Overdiagnosis and Overtreatment - Enemies of Health Care Reform

If we ever manage to tame Over-diagnosis and Over-treatment – the twin threats to medical reform - many players in the medical universe would find their status - and their livelihoods- downgraded to critical condition. 

Let me offer a single sentence that points out the herculean challenge facing reformers.

One man’s wasteful medical spending is another man’s income.

 You Need the Strength of Hercules to Reform Health Care

The system is riddled with conflicts of interest where various economic interests collide with our health interests.

Here are three hypothetical examples to illustrate my point.  

Political progressives clamor to sharply reduce drug prices to make them affordable for all Americans.  The pharmaceutical industry uses all means necessary to resist this. Of course, making all drugs affordable would crush the drug companies economically.  They argue that such a draconian approach would stifle research, development, and innovation.  Why should a drug company risk investing zillions to develop a cancer vaccine without the promise of great financial reward for the company and the investors?

Healthcare reform advocates want to establish a ‘Medicare for All’ plan, which is essentially a single-payer system.  Commercial insurance companies – who would face elimination – argue that Americans would suffer under government-run socialized medicine.  “Americans deserve a choice in the marketplace,” they would argue.  “Do we want health care run like the Bureau of Motor Vehicles?”

We need to curb our overuse of medical imaging.  One reason that so many patients undergo unnecessary CAT scans is that there’s an imaging center practically on every corner.  Hospital radiology departments are economic engines for hospitals. Restraining radiology testing would improve our health and save zillions, but it would have economic consequences for hospitals, radiologists and investors, all of whom would be expected to push back.  (If you are unclear why this extra testing harms health, type in overdiagnosis in this blog's search box.)

It won’t be easy to untie this Gordian knot.  The challenges I highlight with my profession are not unique to medicine.  Do you think it’s easy to make a dent in streamlining the Military Industrial Complex?  We have all heard of a politician who refuses to close a military base or a weapon manufacturer in his district that the military doesn’t want anymore.  Make sense?

Would you give up your job or close down your company to save the greater good?