So then the physician is lying about its necessity?

“Employers pay the ever increasing health insurance premiums, while the patient pays a $30 copay and feels like they are entitled to thousands of dollars worth of tests or procedures.”

That assumes the money wouldn’t go to the employee if the employer weren’t negotiating with the insurer on his/her behalf. It’s still the employee’s money, or at least a part of their salary package. It IS their money, it’s not their fault the provider cut a deal with the insurer to provide services at a particular cost. No one made the provider do that.

“Which leads to higher overall health care costs and higher premiums.”

Too simply. Lots of things lead to high premiums, from the stock market to the real estate market to the overall health of Americans. It’s not simply “order more tests, everyone pays more money”.

Trust me, they do. All the time. Because you can always make a believable argument that something is necessary. I see people undergo unnecessary studies every day, some of which are potentially risky. If you put the same scenario in front of 10 physicians, 9 might say it’s unnecessary, but if the 10th says it is, the insurance will pay. Medicine is not cookie-cutter; everyone has his/her own medical conditions, symptoms, or family history that makes a study justifiable, even though it may not truly be needed.

Please, no one is ignoring ALLHAT. Its all anyone freaking talked about for a year. But leave the discussions to people who actually practice medicine.

The problem is most patients don’t pay for all those expensive tests and procedures. Employers pay the ever increasing health insurance premiums, while the patient pays a $30 copay and feels like they are entitled to thousands of dollars worth of tests or procedures. Which leads to higher overall health care costs and higher premiums. Eventually if the patient looses their job or the employer can’t afford the increasing premiums anymore, then the patient has to pay some or all of the premium themselves and feel even more entitled to those tests and procedures because “I am paying for it” This leads to even more increased health care costs and no improvement in outcomes.

That doesn’t make sense because it assumes the insurers routinely approve payment on unnecessary procedures. Do they?

But you have a good point in that the payment model the physicians chose is a large part of the problem.

But this is what is so key! How many patients that you know would pay out of pocket for something that a physician told them wasn’t medically necessary (putting today’s malpractice environment aside)? They’re not going to! Who has an extra $12,000 lying around? (number is an estimate) A few people do, but not many. People think because they pay for insurance they should get whatever procedures they want. I guess you could make that argument, but that’s part of what got us in this mess in the first place. Even though it’s you paying for your insurance, it’s all of us paying for the increased cost of medical care.

It’s Saturday morning and you’re listening to NPR…

Have a question for (Drs) Quick and Quack, the Tap-It Brothers? Call 1-888-MED-TALK.

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Why not if the patient wants them and will pay for them?

” For example, 1 in 3 women get a Cesarean Section in this country, supposedly to protect the infant.”

According to who? Whose to say it isn’t done for convenience of either the patient or the doctor?

Acknowledging and speaking truth takes courage and is fraught with risk. Yet, these are the initial cornerstones to begin the struggle toward an ethical and balanced restructuring of a "diseased" system.

AS a victim of predatory surgery, I can safely say that it is impossible to accurately imagine what it is like to live with a combination of surgical-related disability, pain, and enormous loss of quality of life, along with the horror of discovering you have been strategically betrayed by a physician and her "team".

Thank-you to the ethical and patient-caring medical practitioners for speaking out.