A responsible piece in the Chicago Tribune talking about costs, which the Presidential candidates are addressing to varying degrees.
It touches upon the myth that more medicine equates to better care, and cites the Dartmouth studies challenging that assertion:
Researchers from Dartmouth College followed patients after they experienced an acute event, such as a heart attack or a cancer diagnosis. Some of their subjects saw more specialists and spent more time in hospitals than others, getting what researchers call “high-intensity care.” The extra care didn’t help. In fact, the patients in higher-cost, higher-intensity health systems experienced slightly higher mortality rates than those who got less care.
Mention is made of the physician payment system that emphasizes payment for procedures and acute events over chronic disease management:
And doctors? They get paid when they provide services, like draining fluid from MacQuarrie’s painfully swollen legs. They don’t get paid to call every few weeks and ask about symptoms.
At its worst, the health-care system shoots hospitals into a medical arms race to offer the most high-tech, most expensive services, which help their bottom lines.
Finally, end-of-life issues are touched upon. The public will have to face this head on and answer difficult questions. Right now, this attitude is the prevailing thinking from families:
“I don’t care how much it costs. I don’t care how unlikely it is to help.”
Which is compounded by the fact that hospitals have an incentive to order tests, and the costs of futile care are masked by third-party payers.
All in all, a good piece of mainstream media reporting on what’s truly ailing the system.
