CMA Emerges Dazed from Cave, Writes Report.

By Steven Lewis.

Remember the news stories from the sixties and seventies about Japanese soldiers emerging from island caves in full battle regalia, unaware that WW2 ended in 1945?  For them, time had stopped.  They were still at war and girded for combat.  It appears they had some company:  the authors of the recently released Canadian Medical Association report, Health Care Transformation in Canada. 

What a strange, atavistic confection, and what a missed opportunity.  I had high hopes for the report – an updated perspective, some serious self-reflection.  Surely it wouldn’t recycle hoary old solutions and beguile us with policy legerdemain. 

Surely it did.  It is a remarkable document on many levels, both for what’s in it and what isn’t.  Solutions based on unstated premises.  More doctors, more services, more of everything – except restraint.  Don’t take my word for it - read it for yourself.  Here’s a sampler of the report’s proposals: . .

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High Reliability versus High Autonomy: Dryden, Murphy and Patient Safety

Robert G. Evans, Karen Cardiff and Sam Sheps

Healthcare is not a high-reliability industry. The adverse event rate is on the order of 10^-2; industries such as aviation, nuclear power and railways achieve rates of 10^-5 or better. Increasing awareness of this contrast has made "patient safety" a major topic of concern.

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