Despite years of information to the contrary, there are still many people who see better health care as more health care; more tests, more scans and especially more medication. Sadly, much of the benefit of all this more is just more money for the health care system.
Decades ago employers tried to control health care costs by promoting second opinions for surgery; reports said up to 25% of surgery was unnecessary. Google “unnecessary surgery.” Today they mostly just shift costs in the hope employees will somehow manage health care spending that no one else and no entity has been able to do thus far.
Many scientific organizations have pointed out the risks of over treating and over testing; a scan to be cautious may lead to surgery that is unnecessary or treatment of a condition that left undiscovered and untreated has no adverse consequences.
Not only is all this not good for you, it is also not good for your wallet.
Consider this from JAMA
ABSTRACT
The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste—overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse—the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies.
And then read this:
“If doctors do no other good, they at least prepare their patients early for death, undermining little by little and cutting off their enjoyment of life.”These words from Montaigne are 350 years old, but, sadly, too often they describe the results of modern medicine, particularly when it is mindlessly applied in a needlessly heroic way to the end of life.
I spend a lot of time going around to different places warning professionals and the public that overdiagnosis, overtesting, and overtreatment are bad for our health.
Recently I have been witnessing these dangers firsthand. I have a friend who has lung cancer — the “good,” slow-growing kind. His doctors have been less kind than the cancer. They keep screwing up in ways that seem likely to kill my friend before his cancer does.
The basic problem is that modern medicine consistently violates the ancient advice of Hippocrates: “It is better to know the patient who has the disease than the disease the patient has.”
My friend has a small army of very highly specialized doctors all treating lab results in one tiny medical domain while ignoring all the aggressive stuff the other specialists are doing. None of the doctors has a global picture of my friend’s treatment and the specific risks and benefits that apply to each new test or treatment.
The result is dangerous medical chaos. Doctors love pictures and get paid a lot for ordering and reading them. Over the years my friend has been subjected to countless and mostly unnecessary imaging studies with contrast dyes that have compromised his kidneys. It seems likely that renal insufficiency will kill him before his lung cancer does. He is also no longer eligible for additional lung-cancer treatments because his kidneys flunk protocol requirements. And along the way he has been prescribed several unnecessary medications that also hurt his kidneys. Everyone focused on the lung cancer; no one noticed the harm they were doing to the kidneys.
via Why Are Medical Mistakes Our Third Leading Cause of Death? | Allen Frances.
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