Safety in U.S. healthcare has been a different story, he said.
In "To Err Is Human," (the Institute of Medicine's 1999 report, of which Chassin was one of the authors) there were 44,000 to 98,000 deaths in hospitals due to errors a year, out of 34 million hospitalizations. Or a death rate of 3,800 deaths per million, Chassin said.
Compare this to 1.74 deaths per million in the same time period for the U.S. airline industry, he said.
"Hospital care is 750 to 1,000 times less safe than air travel in the United States," he said.
"And if you don't like that estimate, here's another," he said. "The Harvard Medical Practice Study (of 1991) showed that 1% of hospital patients were injured due to errors judged... to be negligent. That's a death or injury rate of 10,000 per million. The U.S. airline comparative number is 341 people dead or injured in 95.2 million flights, U.S. hospital care is 3,000 times less safe than U.S. air travel, or 3.6 per million. By this measure, hospital care is almost 3,000 times less safe than air travel."
Chassin acknowledged that the incentive for airlines to be safer is a bit different. He didn't say it, but everyone understands the ignominy an airline faces when 350 people fall to their deaths in one moment. Healthcare safety deaths are not publicized in any way that is nearly as impactful.
"But nevertheless, through a series of very clear steps, the [airline industry] got to where they are now, 1.7 deaths per million flights. And if we don't commit to zero, we're not going to know how close we're getting and we'll be satisfied with small incremental progress every year.