999     Hearings: 2     Relationship Between Health Care Costs and America's Uninsured, Uninsured Americans

6/11/99, 6/15/99

2000     Hearings: 2     Health Care for the Uninsured: The Role of Safety Net Providers, Health Care Coverage: Million Uninsured  and Counting 

3/23/00, 10/4/00

President George W. Bush: 29 Hearings 2000 - 08

2001      Hearings: 5     Living Without Health Insurance, Strengthening the Safety Net: Increasing Access to Essential Health Care Services, Nation's Uninsured

3/13/01, 3/15/01, 3/22/01, 4/4/01, 8/1/01

2002     Hearings: 7     Health Care Tax Credits To Decrease the Number of Uninsured, Uninsured and Affordable Health Care Coverage,  Health Care Crisis of the Uninsured: What Are the Solutions, Future of Universal Service: Ensuring the Sufficiency and Stability of the Fund, Expanding Access to Quality Health Care: Solutions for Uninsured Americans, Small Business Health Market: Bad Reforms Higher Prices and Fewer Choices, Faces of Aging: Personal Struggles To Confront the LongTerm Care Crisis

2/13/02, 2/28/02, 3/12/02, 6/19/02, 7/9/02, 7/11/02, 9/26/02

     

2003     Hearings:3     Small Business Health Care Crisis: Possible Solutions,  In Critical Condition: America's Ailing Health Care System, Overcoming Obstacles Facing the Uninsured: How the Use of Medical Savings Accounts Flexible Spending Accounts and Tax [Credits] Can Help

2/5/03, 3/10/03, 5/8/03

2004     Hearings: 2     What's Driving Health Care Costs and the Uninsured

1/28/04, 3/9/04

2005     Hearings: 1     Solving the Small Business Health Care Crisis: Alternatives for Lowering Costs and Covering the Uninsured

4/20/05

2006     Hearings: 1     Healthcare and Small Business: Proposals That Will Help Lower Costs and Cover the Uninsured

4/27/06

2007     Hearings: 6     Covering the Uninsured Through the Eyes of a Child, Charting a Course for Health Care Reform: Moving Toward Universal Coverage, Examining Innovative Approaches to Covering the Uninsured Through Employer Provided Health Benefits, Health Care Reform: Recommendations To Improve Coordination of Federal and State Initiatives, Working Families in Financial Crisis: Medical Debt and Bankruptcy

2/14/07, 3/1/07,  3/14/07, 3/15/07, 5/22/07, 7/17/07

2008     Hearings: 4     Covering Uninsured  Kids: Missed Opportunities for Moving Forward , The Preexisting Condition Exclusion  Patient Protection Act, Scrambling for Health Insurance Coverage: Health Security for People in Late Middle Age, Making Health Care Reform  Work for Small Business

1/29/08, 3/20/08, 4/3/08,  9/18/08