Ed. Note: This article first appeared in Forbes
Headlines such as "Republicans Pan Trump Budget"
and "Donald Trump’s Budget Is Universally Unloved"
have suggested that identifying problems with President Donald Trump’s proposed federal budget has been like pointing out wet spots on the Titanic.
For example, a chorus along the political spectrum
have criticized the proposed drastic National Institutes of Health (NIH) budget cuts, arguing that it could be the "jump the shark" moment for the United States (a reference to the Happy Days
episode that began the ultimate decline and demise of the popular sitcom series).
No American should want the United States to become Joannie Loves Chachi
or the Happy Days
that had the Married with Children
neighbor Ted McGinley in it, so the hope among many is that the NIH cut will not get through Congress.
But one overlooked potential casualty of the Trump budget is AHRQ. And this casualty could literally kill you.
AHRQ may sound like something you would say when you step on a tack or a cat with tacks. But AHRQ is short for Agency for Healthcare Research and Quality, the federal government entity dedicated to patient safety.
In other words, AHRQ aims to find innovative ways to prevent medical errors and healthcare-associated infections (HAIs) and the physical and mental harm and deaths that can result.
As the AHRQ website explains
, AHRQ "invests in research and evidence to make healthcare safer and improve quality," "creates materials to teach and train healthcare systems and professionals to help them improve care for their patients" and "generates measures and data used to track and improve performance and evaluate progress of the U.S. health system."
An error or an infection in a hospital, clinic, operating room or nursing home is a lot more likely to harm or kill you than a terrorist attack, a nuclear war, an invasion or many of the things that may get increases in funding if the Trump budget were to pass.
In fact, a study from Johns Hopkins University published in BMJ
found that 10% of all U.S. deaths (or over 250,000 deaths per year) are now due to medical errors, making it the third leading cause of death in the U.S.
Estimates of the annual costs of medical errors
have reached $1 trillion. Such numbers are probably underestimates since many medical errors go unnoticed.
Add to these numbers the toll of HAIs, many of which aren't counted as medical errors.
A Centers for Disease Control and Prevention (CDC) video explains
that about 1 in every 25 hospital patients get an HAI.
The HAI Prevalence Survey reported that in 2011
an estimated 722,000 HAIs occurred in U.S. acute care hospitals, resulting in about 75,000 deaths. Again these are also underestimates because many HAIs occur in outpatient clinics and nursing homes.
These problems affect everyone, no matter how wealthy or famous you may be.
Here Actor Dennis Quaid describes how his twins' lives were threatened by accidental medication overdoses:
Singer Kylie Minogue revealed on the Ellen Show
that her breast cancer was initially misdiagnosed.
A number of top athletes such as Peyton Manning and Tom Brady suffered major infections after surgery. The list goes on and on.
Trump's budget proposes to roll AHRQ into NIH. No one wants to hear the words that "we will roll your job into someone else's."
This can be a euphemism for get rid of, lay off, fire or force both of you to wear the same pair of pants at the same time. Rolling AHRQ into NIH just does not make any sense, since what AHRQ does and NIH does are very different. While the U.S. and countries around the world recently have been paying more attention to patient safety and HAIs, the Trump budget goes the exact opposite direction.
AHRQ has many examples of saving lives, money and suffering (preventing suffering, not making it easier to suffer). For example, their National Scorecard talks about
$28 billion and 125,000 lives saved from 2010 to 2015.
I serve on an AHRQ grant review panel and thus regularly see numerous innovative ideas to protect patient safety, ranging from safer medical equipment to new devices to prevent errors and infections to systems to track and alert everyone about medical errors to new strategies and approaches.
AHRQ has also funded our RHEA (Regional Healthcare Ecosystem Analyst) Project
to develop simulation models to improve HAI prevention and control strategies.
In addition to improving patient safety, AHRQ-funded efforts have led to the creation of numerous new businesses and jobs, including many in the growing healthcare safety and infection control industries.
AHRQ funding is an investment, not a cost.
Jeopardizing AHRQ's efforts and its funding would be analogous to trying to save a family money by eliminating budgets to buy new clothes and food. It may seem like it is saving money in the short term, but in the long run such cuts may end up literally hurting and killing Americans.
Posted by: The Wealthy Doctor