How does a Medicaid block grant proposal like that of Congressman Paul Ryan relate to (1) poor treatment of cancer pain, (2) the epidemic of overdose deaths from prescription opioids, (3) the neglect of preventive medicine in the U.S., (4) unnecessary anticoagulant drug related bleeding deaths, (5) FDA drug regulator unresponsiveness to drug safety concerns, and (6) our broken medical malpractice system? My saga at the Los Angeles County + USC Medical Center (LAC-USC) ties these components of our health care system in crisis together.
On March 23, the Institute of Medicine issued a report entitled, “Standards for Developing Trustworthy Clinical Practice Guidelines (CPGs).” The report noted that the National Guideline Clearinghouse accepted722 new guidelines to its database in 2008, bringing the total to nearly 2,700. Almost 1,000 CPGs have been updated because they didn’t quite get it right the first time. A staggering 1,978 CPGs were withdrawn from the database, presumably because they were just too wrong to be updated.