Friday, August 28, 2009

Over-tested America.

Dr. Andrew Weil, author of the forthcoming book, "Why Our Health Matters: A Vision of Medicine That Can Transform our Future," writes at Huffpo today about how excessive testing has escalated medical costs but done little to improve our over-all health as a nation.

Weil writes:

Lest you think the only drawback of over-scanning is wasted billions, note that from 1980 to 2006, per-capita radiation dosage from medical testing more than quintupled. A controversial study published in the November 29, 2007, New England Journal of Medicine estimated that computed tomography (CT) scans -- the type of imaging that has grown most explosively -- administered today could eventually cause up to 2% of cancer deaths.

As with fear, greed also propels expensive, inappropriate treatment. If a clinic loses money each time it counsels a patient to control type 2 diabetes with diet and exercise, but makes a hefty profit when it amputates a foot riddled with diabetic ulcers, how long will it continue to emphasize the former?

The best practice boards proposed in HR 3200, better know to opponents of reform as "death panels" or instruments of "rationing," would help to remove financial incentives from the system and restore the doctor-patient covenant. And they could make us healthier.

Two articles that come to mind:

Barbara Ehrenreich's "Welcome to Cancerland," 2001, chronicles her own diagnosis and treatment for breast cancer and exposes the "breast cancer industry," as an "estimated $12 - 14 billion-a-year business in surgery, 'breast health centers,' chemotherapy 'infusion suites,' radiation treatment centers, mammograms, and drugs...."

And the recent NY Times article "The Cost Conundrum: What a Texas town can teach us about health care" by Dr. Atul Gawande, cited by Weil in his Huffpo piece, an investigation of medical practices in McAllen, Texas, where more is spent on health care than anywhere else in the US. With little result.


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