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Editorial: To cut health costs, doctors, hospitals must end unneeded medical procedures
Sacramento Bee ^ | 4/8/12 | Editor

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 ...


TOPICS: Business/Economy; Editorial; Government
KEYWORDS: deathpanels; healthcare; ipab; obamacare; rationedcare; rationedhealthcare; rationing; sacbee; sacramentobee

1 posted on 04/08/2012 12:06:58 PM PDT by SmithL
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To: SmithL

The reason for those “uneeded” procedures is because people sue them all the time. They have to practice medicine defensively.


2 posted on 04/08/2012 12:10:21 PM PDT by yldstrk ( My heroes have always been cowboys)
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To: yldstrk

So the procedures actually are “needed.”


3 posted on 04/08/2012 12:10:58 PM PDT by yldstrk ( My heroes have always been cowboys)
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To: yldstrk

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.


4 posted on 04/08/2012 12:11:49 PM PDT by tips up (Living is easy with eyes closed, misunderstanding all you see.)
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To: SmithL
The first thing I would cut is the stranglehold of the drug manufacturers and not allow unjust gouging of the market. Lawyers would also need to find other wealth besides chasing ambulances. Politics would have to leave the medical profession and stop their dictatorship and let the market run the business with oversight.
5 posted on 04/08/2012 12:13:59 PM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: SmithL

Tort reform first.


6 posted on 04/08/2012 12:16:38 PM PDT by TASMANIANRED (We kneel to no prince but the Prince of Peace)
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To: SmithL

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.


7 posted on 04/08/2012 12:16:54 PM PDT by Sioux-san
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To: SmithL

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.


8 posted on 04/08/2012 12:19:15 PM PDT by GeronL (The Right to Life came before the Right to Pursue Happiness)
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To: SmithL

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.


9 posted on 04/08/2012 12:20:17 PM PDT by magellan
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To: mountainlion
The first thing I would cut is the stranglehold of the drug manufacturers and not allow unjust gouging of the market

and you would do that with politics, right?

If people paid for their own healthcare, they couldn't be gouged so easily.

10 posted on 04/08/2012 12:21:32 PM PDT by GeronL (The Right to Life came before the Right to Pursue Happiness)
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To: SmithL

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.


11 posted on 04/08/2012 12:23:23 PM PDT by Dapper 26
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To: magellan

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


12 posted on 04/08/2012 12:23:40 PM PDT by GeronL (The Right to Life came before the Right to Pursue Happiness)
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To: GeronL
If people paid for their own healthcare, they couldn't be gouged so easily.

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.

13 posted on 04/08/2012 12:27:36 PM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: SmithL

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.


14 posted on 04/08/2012 12:28:36 PM PDT by AEMILIUS PAULUS (It is a shame that when these people give a riot)
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To: GeronL

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.


15 posted on 04/08/2012 12:29:34 PM PDT by The Working Man
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To: SmithL

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.


16 posted on 04/08/2012 12:36:11 PM PDT by E. Pluribus Unum (Over half of U.S. murders are of black people, and 90% of them are committed by other black people.)
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To: SmithL
Tort reform, flat fee (no percentage) for lawyers, loser pays double costs, proof of intent for punitive damages.

No extensions of patents for meds, no patents for taxpayer funded research.

Watch the prices fall.

17 posted on 04/08/2012 12:42:08 PM PDT by Navy Patriot (Join the Democrats, it's not Fascism when WE do it and the law is what WE say it is.)
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To: yldstrk

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.


18 posted on 04/08/2012 12:43:26 PM PDT by neocon1984
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To: SmithL

Like so many other editors of American newspapers, they need to grow a brain. Leftist idiots, all of them.
>p?
P.sS. Editor without a brain, it is totally unconstitutional, just as you are totally ignorant.


19 posted on 04/08/2012 12:54:25 PM PDT by Robert DeLong (u)
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To: Robert DeLong
Boy you can tell I am mad huh? Didn't even catch my HTML mistake!!!!

DOH

20 posted on 04/08/2012 12:55:57 PM PDT by Robert DeLong (u)
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To: SmithL
Consider.....a planned, elective operation on a female of childbearing age. So, to save money you do not do a pregnancy test. During the prodedure drugs are given which might adversely affect the pregnacy, which had gone undetected. Later a baby is born with an affliction. It might be a result of the drugs....it might not be. The burdon of proof is very low in these kinds of litigation and may very well result in the determination of a 'wrongful birth', which the physician gets to pay for for the rest of his life.

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.

21 posted on 04/08/2012 12:57:47 PM PDT by Texas Songwriter (Ia)
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To: SmithL
This is the reason I love FR, so much common sense. I have truley, incredibly bad “health insurance” . I am irritated with them over it, but I know what makes the costs so high. Government IS the problem, kick out the illegals, muzzle the lawyers, ease restrictions, and let me buy my fricking own dang insurance!
22 posted on 04/08/2012 12:59:00 PM PDT by nerdwithagun (I'd rather go gun to gun then knife to knife.)
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To: GeronL

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.


23 posted on 04/08/2012 1:00:02 PM PDT by freedomfiter2 (Brutal acts of commission and yawning acts of omission both strengthen the hand of the devil.)
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To: SmithL

“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.


24 posted on 04/08/2012 1:02:25 PM PDT by goodnesswins (2012..."We mutually pledge our Lives, our Fortunes, and our Sacred Honor")
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To: mountainlion

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.


25 posted on 04/08/2012 1:21:32 PM PDT by farlander (Fiat Justitia, Ruat Caelum. Sic Semper Tyrannis!)
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To: neocon1984

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.


26 posted on 04/08/2012 1:22:15 PM PDT by cliff630
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To: SmithL

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.


27 posted on 04/08/2012 1:33:10 PM PDT by yefragetuwrabrumuy ("It is already like a government job," he said, "but with goats." -- Iranian goat smuggler)
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To: farlander
Free market would be making back the $3Billion and some profit. Massive overcharges would be making $10Billion on top of the $3B. That would be criminal and not free market to me. Free market is basically what the market can accept. I see withholding a cure for a disease as criminal.
28 posted on 04/08/2012 1:53:22 PM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: mountainlion; farlander
Free market is basically what the market can accept.

"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.

29 posted on 04/08/2012 2:00:30 PM PDT by Tax-chick (Quien vive? JESUS! Y a su nombre? GLORIA! Y a su pueblo? VICTORIA!)
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To: SmithL

“To cut health costs, doctors, hospitals must end unneeded medical procedures”

Sure...
As soon as you explain that to the ambulance chasers.


30 posted on 04/08/2012 2:25:44 PM PDT by tcrlaf (Election 2012: THE RAPTURE OF THE DEMOCRATS)
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To: yldstrk

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.


31 posted on 04/08/2012 2:55:50 PM PDT by RedElement
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To: mountainlion
Massive overcharges would be making $10Billion on top of the $3B.

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?

32 posted on 04/08/2012 3:00:54 PM PDT by Sherman Logan
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To: TASMANIANRED

Exactly. It would be so nice to “systems restore” back to 1965 BTK.

(Before Ted Kennedy)


33 posted on 04/08/2012 4:10:54 PM PDT by rockinqsranch (Dems, Libs, Socialists, call 'em what you will, they ALL have fairies livin' in their trees.)
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To: SmithL
So, the Sac o’s**t Bee is promoting Tort Reform?

We all know that “unnecessary” Procedures in the Hospital magically become “necessary” Procedures in the Courtroom.

What a bunch of Obama butt kissing idiots.

34 posted on 04/08/2012 4:21:26 PM PDT by Kickass Conservative (A day without Obama is like a day without a Tsunami.)
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To: Sherman Logan

Drugs are much cheaper in other countries. Mexico is known for cheap drugs. How much cheaper are drugs there?


35 posted on 04/08/2012 4:42:04 PM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: SmithL

How about not paying for treatment of the common cold? If you’re going to be serious about cutting cost, then be serious.


36 posted on 04/08/2012 4:51:38 PM PDT by reasonisfaith (Or, more accurately---reason serves faith. See W.L. Craig, R. Zacharias, Adrian Rogers, and others.)
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To: SmithL

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.


37 posted on 04/08/2012 4:58:00 PM PDT by Myrddin
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To: SmithL

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.


38 posted on 04/08/2012 5:00:00 PM PDT by grumpygresh (Democrats delenda est; zero sera dans l'enfer bientot.)
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And yet tort reform is still off the table.


39 posted on 04/08/2012 5:32:08 PM PDT by Gene Eric (Newt/Sarah 2012)
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To: RedElement

Emmanuel bros sound evil


40 posted on 04/08/2012 6:14:41 PM PDT by yldstrk ( My heroes have always been cowboys)
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To: SmithL
If it weren't for all the greedy litagator allegators trying to turn the professional liability system into a lottery our institutions and physicians wouldn't need to order all these "cover your A$$" tests and procedures!!!

The editorial board of the Sacramento BEE lack any semblence of common sense on this and thousands of other issues over the years, IMHO!!!

41 posted on 04/08/2012 6:26:15 PM PDT by SierraWasp (Negativity must die because it's self-fulfilling!!!)
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To: SmithL
tort reform Mr.Editor.....tort reform...and doctors will stop ordering superfluous testing to avoid law suits...

better educate the public too....

42 posted on 04/08/2012 10:16:25 PM PDT by cherry
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To: SmithL
tort reform Mr.Editor.....tort reform...and doctors will stop ordering superfluous testing to avoid law suits...

better educate the public too....

43 posted on 04/08/2012 10:16:46 PM PDT by cherry
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To: AEMILIUS PAULUS
all that is true but the MAIN reason health costs are so inflated is because there is a willing sugar daddy called Uncle Sam, and since medicare was made law, the health industry...not so much doctors and nurses and lab techs...but the suppliers and big pharma....has had a constant and unending Christmas spree...

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...

44 posted on 04/08/2012 10:25:53 PM PDT by cherry
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To: TASMANIANRED

“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.

Etc.


45 posted on 04/09/2012 2:39:55 AM PDT by EQAndyBuzz (Solyent Pink is Sheeple!!!!)
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To: mountainlion

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.


46 posted on 04/09/2012 5:49:49 AM PDT by Sherman Logan
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To: Sherman Logan
60 minutes did a segment on buying drugs out of country. Many of them were American made and in the same package. I am not arguing against research and development or a profit margin. All business try to stay in the market that way. There have some drug businesses making very high profits that are not justified. We need to clean up a lot of companies and the government.
47 posted on 04/09/2012 6:00:23 AM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: SmithL
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."

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?

48 posted on 04/09/2012 6:00:49 AM PDT by EBH (God Humbles Nations, Leaders, and Peoples before He uses them for His Purpose)
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To: EQAndyBuzz

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.


49 posted on 04/09/2012 6:58:43 PM PDT by TASMANIANRED (We kneel to no prince but the Prince of Peace)
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