The Affordable Care Act controversy rages on. In this week's BMJ, journalist Jeanne Lenzer says the basic assumption that US people don't have enough health care is misleading and in reality, Americans have too much - and that unnecessary care costs an estimated $800 billion per year.
The article arrives as an international conference named 'Preventing Overdiagnosis' was announced for September, 2013 in the United States, hosted by The Dartmouth Institute for Health Policy and Clinical Practice, in partnership with the BMJ, Consumer Reports and Bond University of Australia.
The U.S. medical establishment prides itself on saving everyone it can. Some contend that overly aggressive treatment is estimated to cause 30,000 deaths among Medicare recipients alone each year, while unnecessary interventions are estimated to account for 10-30% of spending on healthcare, or $250-800 billion annually. Examples range from the overuse of screening tests, commonly called defensive medicine, since it is needed to ward off spurious lawsuits, and imaging technology to questionable surgery.
The doctors contend overtreatment leads to patient harm but the onus of the modern movement is bringing down costs so that the government can afford to get into the health care business. Currently, Office of Management and Budget estimates to provide the high-end treatment people get, even when the prognosis is not good, estimate tens of thousands of dollars in new taxes for citizens.
Because health care has become a political football, rationalizations about overtreatment are receiving significant attention from the American media and politicians. The doctors in the article identified several reasons for overtreatment, including malpractice fears, biased research, patient demand, and financial conflicts of guideline writers in the modern, government-mandated 'teach to the protocol' environment. Several speakers highlighted the way physicians are paid and trained in the US as central factors, and nearly 80% believed that more radical payment reform is necessary to reduce the problem meaningfully.
But as these initiatives begin to move forward, they will face formidable challenges from the medical professionals in the healthcare industry (who don't think they are overpaid) and the general public who fear that the overtreatment argument is just laying thee groundwork to ration care, reports Lenzer.
Advocates of reducing treatment disagree. "Rationing means that you are limiting necessary care. What we are proposing is limiting unnecessary care – harmful care," argues Dr Diane Meier, Professor of Geriatrics and Internal Medicine at Mount Sinai School of Medicine.
Jerome R Hoffman, Emeritus Professor of Medicine at the University of California, Los Angeles, said: "There's already lots of rationing in healthcare; wouldn't it be better for us to decide what should be available, based on what's best for our health, rather than having insurance companies decide, based on what's most profitable for them?" U.K. NHS patients and doctors disagree that government should be deciding who to save and claim it is just a 'death pathyway', since some claim they kill 130,000 patients per year rationing care, while others contend that resources wasted on unnecessary care are better spent treating and preventing illness in the underinsured or uninsured. But the underinsured and uninsured should not exist under the Affordable Care Act.
- PHYSICAL SCIENCES
- EARTH SCIENCES
- LIFE SCIENCES
- SOCIAL SCIENCES
Subscribe to the newsletter
Stay in touch with the scientific world!
Know Science And Want To Write?
- Kudos To "The Independent" Newspaper For Debunking Nibiru "Blood Moon" Hoax
- It's Not The Nicotine: US Teens More Likely To Vape For Flavorings
- Your Microbiome Did Not Cause Your Weight Problem
- Control Cancer By Making The Tumor Cell Environment Hostile
- A Great Blitz Game
- On Sexuality, You Weren't Born That Way, Says Paper
- Beekeeping Fad And The Stress Of Traveling Is Harmful To Bees
- "Thanks, Skynix, glad you like the articles. Yes of course, to many readers of Science20 then what..."
- "Yes that's a good point, the Moon can look reddish just as the sun does when close to the horizon..."
- "When will you people open your eyes and see that this is very much real and thats a FACT..."
- "So I thought I would post a comment to say thank you for all the articles you've done on this subject..."
- "Right, could it just be light reflected / refracted in the bus windows? With buses particularly..."
- Gallup Poll: Great Example of How to Bias a Social Science Study
- Another Kardashian Craze Debunked
- Fad Friday: Ditch The Body Wrap!
- Commonly Cited Stat of 10 Bacteria for Every 1 Human Cell Is Wrong
- Why The EpiPen And Other Generic Drugs Are So Expensive
- Latest IARC Report Connects Fatness with More Cancers