It is a pity that our system does not seem to be structured to deal in a similar way to problems of prevention, as in, for example, the case of Tim Russert. Untreated hypertriglyceridemia, in someone with established heart disease? I expect this situation is common enough. But isn’t is something that responsible people need to reassess?

The science, after all, seems to favor the treatment of high triglycerides. In 2006 the AHA advised one therapy (EPA + DHA, under supervision of a physician) for those with documented CHD, like Russert. More recently a scientific journal, ATVB, found that in cases of hypertriglyceridemia and low HDLs, the overweight “derive a disproportionately large reduction in cardiovascular events” from another therapy.

And yet the popular response to Russert’s untimely death is just a demand for more imaging. A disconnect, don’t you think? And not likely to promote the best use of resouces?

Hopefully, other organizations can follow this example – not only of owning up to mistakes, but to maintaining this sort of transparency when it comes to the more sensitive, or controversial, side of health care. Incidents such as these, along with end of life care, access to care issues, and setting reasonable expectations for health outcomes will, when made public, all present far more treacherous ethical challenges than will cost transparency alone.

No discipline will ever be perfected, but – especially in health care – the ability to identify and rectify imperfections must be practiced with the highest level of integrity. The ultimate solution to rectify these specific errors is, as yet, unapparent; but Mr. Levy and his staff have demonstrated the exact kind of integrity necessary to ensure that our health care system is a true work in progress, not a broken machine.