Back to basics in credit and health

There's a parallel in health care to the economic crisis--and you might die of this problem before your pension recovers because there is little attention to the basics of the spread of infection. When I was hospitalized for 2 days upon our return from Italy in June, I was not impressed by the cleanliness and sanitation of the first class hospital paid for by my first class health insurance (the bills aren't all in yet, but it is over $6,000) through Medicare and State Teachers. On the other hand, the staff was pleasant, attentive and caring, and I'm sure they score A+ on that. That I spread whatever I had around the ER waiting area for 8 hours didn't seem to matter.

Our country seems to be collapsing from the clutter and fall out of "the next best thing." In health care it is antibiotics and endless expensive social studies about gaps based on race, gender, and quality of insurance coverage, and in government it is faulty loan practices by the lenders because of social engineering from Congress also sick with gapitis.

There are well established steps to prevent infections in hospitals. And even today with widespread information available on the growth of super bugs, doctors may ignore them. Even in the 1980s when I worked in the Veternary Medicine Library at Ohio State I was seeing a return to interest in infectious diseases--antibiotics having already run out of miracles. We knew in the 1990s that workers in vet hospitals were transmitting bacteria to their sick charges, or taking things home to their own pets, just because of poor disinfection of rooms, equipment, and (!) artificial fingernails, which are terribly difficult to keep clean.

Laura Landro writes on super bugs in today's Wall St. Journal, and it isn't anything new that will save us--it's a return to basics.

[Peter Pronovost, a professor at Johns Hopkins University School of Medicine] With no new antibiotics immediately on the horizon for either class, preventing infections "comes down to blocking and tackling," Dr. Pronovost says -- quickly diagnosing infections, using appropriate antibiotics and "going back to basics" such as getting health-care workers to wash hands.

In partnership with the Michigan Hospital Association, Dr. Pronovost developed a program to prevent bloodstream infections, which can be caused by both gram-negative and gram-positive bacteria and often strike patients in ICUs with large catheters inserted into their veins. With five practices -- handwashing, draping patients before inserting the lines, cleaning the skin properly, avoiding catheters in the groin and removing them as soon as possible -- the consortium reported that the rate of infections in Michigan ICUs dropped by 66% over an 18-month period. The process saved more than 1,729 lives and $246 million.

Dr. Pronovost says that while the steps are well-established, his research shows doctors skip steps more than a third of the time. Today, the Agency for Healthcare Research and Quality, part of the federal Department of Health and Human Services, plans to announce that it will provide funding to expand Dr. Pronovost's program to 10 other states.

If you borrowed money for a home before the mid-90s, you can probably come up with five basics that the Congress and lending institutions have been igoring for a decade.

1. good job
2. good credit rating
3. no more than 1/3 of monthly income for housing expenses
4. neighborhood with sound housing stock
5. 20% down so buyer would have something invested

Time to clean up the bugs in hospitals and Congress.

Perhaps the dumbest thing in this article by Ms. Landro is the report that HHS plans to expand funding for Pronovost's program to 10 other states. Haven't we known this for a century? More posters reminding doctors to scrub down (up?) at a million dollars a pop?