Listen to this PodcastMore 60-Second Health
When was the last time you left the doctor's office without a prescription, test or referral? It's probably been a while. And many argue that this increase in care—more drugs, procedures and tests—is a big reason the U.S. spends about twice as much on healthcare as other industrialized countries.
Despite all the extra treatment, the U.S. ranks only 36th in life expectancy, just below Cuba.
Even doctors say we could do a little less doctoring. Forty-two percent of primary care physicians think their own patients are getting too much healthcare. That’s according to a survey analysis published in the Archives of Internal Medicine. [Brenda E. Sirovich, Steven Woloshin and Lisa M. Schwartz, "Too little? Too much? Primary care physicians' views on U.S. health care"]
So why do docs keep giving these extra tests, meds and referrals? To avoid malpractice suits, according to the report. More than three quarters of physicians fessed up to practicing more aggressively because they worried about being sued. This fear is so pervasive that it has its own name: "defensive medicine." But to keep patients healthier and costs down, maybe it's time to send this kind of practice to the morgue.
—Katherine Harmon
[The above text is a transcript of this podcast.]
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16 Comments
Add CommentIt's so obvious that our health care is a joke. Mabey if we averaged the amount of care the insurred get then subtract the amount that the uninsurred get then redistributed it all to everyone we could be a healthy nation. I know thats a oversimplified explanation but really, the free market and medicine? Mabey if I went to a "for profit" college that would make sense!
Reply | Report Abuse | Link to thisAnd how many die early because of All those complications from those Drugs they can't leave the Office without?
Reply | Report Abuse | Link to thisThese type of articles are preparing the public for healthcare rationing. The United States has by far the best survival rates for all forms of cancer. Least length of wait time for procedures. The finest health care system by far in the world...
Reply | Report Abuse | Link to thisIn Great Britain if a person is 59 1/2 or older and has any type of heart trouble no treatment is provided as it is a bad investment of socialized medicine. Over-weight and diabetic in Great Britain then lose the weight first before treatment.
Thirty million people are about to be put under Medicaid starting in 2014, and every hospital system fully expects and is planning for a single payer system as it is cheaper for employers to pay the 2k fine than offer insurance. Obamacare is the largest boondoggle soical program in the history of the world. Hospitals systems are already investigting methods to maximize payments from the government. Read overcharging and fraud...unavoidable to keep the current healthcare funded and not collapse...
Europe and Canada are financially failing because of socialist health programs and Obama has now fated the same for the USA. God Bless America.
Im sorry petemicus but you are misinformed, the NHS in Britian dosen't refuse to treat 59&1/2 year old patients with heart trouble. Perhaps you heard the much quoted but later retracted story in Investor's Business Daily regarding ALS sufferer and briliant physicist Stephen Hawking's likleyhood or "chance" of receiving health care in the U.K.(they said he would not be treated). Stephen Hawking is a citizen of the U.K. and is regularly treated by the NHS. If your source of information is political speeches you should really vet information before propagating it, politicians are not reliable sources of information.
Reply | Report Abuse | Link to thisValue for human life has got more priority than that for any other living organism.Doctors give a try on possible tests they can conduct.Docs do make a lot of money out of doctoring.Its part of their profession and higher global demand for medical treatment.Innovations in application of medical treatment for human diseases has risen rapidly in a decade or 2.
Reply | Report Abuse | Link to thisIts all fair because health is being taken care of in best possible way.
We have potential access to excellent health care in the US. The big problem is paying for it. The "free marketplace" concept that was touted to lower costs has not worked well. Many people die because they cannot afford care and avoid seeking it when ill. Others exacerbate their illness by not seeking early treatment, driving up costs. Many many others do not practice good personal health care and develop preventable conditions that are difficult and expensive to treat. Many who have insurance run to the doctor for every little twinge. Medical and drug advertising tries to sell us on the concept that we all have some problem that can be fixed by one drug or another. Doctors are forced to practice "defensive medicine" and are paid on the basis of the number and type of procedures they perform. We all know the problems.
Reply | Report Abuse | Link to thisSuggestions:
End "fee for service" practice. Replace it with fixed salaries for doctors.
Institute serious tort and malpractice insurance reform.
Create a single payer, not for profit health insurance program.
Base health insurance prices and/or co-pays on individual risk factors, just as auto insurance does. A smoker, a heavy drinker, an overweight person, a person who does not wear a helmet while biking, who is not compliant with medication or medical advise, etc. pays much more of the cost of treatment out of pocket.
Become sensible as a nation about end of life care and, in addition provide consumers who have terminal conditions with the right to choose to access medical assistance to end their lives painlessly and with dignity when they wish.
Curtail the advertising of prescription and OTC drugs.
Reform drug and procedure testing so that we have more accurate data concerning efficacy and cost/benefit ratios.
These ideas won't solve all the problems but they would be a starting place. And no, I don't know how we might overcome the broken political process in the US in order to make any useful changes. Talk about being terminally ill!!!
What specific ideas do you have?
Canada is not failing and Europe's problems are due to corrupt private banking practices, the same as the US. Canada pays half of what we pay for the same treatments, and people live longer, so that seems to indicate they have a better system as opposed to cancer survival rates, which are higher in the US because we pay so much to keep from dying when all hope is really gone.
Reply | Report Abuse | Link to thisBlaming Obama for things he has tried to do is no help, the only people really beating on the health plan are tea party bigots who love the fact they can combine politics and racial hatred in one package.
Maybe it's not about healthcare but rather distribution of resources and our economic model, Capitalism. Perhaps this sector of the economy should be segmented out and managed socially. After all, expendable income and what we do with it is one thing, whereas an individuals privilege to life is quite another. Our current Insurance system itself is a poor form of subsidization. And we already don't get all the care we want or need, being controlled by HMO protocols and insurance benefit plans. So the fears of nationalizing is unfounded. It won't make things worse, we are already at the bottom for most people.
Reply | Report Abuse | Link to thisI find it interesting that many (maybe most) on robust socialized plans like social security and medicare (I'd like to include defined benefit retirement plans and health insurance paid by employers) simply do not understand that without these, they themselves could ill afford an illness. Medical care no longer costs a small part of wages or earned income. Medical care costs are greater than anyone but a wealthy person can pay. If you really want to take the capitalist perspective, let's make it fee for service entirely. No subsidies, no insurance, no discounts. Then we would find many many doctors out of work, stepping over corpses on their way to the unemployment office.
Reply | Report Abuse | Link to thisIn 1993 the Liberals, under Chretien, wiped out a 42 billion dollar debt for Canada providing yearly surpluses and regulating the bank system. The Conservatives have continued to provide strong economic leadership which is why Canada had no housing or bank issues during the time of the wall street collapse. A combination of stimulus, cuts and tax increases and we were back on track. Now do have a some debt but it is per capita one of the smallest amounts in world with every citizen getting full health coverage. Our citizens live longer than those in the U.S and spend less per citizen on health care. We do have a problem with waiting lines for things like knee replacements, minor surgery and non emergency and er waiting time which we are trying to solve. However, when it comes to more complex medical care and emergency treatments everyone has quick access to the top cancer, internist's, neurologists and top hospitals and we do not pay a penny or end up on the street homeless not being able to afford our hospital bills. We take care of each other like every other country in the western world except the U.S.
Reply | Report Abuse | Link to thisCubans are a little bit hungry, and low calories diets, at least in rodents, increase life span. In humans, for sure low calorie intake brings down the incidence of diabetes and other sources of high cardiovascular risk. You have to balance many things before making a choice, or thinking that some places are better just because mortality there is lower. If you put everybody in isolation cells, incidence of STD and crime will soon approach zero, and there are no thieves where there is nothing you can steal.
Reply | Report Abuse | Link to thisIt is foolish and untrue to say that Canada is failing, and that it is failing because of it's healthcare system. Sounds like typical free market fundamentalist idiocracy to me. Canada is in no way failing, our economics have not suffered to nearly the extent that the American system has, and we have only suffered because we trade so much with the US. Our healthcare system saves all of us tons of cash because we don't have to either spend tons of money on insurance, rely on employers who can barely remain solvent because of their health care insurance, or risk going bankrupt if we are uninsured when a family member gets sick.
Reply | Report Abuse | Link to thisMy dad was diagnosed, and three years later, died from cancer. We suffered no financial hardship, he received the gold standard in cancer treatment with no wait times, excellent doctors, and full medical care free. My mom suffers chronic polymyalgia, sees specialists regular, is on Rituxan immunotherapy, and is doing well. We are lower middle class, but happy and healthy, something that would be impossible in the US
Sometimes you get too much, sometimes you get too little.
Reply | Report Abuse | Link to thisI find when it is something straight forward that may or may not need a script (like a virus sinus infection versus a bacterial one), you always get a script (which is a mistake but I have found younger doctors to be more willing to send myself or the kids home with just "get some rest"). The same goes for bloodwork, obvious things get handled well and efficiently.
BUT, when it is something that the doctor does not have a good idea about early on, then I find our US health care system to be rather poor. Doctor's are not properly trained to be systematically analytical when facing a tough diagnosis. They need to become detectives, much like Holmes, rather than going by their gut. There is nothing worse than going to see 3 specialists who all re-run (roughly) the same tests, make conclusions, give treatment and then when treatment fails they basically give up. A total waste of health care money that can quickly amass to large sums (specialists cost alot along with the tests they request). I beleive part of this is the problem with not wanting to get sued but it is also a problem with their training and attitude. It is the difference between a good doctor and a so-so doctor. All American doctors have a good background when it comes to knowledge of their field, the difference between great to so-so application of that knowledge is whether or not they are systematic about tough cases. This is where a good expert knowledge base system could help alot, to form a list of possibilities and then give them the proper ranking. Such a system could also help alleviate lawsuits, by following a set protocol doctors could protect themselves. (and no, I don't/didn't work on Watson, just have wondered for years why this doesn't exists. Doctors are not perfect, tools will help them make better diagnosis).
Petemicus is definitely pushing a political agenda not based on real facts.Why do so many Americans cross the border to Canada to buy necessary and affordable drugs?
Reply | Report Abuse | Link to thisHere in Australia, hospital care is free and health care, including medicine, in general attracts a 15% fee while the public revenue contributes the rest. There is an option for private fee health insurance (public funding does not cover breast implants or other non-life threatening conditions) and some people take it.
If Petemicus chooses to look it up, Australians have the
longest life span in the developed world...and actually want the official retirement age to be increased! I reckon all that sunshine and sea do help, but maybe not worrying about health helps relieve stress related disease!
My stepson is a GP and grumbles about taxes (who doesn't) but is the 10% top group. And, if he judges a patient might be financially struggling, waives his 15% surcharge and accepts the government fixed fee - quite generous.
So, Petromicus (Is this a Latin author like Cato the Elder whom I do not admire?), check your facts first.
Regards, TKerr
I agree with most of your ideas but I have to take issue with "Base health insurance prices and/or co-pays on individual risk factors". Insurers are already doing that and frankly abusing the practice. They will deny you or gouge you for "risk factors" such as hay fever or a bad back. It is a major victory of healthcare reform to _stop_ insurers using these factors. Even so-called voluntary risk factors, such as obesity, involve such complex intersections between heredity, environment and behavior it is hard to pin it entirely on individually-controllable factors that might respond to an increase in health insurance costs. Even if car insurance was a good parallel we can hardly claim that the car insurance model has been a success in reducing the number of uninsured drivers. Too many people who cannot afford car insurance simply go without, despite the law, at a significant cost to the rest of us.
Reply | Report Abuse | Link to this"Defensive medicine." Is this because besides malpractice fear, the docs have little or no confidence in their own diagnosis? Or they don’t have time to do a proper diagnosis and they use tests to develop a diagnosis and not the other way round. Mind you there are some docs who directly get benefited from unwanted tests in their offices!
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