Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

2 C-words that explain the rising cost of health

Timothy Johnson, MD, MPH
Policy
November 10, 2012
53 Shares
Share
Tweet
Share

Having established that the U.S. spends twice as much per person on healthcare as the average per person cost in all other developed countries – but with no better overall results – it is time to ask how this happens.

Obviously, there are many factors contributing to this dangerous cost escalation, but in my mind two stand out.

The first is our unrealistic expectations as American healthcare consumers. Here are a bunch of words beginning with the letter “C” that I think fairly describe our typical hopes for our healthcare: convenience, compassion, communication, coordination. Nothing wrong with those hopes, but they all require time and people which means higher cost.

However, the “C” word that I believe really affects cost is this one: Cutting Edge. (Yes, I know that is two words, but you get the idea). We Americans have come to believe that the newest drug/device/test/procedure is the best.

This belief is fueled by many forces, but the most important may be the constant barrage of reporting about medical “breakthroughs” in our media.

This is a subject that hits home given that I spent 25 years as the Medical Editor of ABC News. I remember vividly when I first fully realized how we in the media were contributing to this public expectation/belief that the newest was the best.

During the 1990s some leading experts in the treatment of breast cancer began to “report” that the use of bone marrow transplants (which include very high-dose chemotherapies) for advanced breast cancer was better than standard chemotherapy. And because these reports were coming from true experts in the field, we in the media reported on their statements.

Predictably, women with advanced breast cancer, and their families, started demanding this new treatment, and when insurance companies denied payment, they often sued those companies.

This growing demand went on for several years until 1999 when three gold standard studies were finally presented at a major cancer meeting (the American Society of Clinical Oncology meeting) showing definitively that bone marrow transplants for advanced breast cancer were no better than standard chemotherapy.

American doctors stopped doing those transplants very quickly but because these studies had been so long in coming, tens of thousands of American women had been subjected to unnecessary treatment that was more costly and dangerous than the standard treatment available.

This phenomenon – the reporting of new breakthroughs – has grown in our society, especially with the addition of “direct to consumer” advertising for new drugs and procedures.

And this has often led to an “arms race” between major medical centers in the same geographical area who are competing with each other for “good patients” – meaning patients with money and/or insurance who can pay for the (usually) costly new tests and treatments that bring in good income.

But there is a final “C” word to add to the list of our typical expectations: we Americans want healthcare that is “Cheap”or even “Cost-free” in terms of our pocketbooks. In other words, we Americans have been raised with the expectation, now often subconscious, that “someone else” should/will pay for our healthcare – our employer in many cases, government programs for many others.

Timothy Johnson trained as an emergency room physician but switched careers in 1984 when he joined ABC News as its first full time Medical Editor. Although he retired from that role in 2010, he continues as Senior Medical Contributor.  He blogs at Timothy Johnson, MD: On Health.

Prev

Make IT vendors your partner for a smooth EMR transition

November 10, 2012 Kevin 5
…
Next

Take advantage of the vision of primary care physicians

November 10, 2012 Kevin 4
…

Tagged as: Primary Care, Public Health & Policy

Post navigation

< Previous Post
Make IT vendors your partner for a smooth EMR transition
Next Post >
Take advantage of the vision of primary care physicians

More by Timothy Johnson, MD, MPH

  • a desk with keyboard and ipad with the kevinmd logo

    The fiscal disaster of healthcare costs has a human toll

    Timothy Johnson, MD, MPH
  • a desk with keyboard and ipad with the kevinmd logo

    Medical homes need ready access to good data

    Timothy Johnson, MD, MPH
  • a desk with keyboard and ipad with the kevinmd logo

    4 essential elements of true health reform

    Timothy Johnson, MD, MPH

More in Policy

  • Pediatricians grapple with guns in America, from Band-Aids to bullets

    Tasia Isbell, MD, MPH
  • Health care wins, losses, and lessons

    Robert Pearl, MD
  • Maximizing care amidst provider shortages: the power of measurement-based care

    Tom Zaubler, MD
  • Unveiling excessive medical billing and greed

    Amol Saxena, DPM, MPH
  • Chronic health issues and homelessness

    Michele Luckenbaugh
  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns
  • Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin
  • Despite Taboo, Med Students, Doctors Use Substances Too
  • White House Opens Gun Violence Prevention Office
  • Nurses Step Up to Bat on Educating Patients About Climate Change

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

2 C-words that explain the rising cost of health
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...