Friday, June 10, 2011

Two good ideas to control medical costs


Like many of my readers, I've been appalled by the cost of medical procedures these days, particularly the cost of ongoing, post-procedure health care. I've been at a loss to explain why the costs continue to rise so steeply. There seems to be no rhyme or reason to it. Now two fellow bloggers have written about it. Each sheds light on the subject from a different perspective.

Matt, a law enforcement officer in Texas, writes about his experiences this week.

I've got a very simple law that we could pass that will go a LONG way toward medical healthcare reform.

Require that, within one business day, the healthcare provider give you a straightforward answer to this question:

"How much is this going to cost?"

. . .

I asked her, "What's the cost of this? How much are we saving daily by having her come home early? What is the average daily cost of her care?"

She didn't know, but turned me over to a person at their facility who could "better answer my questions." That lady didn't know, either. "We don't do any billing here," she told me. "That's done from the corporate offices in Pennsylvania."

But she went on to assure me that the bill was to be sent to Mom's insurance companies, who typically covered most of these things, before we'd ever get a bill.

"But somebody, somewhere, knows what this costs," I protested.

"No, we won't really know, until we bill the insurance companies, and see what they pay," she told me.

This is ridiculous.


There's more at the link.

Then, Dr. Lucy Hornstein, a physician who blogs at Musings Of A Dinosaur, makes a very cogent observation about the increasing efforts of specialists to do a generalist's job.

Guy in his late 50s with a mass on his kidney; turns out to be benign, which can’t be figured until it’s removed. Urologist does a lovely job of removing the kidney; everything goes swimmingly; guy makes an uneventful recovery; all is well. What’s next?

“I have asked the patient to return in one year with a PSA,” says the urologist’s letter.

Huh?

What the hell does a PSA have to do with the kidneys? (Hint: nothing.) Why does a guy with no lower urinary tract symptoms — with no symptoms at all, now that his kidney mass is gone (though technically, he didn’t have any symptoms with that either) — have to go back to the urologist next year, and presumably every year until his death, with an annual PSA?

. . .

It’s all part of mission creep on the part of specialty medicine. Why settle for just taking care of the problem at hand, when you can keep filling up your appointment book on an ongoing basis?

. . .

Want a realistic approach to curbing the meteoric rise in medical costs? Call off the specialists after they’ve taken care of an acute condition. Get them to relinquish patients back into my care — with parameters for monitoring — and let me do my job.


Again, more at the link.

I highly recommend both posts for a very illuminating look at why medical costs are so much higher than they need to be.

Peter

1 comment:

trailbee said...

My cancer recurred twice, the third time with major surgery, chemo and radiation. Within two weeks of the end of chemo I was passed to a PA, Physician's Assistant, who I now see for follow-up care. And, we thoroughly discuss all future procedures before they are requested. But, looking at the bills I did not have to pay, I still had sticker-shock.
My husband, on the other hand, goes to two drs., primary care and a urologist, both of which always manage to tack on a little something extra. The problem is how do you know what is or is not necessary? Yes, you can ask, but one gets such a reasonable answer, we have to be very alert about our own bodies, and not just accept something just because the doc says so. We forget that we have managed to live a whole 70 years and are not really stupid. We are just made to feel that way. Got to watch that!