Comments on: Why health care costs so much

By: DB’s Medical Rants » Blog Archive » DrRich on health care inflation

Fri, 19 Oct 2007 13:05:27 +0000

[...] that their plan will not control health care costs. I hearken back to my post from last year – Why health care costs so much. Please reread that [...]

By: amy

amy — Mon, 02 Oct 2006 05:13:21 +0000

“Doctors also often have no clue as to where to send patients for the most cost-effective care.”
This will change as more patient have high deductible insurance. More competition among smaller competitors is the answer (lower overhead and higher flexibility). In my small office, I discount when I want. When I was working for a large group, I could never do that.

By: BC

BC — Wed, 27 Sep 2006 19:10:12 +0000

I would argue that expensive and often futile care at the end of life is NOT money well spent. Sometimes, the patient does not even want the care but is unable to communicate that fact, and there is no living will or advance directive. Sometimes palliation or hospice care would be much more appropriate and less costly, but doctors may feel they have no choice but to do everything because they are afraid they will be sued if they don’t.

Doctors also often have no clue as to where to send patients for the most cost-effective care. If there is a choice of five imaging centers for an MRI or three nearby hospitals for an outpatient procedure and all provide equal quality but at wildly different prices, the docs neither know nor care what any of them charge. Since doctors drive virtually all healthcare costs through hospital admissions, referrals, prescriptions, ordering tests and doing procedures themselves, I suggest they, in conjunction with insurers, make it part of their job to not just give the patient a prescription for an MRI, for example, but to be able to direct the patient to the most cost-effective imaging center or have a staff member who can do so.

By: Rob

Rob — Wed, 27 Sep 2006 14:58:42 +0000

Not even most forms of preventive care, like keeping diabetes under control, usually save money, despite what many people think.

Where did he get this information? Certainly some disease processes occur where the data is not clear, but diabetes?

This is clearly a case where the press takes liberties they should not take and mislead the public. There is little question that flu vaccine, childhood immunization, and aspirin therapy saves money. Things such as diabetes at worst are “unproven,” but to make a statement that prevention does not save money is way beyond what can be accurately said.

Regarding the overall cost of healthcare, the debate hinges on whether prevention saves money. We could decrease use of defibrillators, CABG, Stents, Colon Cancer treatment, bone marrow transplants, pneumonia, and other significant morbid conditions by engaging in proper prevention. We choose to be ignore the addage “an ounce of prevention is worth a pound of cure” and instead throw money into expensive therapies rather than preventing the underlying diseases in the first place.

Of course, your dear lawyer friend may want to sue me regarding my opinion in this….