As the Supreme Court debates the fate of “Obama Care,” we should recall the formal name of the law: the Patient Protection and Affordable Care Act (PPACA). Most of the public debate has been about the cost of health care, losing sight of the urgent need to fix the ongoing crisis of quality and patient safety. More health care organizations need to adopt the lean management philosophy to “bend the cost curve” and save lives, as some innovators have proven during the last 10 years.

The most highly touted aspects of the PPACA include attempts to protect patients by increasing their access to health insurance. A 2009 Harvard Medical School study estimated that 45,000 Americans die each year due to a lack of coverage. Even if patients can get appointments or get admitted to a hospital, there are dangers that are underappreciated by the public. The Department of Health and Human Services reported, in 2008, that 80,000 Medicare patients die each year due to preventable medical errors. Other studies estimate that 90,000 patients are killed annually by hospital-acquired infections. Ironically, we are granting easier access to a very dangerous system.

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