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?
You forgot medical liability as a primary cause of over utilization.
ReplyDeleteMedical liability is a necessity until the medical profession develops a robust way to make practitioners accountable.
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