Health care is a hot topic, maybe so hot we’ve been blinded by assumptions.

Pick up the paper or turn on the news and the debate about America’s health is all over the place. From Maine’s new Dirigo initiative, to Congress’ attempt to add prescription drug coverage to Medicare to amazing medical advances and procedures – consider doctor’s efforts to separate Iranian twin sisters joined at the head – health care receives our attention and our dollars like few other things. And that’s rightly so.

But a disturbing study by RAND, published recently in the New England Journal of Medicine, has identified major shortcomings in medical care in the United States.

Often, the question we have asked is how do we afford the world class and super-advanced medical care we have grown to expect. The RAND report skips that dilemma altogether and asks just exactly how good is the care we receive.

The answer is shocking.

According to the report, adults fail to receive recommended treatments almost half of the time.

For example, patients with diabetes received only 45 percent of the care they need. Patients with coronary artery disease received 68 percent of recommended care, but just 45 percent of heart attack patients received medications that could reduce their risk of death by more than 20 percent. And patients with pneumonia received just 39 percent of recommended care and fewer than 66 percent of elderly Americans were vaccinated against pneumonia, even though experts say as many as 10,000 deaths could be prevented annually with this simple step.

The study examined preventive care and management of 30 common health problems and gathered information from telephone surveys and a review of medical records. According to RAND, about 7,000 people in 12 metropolitan areas were interviewed.

RAND makes a few recommendations on how to improve our health care system. Improving standards of care, increasing the availability of treatment information and measuring performance could mitigate some of the problems. RAND also suggests a complete overhaul of current information systems that would ease the storing and retrieval of health data and make it easier for doctors and nurses to access that information.

Beyond system-wide fixes, patients must take more responsibility.

We all have an obligation to question the treatments we receive, to educate ourselves on the care available for our ailments and make the effort to prevent illness before it strikes.

This study, while just a snapshot of the U.S. health care machine, should serve as a wake-up call. Our health and the treatment we receive are only as good as we make them.


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