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school in Connecticut

#201 User is online   mike777 

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Posted 2012-December-22, 08:46

These numbers surprised me:

11,000 homicides by gun
187,000 deaths in hospitals from medical errors.
medical errors amount to 18-45% of Total US health-care spending.



Another study, conducted by John Goodman and associates of the National Center for Policy Analysis in Dallas, TX and also reported in the April, 2011 Issue of Health Affairs, reported that medical errors cause as many as 187,000 deaths in hospitals each year, and 6.1 million injuries, both in and out of hospitals in the U.S. This study estimated that the social costs, in lives lost and disabilities caused, from these medical errors amounted to between $393 Billion to $958 Billion in 2006, equivalent to 18% to 45% of total US health-care spending in that year.

http://www.helpingyo...ased-in-the-u-s


A study reported in the November 25, 2010 issue of the New England Journal of Medicine, also confirmed that medical errors in U.S. hospitals are a serious problem. The study, conducted by lead author Christopher Landrigan, M.D., M.P.H. of the Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, and a group of doctors from Harvard Medical School, Standford University School of Medicine, and the Institute for Healthcare Improvement, reported that even in places where local governments have made efforts to improve safety of inpatient care, such as in hospitals in North Carolina, the high rate of detected medical errors did not change over a 5-year period between 2002 and 2007
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#202 User is online   kenberg 

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Posted 2012-December-22, 09:16

I had not thought along these lines, but now that I think about it I have no trouble at all believing that I am far more likely to die from a medical error than by someone shooting me. Most of us, with a little luck and planning, can avoid ever being in a situation involving guns. It's very unlikely I will be killed accidentally by gunshot, very unlikely I will be killed intentionally by gunshot, and I have no interest in suicide. I do, however, have medical issues. We all will, sooner or later.
Right after moving I had to find a new doctor and dentist. The first try in each area was a disaster. I am reasonably happy with the various medical folks I see now, I am very happy with some of them, but there are still some concerns. Pick any profession you want, not everyone in it would deserve recommendation. It's no different in the medical profession.

At any rate, death from medical error strikes me as far more likely than death by some gun toting bad guy.

For other people in other circumstances, the equation changes. Still, overall, it does not surprise me that death by medical error swamps homicide by gun.
Ken
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#203 User is offline   blackshoe 

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Posted 2012-December-22, 13:22

So how does that make him different from any other political leader? B-)
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#204 User is offline   hrothgar 

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Posted 2012-December-22, 14:28

 kenberg, on 2012-December-22, 07:56, said:

Returning to the original topic,I see that Wayne LaPierre has put forth the NRA's solution.Put armed police in every school in the nation. I believe we all owe Mr LaPierre a vote of thanks. If anyone had any doubts that he is a moron leading an organization of idiots, this should clear up the matter.


Lapierre's proposal is completely over the top.
I can't conceive of anyone seriously considering adopting this proposal nor do I believe that this was any kind of serious suggestion.

It's possible that he is a complete and utter loon, however, I think its more likely that he is trying to derail the conversation.
If the NRA can switch the conversation away from reasonable gun control measures and get people talking about "How stupid Wayne LaPierre is" they win.
Alderaan delenda est
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#205 User is offline   lalldonn 

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Posted 2012-December-22, 14:41

Columbine had an armed guard on duty during their massacre.
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#206 User is offline   blackshoe 

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Posted 2012-December-22, 15:04

Did they? Where was he while it was going down? No mention of an armed guard in the report I just read. There was a security camera in the cafeteria, but the planting of the first two bombs (by leaving duffle bags in the area) was missed because "a custodian" was changing the videotape at the time. Seems to me pretty stupid to be incapacitating your security cameras in the middle of a busy day.

From wikipedia: "A United States Secret Service study concluded that schools were placing false hope in physical security, when they should be paying more attention to the pre-attack behaviors of students. Zero-tolerance policies and metal detectors "are unlikely to be helpful," the Secret Service researchers found. The researchers focused on questions concerning the reliance on SWAT teams when most attacks are over before police arrive, profiling of students who show warning signs in the absence of a definitive profile, expulsion of students for minor infractions when expulsion is the spark that push some to return to school with a gun, buying software not based on school shooting studies to evaluate threats although killers rarely make direct threats, and reliance on metal detectors and police officers in schools when the shooters often make no effort to conceal their weapons."

I wonder if LaPierre is aware of the study. :D
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#207 User is offline   lalldonn 

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Posted 2012-December-22, 15:16

 blackshoe, on 2012-December-22, 15:04, said:

Did they? Where was he while it was going down? No mention of an armed guard in the report I just read. There was a security camera in the cafeteria, but the planting of the first two bombs (by leaving duffle bags in the area) was missed because "a custodian" was changing the videotape at the time. Seems to me pretty stupid to be incapacitating your security cameras in the middle of a busy day.

Just google Columbine armed guard, this was the first hit.

"On April 20, 1999, Eric Harris and Dylan Klebold killed 12 students and one teacher at Columbine. On the scene that day was Neil Gardner, an armed sheriff’s deputy who had been policing the school for almost two years.

As a CNN report describes, Gardner was eating lunch when he got a call from a custodian that he was needed in the school’s back parking lot. A few minutes later, he encountered Harris and the two exchanged gunfire. Harris was not hit and ran back inside the school. At that point, “Gardner called for additional units to respond to the south parking lot of Columbine High School. … While he was on the radio calling for assistance, five other Jefferson County deputies already were on their way, arriving only minutes after the first report of a ‘female down’ at Columbine High School.” Later, Gardner saw Harris again, through a broken window. Once again, he fired. Once again, he didn’t hit him."
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#208 User is online   PassedOut 

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Posted 2012-December-22, 15:47

 mike777, on 2012-December-22, 08:46, said:

These numbers surprised me:

11,000 homicides by gun
187,000 deaths in hospitals from medical errors.
medical errors amount to 18-45% of Total US health-care spending.

One of the ways that the ACA saves money over the long haul is by taking measures to reduce costly medical errors. While there are many facets to this, there are a couple of major milestones that you can read about here: Key Features of the Affordable Care Act, By Year

Quote

2012

IMPROVING QUALITY AND LOWERING COSTS

Linking Payment to Quality Outcomes. The law establishes a hospital Value-Based Purchasing program (VBP) in Traditional Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures relating to heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients’ perception of care. Effective for payments for discharges occurring on or after October 1, 2012.

2015

IMPROVING QUALITY AND LOWERING COSTS

Paying Physicians Based on Value Not Volume. A new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care. Effective January 1, 2015.

Getting medical costs down has many elements, but these provisions are important. As a life-long business person, I know from experience that pay incentives can increase quality significantly.
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#209 User is online   mike777 

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Posted 2012-December-22, 18:25

One of the ways that the ACA saves money over the long haul is by taking measures to reduce costly medical errors. While there are many facets to this, there are a couple of major milestones that you can read about here: Key Features of the Affordable Care Act, By Year

---Standford University School of Medicine, and the Institute for Healthcare Improvement, reported that even in places where local governments have made efforts to improve safety of inpatient care, such as in hospitals in North Carolina, the high rate of detected medical errors did not change over a 5-year period between 2002 and 2007

I see at a local govt level it did not work.

Interesting experiment to use federal taxpayer money to private hospitals and doctors to reduce medical errors.

We worry about "too big", but the biggest error-prone centralized top-down institution in the world is the US Gov. It is getting bigger

It would also be interesting to see the public's reaction to headlines such as 20 school children killed by medical errors over the weekend.
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#210 User is offline   nige1 

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Posted 2012-December-22, 19:20

 mike777, on 2012-December-22, 18:25, said:

It would also be interesting to see the public's reaction to headlines such as 20 school children killed by medical errors over the weekend.
IMO it wouldn't be news to most people who already regard hospitals as killing fields. Religious people (and many others) allocate accidents and mistakes to a different category from seemingly deliberate acts, even if the effects can be equally dire.
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#211 User is online   mike777 

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Posted 2012-December-22, 19:48

 nige1, on 2012-December-22, 19:20, said:

IMO it wouldn't be news to most people who already regard hospitals as killing fields. Religious people (and many others) allocate accidents and mistakes to a different category from seemingly deliberate acts, even if the effects can be equally dire.


or in this case the effects are greater than ten times more dire!

11k compared to 180K


good point but how many of us want to fly with a pilot or airline who keeps crashing by accident or mistake.

For some reason we seem less skeptical when it comes to medical care.
We seem "domain dependent" in our skepticism.

Homicide by gun is one issue but death by medical error seems to not grab the media or politicians.

Perhaps this is because of the "illusion of control" we become domain dependent.
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#212 User is offline   hrothgar 

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Posted 2012-December-22, 20:08

 mike777, on 2012-December-22, 19:48, said:


For some reason we seem less skeptical when it comes to medical care.
We seem "domain dependent" in our skepticism.

Homicide by gun is one issue but death by medical error seems to not grab the media or politicians.

Perhaps this is because of the "illusion of control" we become domain dependent.


Personally, I was raised with the understanding that sick people sometimes don't get better.
I was also lead to believe that "not getting shot" was a standard part of the educational experience.
Alderaan delenda est
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#213 User is online   awm 

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Posted 2012-December-22, 20:40

 Fluffy, on 2012-December-22, 04:24, said:

just note that Religion being illogical is part of your beliefs.


Actually I think a lot of religious people would happily agree that they sometimes make decisions based on faith rather than logic, and in fact they would condemn what they see as the potential amorality of basing decisions on logical or utilitarian basis.
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#214 User is online   mike777 

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Posted 2012-December-22, 21:06

20 school children killed by guns is one issue but where is the outcry for 200-300 school children killed by medical error.


Where is the skepticism based on science not on what you believe?

I would just like to see the same skepticism that is directed toward Bishops or guns directed towards medical errors which frankly affects more of us in our daily lives in terms of relevence and consequences.

I am not suggesting you should not be skeptical of Bishops, religion, or guns just medical errors more so at it affects your daily life to a much greater degree.


:)
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#215 User is online   kenberg 

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Posted 2012-December-22, 21:32

 mike777, on 2012-December-22, 21:06, said:

20 school children killed by guns is one issue but where is the outcry for 200-300 school children killed by medical error.


A key difference is in intent. No one wishes to see children, or anyone, die from gunshots or medical errors, or any other cause..

Errors come in degrees and types. An emergency develops, medical personnel address it as best they can but they choose wrongly, the patient dies. A tragedy. Sometimes the person making the error should be held responsible in that they were careless, or sleepy, or drunk, or something. Other times they were just wrong. It happens.

I have not died from a medical error. But I have certainly seen medical errors. I'll be 74 next week, anyone my age who has not seen a medical error just has not been paying attention. The first MD I chose after my move was a moron. I could put it more kindly, but only by forsaking accuracy. I need better than that, but I don't expect infallibility. I expect good knowledge, good judgment, good communication. After that, if we also have good luck, that would really be nice.

It just is not the same thing to speak of errors alongside intentional killing.

But sure, reducing errors would be very good.,
Ken
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#216 User is offline   hrothgar 

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Posted 2012-December-22, 21:38

 mike777, on 2012-December-22, 21:06, said:

20 school children killed by guns is one issue but where is the outcry for 200-300 school children killed by medical error.


Where is the skepticism based on science not on what you believe?

I would just like to see the same skepticism that is directed toward Bishops or guns directed towards medical errors which frankly affects more of us in our daily lives in terms of relevence and consequences.

I am not suggesting you should not be skeptical of Bishops, religion, or guns just medical errors more so at it affects your daily life to a much greater degree.



Familiarity breeds contempt

Like it or not, people get inured to the everyday and the mundane.
Sorry that the world isn't perfect.
Better get used to it.
Alderaan delenda est
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#217 User is online   mike777 

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Posted 2012-December-22, 21:39

 kenberg, on 2012-December-22, 21:32, said:

A key difference is in intent. No one wishes to see children, or anyone, die from gunshots or medical errors, or any other cause..

Errors come in degrees and types. An emergency develops, medical personnel address it as best they can but they choose wrongly, the patient dies. A tragedy. Sometimes the person making the error should be held responsible in that they were careless, or sleepy, or drunk, or something. Other times they were just wrong. It happens.

I have not died from a medical error. But I have certainly seen medical errors. I'll be 74 next week, anyone my age who has not seen a medical error just has not been paying attention. The first MD I chose after my move was a moron. I could put it more kindly, but only by forsaking accuracy. I need better than that, but I don't expect infallibility. I expect good knowledge, good judgment, good communication. After that, if we also have good luck, that would really be nice.

It just is not the same thing to speak of errors alongside intentional killing.

But sure, reducing errors would be very good.,



ty thanks for your reply...


As you noted I did not say they are the same thing.

Clearly medical error caused many more deaths.

I called for science over what you may believe
I called for skepticism directed towards medicine.


But sure, reducing errors would be very good.,


We Agree!
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#218 User is online   mike777 

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Posted 2012-December-22, 21:41

Perhaps Familiarity breeds domain dependence when it comes to science vs belief.

I did say illusion of control.


The illusion of control is the tendency for people to overestimate their ability to control events, for instance to feel that they control outcomes that they demonstrably have no influence over.[1] The effect was named by psychologist Ellen Langer and has been replicated in many different contexts

http://en.wikipedia....sion_of_control
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#219 User is offline   hrothgar 

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Posted 2012-December-22, 21:45

 mike777, on 2012-December-22, 21:41, said:

Perhaps Familiarity breeds domain dependence when it comes to science vs belief.

I did say illusion of control.

The illusion of control is the tendency for people to overestimate their ability to control events, for instance to feel that they control outcomes that they demonstrably have no influence over.[1] The effect was named by psychologist Ellen Langer and has been replicated in many different contexts

http://en.wikipedia....sion_of_control


Seems to me that you are the one arguing that we need to control medical errors while the rest of us are suggesting that you learn to accept it...
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#220 User is online   mike777 

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Posted 2012-December-22, 21:48

Actually people are arguing to prevent killings.

but if I need to just accept 187,000 deaths by medical errors....that is one argument with no skepticism presented by some posters.

If we dont have control over much including medical issues and I agree we dont, perhaps inaction will reduce medical errors in less agressive cases...anyway just a thought.
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