Profit Drives Healthcare Costs and Decreases Overall Health

Our perverse profit-driven health care system which rewards procedures over health drives the biotech industry to produce more expensive less effective devices and drugs to support help drive the $$billions of unnecessary procedures and drugs ordered by physicians. Among these are the needless number of CAT scans, MRIs, angioplasties, hysterectomies, knee replacements, arthroscopic surgeries, etc. When we reimburse by fee for service, there is no incentive for conservative treatment and every incentive for the doctor to perform the most expensive tests. Venture capitalists understand that there is money to be made to support these treatments and pour capital into biotech firms. That’s why there is a new and better MRI or titanium shoulder introduced into the system every year. As long as we continue to compensate doctors by the number of procedures they perform we will continue to have more useless expensive devices flooding the market demanding more “victims”.

Ten million MRIs are done each year in the USA at a cost of $750 to $950 a piece. Many of these are used inappropriately as diagnostic tests, rather than as presurgical tools. Research has shown that 40% of patients with advanced disc degeneration did not have back pain.  Based on these findings, rather than performing an MRI, it is recommended that patients be managed conservatively for a few months (with analgesics for pain management). If the pain persists, further treatment may be warranted.

The frightening thing is that most doctors don’t even know what better care is!! The prestigious Institute of Medicine published a report that estimates that only about half of what doctors do today is backed up by solid scientific evidence (Brownlee, AARP Magazine, July/Aug 2008). The rest go by their intuition or gut feelings.

Now, how do we get doctors and patients to buy into this? Doctors buy MRI scanners to use them; after all, they get reimbursed mucho dinero for their use. For example, two thirds of the money Medicare paid for imaging was for scans in doctors offices. We spend more than $26 billion each year on spinal fusions, even though research has shown that the surgery is not superior to other methods to relieve back pain. And then there is the patient’s role in all of this. Many of us are too eager for surgery. After all, insurance is paying! Who do you think pays for the insurance. We do! Have you seen how much is deducted from your check each month for insurance? Do you see how much it goes up every year? Have you seen how much your deductibles and co-pays have risen? Have you noticed that your pay hasn’t kept up with inflation? Do you think your Medicare premiums actually pay for all the needless tests that you get done?

With every procedure there is risk of infection, stroke or death. We demand drugs that we see on television, for heavens sake. It isn’t candy! It’s your body you’re putting them into! There are over 600,000 adverse drug reactions each year resulting in over 30,000 deaths! We must be more involved with our healthcare. Apparently, many physicians out there would rather pad their bank accounts than do what’s best for their patients. In the absence of full disclosure, we must, as consumers, ask the right questions of our doctors before consenting to any procedures or drugs. Are you sure you made the right diagnosis? Could it be something else? Are there less risky treatments that would work? What are the risks and benefits? If you are still unsure, get a second opinion; this is a life and death situation!

Removing the profit incentive is really the only way to reform healthcare. Think about it- is it moral to make a profit over someone’s health?? Besides, healthcare  doesn’t conform to free market principles. We cannot do without healthcare!

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