Skip to comments.Editorial: To cut health costs, doctors, hospitals must end unneeded medical procedures
Posted on 04/08/2012 12:06:47 PM PDT by SmithL
For weeks now, the nation has been riveted by arguments in the U.S. Supreme Court over one provision of the Affordable Care Act. Does the law's requirement that every adult buy health insurance violate the U.S. Constitution?
We think it does not.
Yet even if the court ultimately shares that view, the federal health care reform law will face monumental hurdles to be successfully implemented. The biggest of these is its cost. Can the nation afford to insure all its citizens? If we don't get a handle on rising health care costs the answer to that more important question is an emphatic "no."
And that's what makes last week's announcement by physicians representing nine medical specialties so welcome. The physicians have identified 45 specific medical tests and procedures, five within each specialty, which they think are either overused or misused. They are either unnecessary, lacking benefits to patients or, in some cases, even harmful.
The most commonly overused procedure sited in the report include:
EKGs and other heart screening tests performed on patients with no evidence of risk.
Chest X-rays for patients undergoing outpatient surgery who are otherwise healthy adults with no cardiac symptoms.
CT scans or antibiotics for patients with mild or moderate sinus infections.
Routine cancer screening for dialysis patients, particularly those with limited life expectancies.
Bone scans on women under 65 and men under 70 years of age.
Extensive diagnostic tests for people with allergies.
CT scans and other imaging procedures for simple headaches.
Such tests and procedures rarely benefit patients. Worse, they can cause harm or lead to false positives and over treatment.
(Excerpt) Read more at sacbee.com ...
The reason for those “uneeded” procedures is because people sue them all the time. They have to practice medicine defensively.
So the procedures actually are “needed.”
Exactly. Miss something due to not ordering a test and get sued. Waving this editorial around in the court room won’t serve as a defense.
Tort reform first.
Get Government and Employers out of medical insurance - let me buy my own policy with whatever benefits I want and can afford. Keep me, the patient, in the center (because I am paying the bills), and we’ll see how many tests and procedures are really needed. Home Owners Insurance wasn’t meant to cover broken windows and screens. Medical insurance was never meant to cover everything either. Hospital costs went up when Medicare contracts drove the train by paying a high % of the hospital’s “costs” - Charges skyrocketed. The patient was a mere pawn on the chessboard. This is about personal responsibility and freedom - get individual control back, and the costs will go down. It’s the only way. This is something that cannot be tweaked back to normalcy.
Once someone else is paying, you lose all decision making.
This should be between people and their doctors, this would never come up if everyone paid their own way.
I don’t understand how anyone can believe the government can compel someone to make a particular purchase. Even if someone buys the premise non-activity in the health insurance market is in fact participation, and therefore can be regulated under the commerce clause, I do not understand how purchasing a product can be compelled. There has to be much more to allow this.
The mandate is nothing more than a quip-pro-quo to the insurance companies to compensate them for the requirement to cover those with pre-existing conditions. It is a direct subsidy.
There are other ways to drive the necessary purchase of health insurance (tax credits, etc.). The individual mandate would set a precident for the federal government to mandate the purchase of anything. It is not narrow, because ObamaCare requirements are so broad.
and you would do that with politics, right?
If people paid for their own healthcare, they couldn't be gouged so easily.
Isn’t this the whole issue concerning Tort reform that Howard Dean said the Democrats were afraid to touch? If we only had a half hearted attempt at Tort reform, one half of ObamaCare would be unnecessary.
mandate you join a gym
mandate you buy a certain number of fruits and veggies each week
mandate you provide contraceptives to your children
all in the name of “health”
Yep... like we can’t see it coming
We do need competition but there needs to be some protection say if a company finds a natural cure for cancer and tries for decades and fails to make a marketable drug and people die. I know they need to charge for research but that is no excuse for massive overcharges even if you have your won healthcare.
The cost of medical services in the U.S. is directly related to: the vast number of illegal aliens receiving free care. Next of course meritless litigation adds to the cost. In addition, we have the so called “poor” receiving their freebees. I’m sure there are other factors but those that I named are pricing the middle class out of health care.
Using the “Health Care Mandate” you can decree ANYTHING because your health is affected either negatively or positively by everything you do, wear, eat, live at, etc.
That is why this whole Obamacare is so damn dangerous to the liberty of every citizen of the United States.
To the Editors of the Sacramento Bee: You could end “unneeded tests” without Obamacare if you instituted tort reform, but you consider the lawsuit lottery to be a civil right of Eric Holder’s people, so that will never happen.
No extensions of patents for meds, no patents for taxpayer funded research.
Watch the prices fall.
We absolutely need tort reform before the healthcare system can be made more efficient and less costly. John Edwards and his ambulance chasing buddies made more money off the healthcare system than any doctors.
Also, the decision about whether a procedure is necessary should be left to doctor and patient, not bureaucrats and newspaper editorial writers.
Like so many other editors of American newspapers, they need to grow a brain. Leftist idiots, all of them.
P.sS. Editor without a brain, it is totally unconstitutional, just as you are totally ignorant.
The threshold for assignment of blame is easy in the minds of jurors. Don't ask physicians to take personal risks which no reasonable person would take. Leave the practice of the art of medicine to those who are capable in that practice. Get the lawyers out of it. Change the laws to what would be reasonable. If we do not we will find ourselves with conscripted physicians who work at the pleasure of beaurocrats who know nothing but accounting lines and moral relativism. It is getting very late to do anything about it.
This should be between people and their doctors, this would never come up if everyone paid their own way.
Exactly, making sure that everyone has health insurance isn’t the solution, eliminating insurance is. Fixing the healthcare problem involves tort reform, having the patient pay his own bills and having doctors quote prices before treatment begins.
“Bone Scans for women under age 65”.....hmmmm...are they talking about the DEXA? If so, that seems contrary to good medical planning.....sheesh. (It’s good to know your bone health in your 40-50’s....so that you can “bulk” up your bones appropriately for later age IMHO.
I guess you don’t understand the principle of free market, do you ? How do you define “massive overcharges” ? Do you have ANY idea what it costs to bring a drug to the market ? At last count, that’s 3 BILLION - yea, with a *B*, and that’s not of gooberment funny money but real money a company needs to get back through sales. Where do you get this idea that they should just provide it to you at whatever price suits you ?
Next thing it’ll be “it’s a right”. Then what? If there aren’t enough doctors they’ll take your kid and say “this one must go to medical school and serve” ? Where does it stop ? Not enough nurses ? Oh we’ll just draft some. That worked out great in the Soviet Union.
Sounds like a polite way to introduce “death panels.”
BTW: All the talk of contraceptives, abortions, erection
aids suggest another solution. Why not vasectomize all
newborn males* and eliminate all the above uterine-prostate
problems. Turn the country back to the Indians.
* Of course all living males need to be clipped.
Probably the best solution all-around would be the following.
1) End Medicare. If older people cannot afford health care, they should be moved into a system designed for state healthcare. This would also mean an effective end to Medicaid, with states getting block grants, left up to their own management, for the poor.
2) Strictly limit insurance pooling for ordinary health care, to catastrophic coverage. HMO pooling would be pay as you go, with no government funding. Doctors already “outside of the system” of government funding and insurance have found they can charge 50% less, and still have higher profit margins, as well as provide quality care.
3) Disassociate health care from employment. If an employer wants to offer health care, it must be fully funded, not insured, and pay as you go.
4) Take most liability out of malpractice. Malpractice should result in loss of medical license. Only if the license to practice has been revoked should a physician be subject to civil litigation.
"Free market" is what a free individual will pay for what he wants to buy, in the absence of legal restraints on either the buyer or the seller. Anything else is the imposition, by force, of *someone's* conception of what should be bought and sold and what the exchange price should be.
That is, to belabor the point, the opposite of freedom.
“To cut health costs, doctors, hospitals must end unneeded medical procedures”
As soon as you explain that to the ambulance chasers.
Whether or not a medical procedure is “needed” is somewhat analogous to the distinction between major and minor surgery.
Minor surgery implies low risk, little pain and a quick return to normal life.
Major surgery is any surgical procedure performed on me.
Most people who show up at the doctors office expect things be done to address their complaint. They are not comforted by the line, “it is statistically unlikely that there is anything seriously wrong with you, therefore, we aren’t going to check out any of your complaints.”
If one goes to the doctor with an ailment, the expectation is that the doctor will do what is necessary to diagnose and treat the ailment. Otherwise, why go?
The doctor’s responsibility is to the patient - not to the insurance company, not to Medicare drones (roots of this are in the Hippocratic Oath). There is no question that current third party payment methods take most of the immediate cost out of the discussion for the patient. But that is not the fault of the individual doctor or patient, and does not change the facts of what the doctor is responsible for.
Ezekiel Emmaneul, Rahm Emmmanuel’s brother (a physician), has written that docs need to abandon the Hippocratic Oath and its placement of the patient’s good as the doc’s main focus, to be replaced by “societal good” and the “management of society’s resources” (not quoting him directly). If that happens, understand the doc is no longer working for you.
What about the dozens to hundreds of drugs that fail the tests for a variety of reasons and at different stages of the process?
The few drugs that do pan out MUST pay the costs of all the failures, plus produce a profit for the company. Or it won't be in business long to produce more wonderful new drugs.
Unless I'm quite confused I don't see drug companies reporting 50% to 80% profits.
The average profit margin of the pharmaceutical companies in the Fortune 1000 list is 16% (profits as a percent of revenue). This is in line with the profit margins of the banking (13%), diversified financial (11%), tobacco (11%), and real estate (10%) industries (Fortune, 2002)1 . None of these industries has the need to pour money back into research that the pharmaceutical industry does.
This is from 10 years ago. Though I suspect they aren't much different now.
Apple profits are over 40%. Isn't a new drug that saves lives worth something vaguely resembling the rewards for a new iPad?
Exactly. It would be so nice to “systems restore” back to 1965 BTK.
(Before Ted Kennedy)
We all know that “unnecessary” Procedures in the Hospital magically become “necessary” Procedures in the Courtroom.
What a bunch of Obama butt kissing idiots.
Drugs are much cheaper in other countries. Mexico is known for cheap drugs. How much cheaper are drugs there?
How about not paying for treatment of the common cold? If you’re going to be serious about cutting cost, then be serious.
Tort reform. The procedures are CYA for doctors to avoid lawsuits. Remove the lawsuit threat and docs will order what they need for a legitimate diagnosis. It would help to get the freeloaders off the doctor’s back as well. Mandating treatment for people who can’t or won’t pay for services makes it necessary to burden other patients to make up the losses. That is wrong. Socialism is always a failure...no matter what method is attempted to implement it.
Tests like ECG, CXR and head CT are usually unneeded. Just like driving a car without an airbag or seatbelt. The problem is that when you restrict your range of indications, you miss some important diagnoses. Well, at least if more people die earlier, medical costs will go down.
And yet tort reform is still off the table.
Emmanuel bros sound evil
The editorial board of the Sacramento BEE lack any semblence of common sense on this and thousands of other issues over the years, IMHO!!!
better educate the public too....
better educate the public too....
why hold back on xrays and ct scans and dozens of medicines and physical therapies and constant repeated lab tests when rich Uncle is paying...
sure, Sugar daddy is not paying its full share of all those costs, but they were in the beginning...old habits are hard to break...
and now, the rest of us premium paying public is paying off the huge gap in what the govt isn't paying....and now, that includes the illegals as well...
“Tort reform first.”
As with any law that that affects a large group of people.
Illegal Immigration? Build the wall, then we will talk.
Oil & Gas exploration? Kill the EPA regs, then let’s talk.
Drugs are much cheaper in other countries because they take the drugs developed by American firms and duplicate them.
Drugs are like computer chips. Developing the the first pill or chip costs $1B. Thereafter they cost .05 each to produce.
Except chip companies generally don’t have to discard 50 of the chips they are developing before they return any revenue.
When you buy drugs in Mexico or elsewhere in the 3rd world, you may or may not be getting what you think you are getting. Where piracy is common, you also get a lot of counterfeiting.
Then that tells me the 0bamacare law that was created to solve this crisis is the wrong answer. The answer to this dilemma is not and does not lie in insurance or in figuring out ways for people to pay for it.
This is the first clue to the 'left' that the problem is not with the people trying to pay for it. The problem is somewhere else in the medical system.
To find that answer one must ask what is driving the costs up?
I know a semi-doc.
She went almost finished everything except the exam and the last of the residency requirements.
Instead she works with a bunch of lawyers looking for deep pockets.
She has gotten rich by fleecing doctors, health systems , companies and consequently the public.
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