Remember, the flap last year over the study that suggested new guidelines for women to receive a mammogram, remember what happened? The researches had to back track, amend their recommendations and just about every politician joined the cause to oppose the guidelines. That is because we have come to think that more is better when it comes to health care and woe be it to anyone who says otherwise.
In addition, as a result of the ‘more is better mentality’ there are many people who believe that prescribed treatment is always the course to follow and ignore that certain procedures are simply not warranted, or too risky or of little additional value.
Over the years, I heard scores of claim appeals when a procedure was denied as not medically necessary, or the procedure was not approved for the condition claimed or there was no evidence to support its efficacy. From the patient’s point of view this was just the insurance company interfering, trying to save money or limit care. The treating doctor often pushed this point of view, frequently when there was substantial medical evidence contrary to the doctor’s recommendation.
A new Medicare study sheds some light on the use of certain forms of back surgery. This research is not only important for this procedure, but for the future possibility of managing not only health care costs, but the quality of health care. More of this research and similar conclusions is likely.
While this study deals with a Medicare population, I suspect similar studies and results on various procedures are likely in the general population. Some will blame this effort on health care reform, but this is the reform we need. Yes, it is a very good idea for someone to evaluate objectively the treatment we receive, why and how we receive it and the financial relationships between suppliers, hospitals and doctors that may influence that care.
CHICAGO (AP) — A study of Medicare patients shows that costlier, more complex spinal fusion surgeries are on the rise – and sometimes done unnecessarily – for a common lower back condition caused by aging and arthritis. What’s more alarming is that the findings suggest these more challenging operations are riskier, leading to more complications and even deaths.
“This is exactly what the health care debate has been dancing around,” said Dr. Eugene Carragee of Stanford University Medical Center.
“You have one kind of operation that could cost $20,000 and another that could cost $80,000 and there’s not good evidence the expensive one is being used appropriately in the majority of cases,” Carragee said.
Add to that the expense for patients whose problems after surgery send them back to the hospital or to a nursing home and “that’s not a trivial amount of money” for Medicare, said Carragee. He wrote an accompanying editorial in the Journal of the American Medical Association where the federally funded study appears Wednesday.
The cost to Medicare, just for the hospital charges for the three types of back surgery reviewed is about $1.65 billion a year, according to the researchers…
Rosen applauded a provision in the new health care law that requires device makers and others to file annual reports to the government on their financial ties to doctors. Patients will be able to look up possible conflicts in a government database.
“Too much fusion surgery is done in this country and often for inappropriate reasons,” Rosen said. While complex fusions are needed for some conditions, he said, patients “should not hesitate to get a second opinion.”
QUINNSCOMMENTARY 