Michael Jackon’s demise is a classic story of medical mismanagment – he was done-in by a fragmented healthcare system which is too focused on financial gain. The fact that Mr. Jackson was able to obtain prescriptions for anesthetic agents, not just pain medications, from multiple doctors is truly astounding. While it is becoming painfully clear that Michael Jackson was “playing” the healthcare system to feed his addition, it is even more painfully true that he was allowed to do so to the point of his own demise. Possibly with a physician standing at his side? It should be made absolutely clear that administering some of these agents, particularly propofol, in a non-critical care or operating room environment without physiciological monitoring is extremely risky and shows careless disregard for the sanctity of life. How did this happen? This man was obviously crying out for help and the last thing he needed was another prescription for pain medications or anesthetic agents.

Where was the CARE in his healthcare?
Would a siloed EMR in a doctor’s office have changed the course of this man’s medical treatment?
Did any of his doctors ever communicate with any other doctor caring for this patient?
Did the malpractice system prevent this death – does it really improve healthcare quality or just add to cost of healthcare?
Will a malpractice lawsuit against a physician implicated in the care of Mr. Jackson prevent this from happening again?
Is the healthcare REFORM process going to lead to changes that prevent this type of healthcare from happening in the future?

Do not believe for a second that this is an isolated problem – as a physician I see this type of patient often. The quality of care issue is deep and complex – but without addressing this problem simply covering more lives or further regulating the insurance industry is not going to solve the prime problem.

Healthcare over-expenditures are the result of a system that does not reward good care, rewards overuse of procedures and diagnostic testing and has pitted every major stakeholder against each other resulting in increasing fragmentation and intermediation. The problem is that the healthcare system is NOT a SYSTEM. Address this problem and I believe that all of the other issues fall in place. Healthcare REFORM that does not address this problem will not reduce cost of care nor improve quality of care. It will just further ration resources already made overly scarce by malalignment of interests and misappropriation.