THE BLOG
12/26/2013 12:55 pm ET Updated Feb 25, 2014

Can-Do

Lost in the heated Obamacare debates -- who gets what, who are the winners and who are the losers -- is the health of American health care itself.

Is it safe to go to the hospital? The short answer is, "Well, no."

Recent studies clarify the harm done in even the most beautiful of hospitals. The Journal of Patient Safety Study estimates 210,000 hospital patients a year have premature deaths attributable to such incidents as misdiagnosis, medication errors, surgical mistakes and errors of omission. Of these, the Center for Disease Control conservatively estimates 23,000 deaths occur from infections by superbugs acquired in the hospital: Vancomycin-resistant Enterococcus (VRE), Carbapenem-resistant Enterobacteriaceae (CRE) and the most notorious of the bunch, Methicillin-resistant Staphylococcus aureus (MRSA).

These are bacteria that have mutated to resist the umph of some of our strongest antibiotics. They would equal Parkinson's as the 14th leading cause of death in America... if they were counted in the statistics. Amazingly, they are not. The CDC's denial is symptomatic of avoiding the issue... across the board.

Hospital Compare, the feds' latest attempt at transparency, has been rating hospital quality since 2005; they have never posted comparisons of hospital-acquired infection. And they still don't (although the New York Times reports they plan to soon, eight years after the fact).

Know-it-all trial lawyers look to amass fortunes in suits over the low-hanging fruit of wrong-limb surgery, but they seem oblivious to the rotten fruit of infection festering beyond the reach of their sketchy knowledge base.

Obamacare, too, defaults on the problem. Hospital-acquired infection is to be penalized at 1 percent of reimbursement (Title III, Section 3008)... as if a 1 percent penalty is going to infuriate hospitals to action. In actuality, hospital-acquired infections constitute a profit center: We often care for infected patients over two weeks with an easily administered course of IV antibiotics... at acute-care prices (which presume multiple treatments, diagnostics, and medical interventions). Nice work, if you can get it, even after being penalized the 1 percent.

For some years hospital staffs have indulged in wishful thinking that the National Institute of Health would crack the DNA codes of superbugs like they did for HIV, a far more publicized infestation. No such luck. The next step is seeing that another approach is definitely now required.

Unfortunately, efforts to stop the spread of these hospital born-and-bred mutants have focused so far on changing human behavior by reprogramming bedside caregivers.

In the trenches, doctors and nurses are recipients of numerous edicts formulated by the Center for Medicare Services; their weak sister inspector, the Joint Commission; and ambitious local careerists. The knee-jerk reaction to even the most inconsequential health care problem is a new form to fill out. At the same time, to save money, facilities cut staffing matrixes close to the core, meaning that, often as not, hospital medical teams work "short staffed." Paperwork being a given, little time is left for the niceties of full compliance with precaution protocols, often time consuming and honored in the breach.

The Center for Medicare Services is a bill-paying service, not a dynamic organization. They don't have the imagination or drive needed to solve this problem... any more than they ever had the competence of putting up the Obamacare website. A case of mistaken identity.

Let's get real. Far easier than changing Medicare's institutional habits would be engineering our way out of this dilemma. Isn't that what American does best?

Why not a national effort to design and add high-tech quarantine rooms and, in bigger facilities, quarantined wings to our community hospitals? Such renovations will be a small price to pay given the growing magnitude of the problem.

And, hey: The Center for Innovation is giving out grants hand-over-fist for high-concept demonstration models of "patient-centered," "evidence-based" care. Well:

*What if they came down to earth and funded an architectural competition for best designs of isolation rooms that would be foolproof?

*What if they put together doctors and nurses who work with these problems day in and day out to select floor plans that make the most sense and are flexible enough to incorporate future innovations?

*What if someone notified the Administration that there's still a recession in the building trades, and that adding new hospital rooms would put thousands to work?

*What if Wall Street -- we bailed them out in their time of need, didn't we? -- returned the favor by crafting low-interest, government-backed securities to finance construction costs?

Controlling superbugs is something we can do.