Hey, guys, there’s a nexus between this kind of marketing, the high-tech effect on corporate profits and physicians’ bottom lines, the drive to shift more of the cost of care to Medicare beneficiaries as a way to solve the government’s spending problem, and the deficit. This connection has been missing from both political discourse and media speak. It’s easier for the press to quote ad nauseam the political line that Medicare cuts may be necessary to bring down the deficit than to investigate the reasons why. Perhaps the CT study will prompt more journos—and members of the public—to ask the “why” question.
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The combination of easy market access for novel medical technology and fee for service compensation for providers is a recipe for runaway health care costs and is by far the largest contributor to our national economic distress. This combination damages not only the Medicare program, but programs across the spectrum of public and private sector payers. Until the perverse synergy of health care's "supply side" is addressed, the US will continue to struggle with health care spending growth.
#1 Posted by Health Policy Wonk, CJR on Thu 18 Aug 2011 at 10:56 AM
The irony is that the sales pitch for these high-tech solutions is based on reducing costs (reducing errors, reducing paper records, etc). There you have market capitalism in a nutshell, pay us a but-load of money now to save later!
#2 Posted by dblacksd, CJR on Fri 19 Aug 2011 at 01:01 AM
Good piece, Trudy. Thing I notice among gear-heads, myself included, is we sometimes get so enamored with the new machinery that we forget the fundamentals. I spoke to a guy a few months ago whose wife had fallen down the stairs while carrying their three year old daughter. Rushed to the ER where the little girl was--yes--given a CT scan. Came up clean. They're discharged and changing her diaper in the hospital's rest room when the girl starts screaming. Turned out her leg was broken & the ER staff had forgotten to do an X-ray.
#3 Posted by Edward Ericson Jr., CJR on Fri 19 Aug 2011 at 02:46 PM
As an ER doctor, I can tell you why we are ordering more CT scans- they often yield definitive diagnoses on high risk conditions such as appendicitis, strokes, pulmonary emboli, traumatic injuries, or they rule them out.
The technology is improving and these scans are increasingly found to be 'standard of care' for diagnosis of things they were not used for in the past.
We do not make any extra money by ordering them. Radiologists get paid for that.
So please stop the conspiracy theories. And thank god that medical technology continues to improve if you or your love one should need it one day.
#4 Posted by dbr1, CJR on Mon 22 Aug 2011 at 04:27 AM