Could Tim Russert's Heart Attack Have Been Avoided?

Not a trivial or academic question. Time magazinereceived the recommended care developed by
identified the NBC's Meet the Press moderatorexpert committees.
and Washington bureau chief as one of the 100Unfortunately, one can't assume that the best
most influential people in world in 2008. His loss atpreventive care is done at university medical
such a young age, 58, is tragic. His ability to makecenters. A study in California found that the
complex topics clear for the public and to ask theintegrated healthcare organization Kaiser
hard questions will be missed in this the mostPermanente outperformed both university medical
historic presidential races in American history.centers and community hospitals in decreasing
But was his sudden passing and fatal heart attacktheirpatients' heart attack risk and death by 30
an avoidable tragedy? His internist, Dr. Michaelpercent. The vertically integrated VA healthcare
Newman, who is affiliated with Georgesystem was also found to outperform
Washington Medical Center, noted that Mr.community hospitals in caring for diabetics. It
Russert died of asudden coronary thrombosis,consistently ensured its patients got the right
which can occur without warning. Mr.Russert hadmedications at the right dosages better that
been diagnosed with asymptomatic heart diseasethose in the communities around them.
which reportedly was well-controlled withIt seems that as a country we take for granted
medication and exercise. He passed a cardiacthe failings of the healthcare system which are
stress test in late April. It seems like he got theoccurring with alarming frequency. As we mourn
appropriate care.the unexpected passing of a great journalist, we
Yet, our healthcare system only provides theshould instead ask ourselves whether there were
right preventive care 55 percent of the time.systematic failures in the healthcare system that
What medical students know, lowering bloodMr. Russert relied on to keep him well? The goal
pressure, controlling cholesterol, and arrangingwouldn't be to find negligence or to identify
age-appropriate cancer screenings, shown to savescapegoats, as like the aviation industry, the
lives, are not done routinely in this country. Thedelivery of healthcare is too complex to simply
ability of doctors and insurance plans to provideisolateone person or entity that resulted in the
this basic fundamental care varies by about 20mishap. It is very likely that General Electric, NBC's
percent. If one compared the safetyparent company, provided him with health
performance of the top 10 percent of airlines withinsurance options that were accredited by NCQA
thenational average, the quality gap was far lessas excellent in keeping people healthy.
at less than 1 percent.Is it possible, however, that the recommended
The National Committee for Quality Assurancecare wasn't delivered? As our nation struggles
(NCQA) estimates that had all doctors andwith how to make the healthcare system more
insurance plans performed at the level of theaffordable, accessible, and with higher quality, the
nation's top 10 percent that 80,000 Americans, alldebate boils down to who is best in determining
who had health insurance, would have avoidedthe right care at the right time. Is the on us on
premature death. That is twice the number ofpatients? Does the responsibility rest on the
breast cancer deaths annually. A study of 20,000healthcare industry? It is an important
patients in 12 US major cities found that only 68conversation our country must have and certainly
percent of those with heart disease and only 65would have gone better with a skilled moderator
percent of those with high blood pressurelike Mr.