The Bush administration released a pair of much-awaited reports on the quality of American health care, after extensive revisions that made the findings more upbeat than some experts thought justified.
The two studies, produced by a research arm of the Department of Health and Human Services, went through numerous drafts and were exhaustively reviewed within HHS, officials said.
In several cases, language included in drafts prepared this summer was toned down, emphasizing improvements or challenges rather than problems that afflict the quality of care in public and private health systems in the U.S.
For example, early versions of the National Healthcare Quality report warned that the U.S. health system "is not capable" of preventing or managing diabetes, while the final report said the health system "must respond in order to prevent and manage" the disease. Both versions of the report acknowledged diabetes as a growing problem in the U.S.
[...]
Some outside health-care advocates suggested that the two studies were toned down and delayed until after the Medicare overhaul and prescription-drug bill passed Congress for fear Democrats might seize on the reports to press for greater funding for quality initiatives, possibly complicating Republican efforts to pass the bill.
[...]
The reports' tone differs markedly from several reports on quality issued over the past few years by the Institute of Medicine, an arm of the National Academy of Sciences, which has spoken of a "quality chasm" that exists between everyday care and so-called best practice. The tone also differs from private research reports, such as that by a Rand Corp. researcher in the New England Journal of Medicine this June, which said Americans got, on average, 54% of recommended care, posing "serious threats to the health of the American public."
[...]
Several health advocacy groups immediately attacked the tone of the reports. "The report is strikingly different in tone from the administration's approach to quality over the last three years," said David Schulke, executive vice president of the American Health Quality Association, a group representing health professionals. "This looks almost as if written by somebody else. The numbers are there, but the text is oddly cheery about some frightening statistics."
Mr. Schulke said the report trumpeted the fact that 69% of heart-attack patients get beta blocker drugs upon admission to the hospital, as opposed to emphasizing that more than 30% don't get the beneficial drugs even though beta blockers have been on the market since the 1960s. "To not mention that fully 30% don't get that life-saving therapy leaps off the page as an omission," Mr. Schulke said, adding that he was puzzled by the tone of the reports, since he considers Dr. Clancy and Secretary Thompson to be acutely aware of safety and quality problems in the U.S. health system.
"Is not capable" describes a real truth; "must respond in order to prevent and manage" avoids the real truth and instead describes a potentiality.
Grades of 69 (percent of heart-attack beta blocker recipients) and 54 (percent of Americans receiving recommended care) were considered failing grades back when I went to school, but that was long before the advent of Leave-No-HMO-Behind Medicare legislation and healthcare CEO protectionism.
