Spending More for Equal Care

By Meg Reid, Undergraduate Research Fellow, January 18, 2012 at 4:00 pm

“America has the best health care in the world.”

This quote could come from practically any politician addressing the situation of health care in America. And they’re right—the technological advancements that have come from American medicine are astounding. This country led the charge that brought us from sickness to treatment to cure for countless conditions.

Flip the coin over, though, and find the disadvantages of American technological prowess. America spends far more than any other industrialized nation on health care, and this increased spending can be largely traced back to unnecessary treatment. Every day, Americans are given tests and procedures that do nothing to improve their health.

Think this can’t possibly be that big of a problem? Shannon Brownlee says in her book Overtreated that between a fifth and a third of health care spending is unnecessary because it provides no benefit.

Take, for example, the proton beam treatment facilities being built by the Mayo Clinic, one in Minnesota and one in Arizona. This innovative cancer treatment has been shown to better target cancerous tissue, leaving healthy cells undamaged and patients in better health—but only for a handful of rare pediatric cancers, affecting less than 3,500 American children. Because of the competitive nature of medical caregivers, there are far more treatment facilities than necessary to treat these children. In an effort to fill treatment slots, the therapy is touted to adult cancer patients, even though proton beam therapy has not been shown to be any more effective than existing treatments.

These facilities are profitable for Mayo and other providers—the Medicare payment for the treatment is a nice $50,000, about twice the price of existing treatment. But spending twice as much for the same benefit is, as Ezekiel J. Emanuel & Steven D. Pearson say in their New York Times opinion piece on the subject, “crazy medicine and unsustainable public policy.”  We shouldn't be paying more unless a procedure has proven advantages.

Thankfully, the health care reform bill hopes to combat this trend with the Patient-Centered Outcomes Research Institute, which will provide information about the comparative effectiveness of medical treatments. However, the American medical system will need much more fundamental change if we are to shift provider incentives from overtreatment to better treatment.

Posted in Health Care | Related Topics: Technology  Health Care Reform  Medical Care