Advancing breast cancer screening – or another example of why health care costs keep rising

We all believe that investing in prevention is a laudable goal. Many observers have criticize physicians for not doing enough prevention. This article describes using MRI to better screen high risk patients for breast cancer – Breast Study Backs M.R.I. Use

The researchers found that 17 cancers in the group were detected by magnetic resonance imaging, compared with 8 by mammography, 7 by ultrasound and 2 by semiannual clinical breast examinations.

“Our results support the position that M.R.I.-based screening is likely to become the cornerstone of breast cancer surveillance for BRCA1 and BRCA2 mutation carriers,” the report said, though adding that “it is necessary to demonstrate that this surveillance tool lowers breast cancer mortality before it can be recommended for general use.”

Clearly a promising result! Women carrying one of these mutations will certainly seek out MRI (despite no outcome data). We all will tend to believe the results should matter. We need not stretch credulity in considering this a better test – despite meager data.

This article does not mention the cost of the relative diagnostic tests. How much more will we spend?

Your first thought in reading that paragraph is probably that we might even save money with early diagnosis. However, how many MRIs will we do to catch each early breast cancer. And despite this study only looking at those with a genetic predisposition – how long before all women demand MRI screeing?

Costs will go up. We hope outcome improve also. But costs will go up.

Health care costs go up because of improved technology and improved medications (both of which cost more than the technologies and medication they replace).

We want to provide and receive the best care possible. This technology looks like it just might represent an important advance.

We should not expect advances to occur without increasing costs. However, these considerations probably contain too much granularity for most diatribes of increasing health care costs.

Politicians will continue to attack health care costs – it produces good sound bites. But the root causes of health care costs increasing are not JUST greed.