NPR reports that the American College of Physicians have published new practice guidelines calling for physicians to be "parsimonious" in the use of health care resources in an effort to rein in costs. According to Virginia Hood, president of the group, this recommendation comes in light of the fact that healthcare costs are twice that of other civilized countries when our outcomes are not as good.
The story is linked to another entry in which NPR comments on medical schools and academic medical centers, places like the Mayo Clinic, increasing their advertising budgets in an effort, in part, to capture more market. I see similar events on a local level: Driving down the freeway one sees billboard after billboard promoting birthing centers, cancer centers, orthopedic centers, heart centers.
It amazes me that, in discussions of healthcare, supposedly knowledgable people continue to look to the physician as the gatekeeper when it comes to cost control. If medical centers have to accommodate advertising budgets, if pharmaceutical houses spend billions on advertising, if insurance interests are beholden to investors and pay seven figure salaries to top executives, if many physician decisions are modulated by concern with legal defense, then healthcare costs will be very, very high. And outcomes will not correlate with the increased expense because these costs have little or nothing to do with providing care. I would argue that the lion's share of healthcare costs are generated by the desire to maintain healthcare as a very lucrative profit center. What's more, I would contend that, outside of practicing defensive medicine, doctors' decision making has very little impact on the bloated fiscal landscape of US healthcare.
Call me naive, but the math in all this appears academically simple and politically complex. Until the political is separated from the clinical and the commercial from the humanitarian, healthcare will be neither affordable or sufficient.
No comments:
Post a Comment