Gore Advocates Health Plan Standards

Vice President Al Gore said Wednesday that 180,000 people die each year in hospitals because of preventable errors as he announced a cooperative effort by business groups, employers and health professionals to create a set of basic quality standards for all health programs.

“Providing higher-quality medical attention means healthier patients, lower costs and greater confidence in America’s health system,” Gore said as he issued a report detailing serious problems of “underuse, overuse, misuse” in the delivery of medical services.

In addition to the figure of 180,000 preventable hospitable deaths, the report noted that:

* Nearly 80% of heart attack victims do not receive treatment with beta-blockers, a potentially lifesaving treatment.

* Half of all patients with colds are incorrectly prescribed antibiotics. The overuse of antibiotics by these and other patients causes them to develop a resistance to such drugs, which raises their medical bills by a total of $7.5 billion a year.

* Sixteen percent of all hysterectomies are unnecessary.

“Poor-quality care leads to sicker patients, more disabilities, higher costs and lower confidence in the health care industry,” says the report by the Department of Health and Human Services, titled “The Challenge and Potential for Assuring Quality Health Care for the 21st Century.”

Gore announced an ambitious planning effort to develop a single set of standards for the highly fragmented business of delivering health care.

Currently, individual insurance companies and health maintenance organizations have their own measures of quality and performance. In addition, independent rating and accreditation groups provide oversight of the health care industry. And some employers have adopted their own standards. But there is no single set of uniform standards accepted as a universal guide to quality care.

The joint public-private endeavor announced Wednesday will create a health care quality forum, a coordinating group charged with “ensur[ing] that consumers have a consistent set of standards so they can choose health plans based on quality--not just cost,” Gore said.

The participants will include “private businesses, health consumer groups, professional organizations, labor unions and employers,” the vice president said.

Gail Warden, the chief executive officer of the Henry Ford Health Care System in Detroit, will chair the planning committee for the quality forum, and James Tallon, president of the United Hospital Fund of New York, will be executive director.

The forum will begin operations after a six-month planning period, according to John Rother, director of public policy for the American Assn. of Retired Persons and one of the 21 members of the planning group.

“We’re trying to bring everyone together to get a consensus developed,” Rother said. There is no intent to replace any group now working on quality issues but rather to bring all the groups together to agree on common standards of quality, according to Rother.

Adopting standards and guidelines should lead to reductions in the numbers of asthma-related deaths, drug reactions and bedsores, the report says. Health plans also can do better at increasing the proportion of adults who get flu shots and in caring for pregnant women to reduce the problems of premature babies.

Businesses, unions and other group buyers of health care “do not have a central repository for learning about best purchase practices,” the report notes.

Health plans are frequently burdened with gathering “excessive data to satisfy the variety of different reporting requirements and information needs of purchasers and consumers,” the report says. In one case, a single health plan had to file nine different quality and performance reports with 675 different items of information.