Money-Driven Medicine: The Real Reason Health Care Costs So by Maggie Mahar

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By Maggie Mahar

Why is treatment within the usa so pricey? for many years, americans have taken it as a question of religion that we spend extra simply because we've got the simplest wellbeing and fitness care method on this planet. yet as charges levitate, that argument turns into tougher to make. at the present time, we spend two times up to Japan on healthiness care—yet few might argue that our overall healthiness care process is two times as good.

Instead, startling new proof means that one out of each 3 of our healthiness care funds is squandered on pointless or redundant checks; unproven, occasionally undesirable strategies; and overpriced medicinal drugs and units that, too usually, aren't any larger than the fewer pricey items they've got replaced.

How did this occur? In Money-Driven Medicine, Maggie Mahar takes the reader behind the curtain of a $2 trillion to witness how billions of greenbacks are wasted in a Hobbesian market that pits the industry's gamers opposed to one another. In remarkably candid interviews, medical professionals, health facility directors, sufferers, future health care economists, company executives, and Wall road analysts describe a conflict of "all opposed to all" which could flip physicians, hospitals, insurers, drugmakers, and machine makers into blood competitors. instead of taking part, medical professionals and hospitals compete. instead of sharing wisdom, drugmakers and machine makers divide worth. instead of pondering long term collective objectives, the imperatives of an impatient market strength well-being care services to target non permanent monetary imperatives. And so investments in untested bleeding-edge clinical applied sciences crowd out investments in details expertise that will, ultimately, not just lessen error yet include costs.

In concept, loose industry festival may still tame future health care inflation. actually, Mahar demonstrates, in terms of drugs, the conventional legislation of offer and insist don't observe. quite often, whilst provide expands, costs fall. yet within the overall healthiness care undefined, because the quantity and diversity of gear, units, and coverings multiplies, call for rises to soak up the surplus, and costs climb. in the meantime, the perverse incentives of a fee-for-service process present wellbeing and fitness care services for doing extra, now not less.

In this fantastically written e-book, Mahar exhibits why medical professionals needs to take accountability for the way forward for our overall healthiness care undefined. at the present time, she observes, "physicians were stripped in their status as execs: Insurers handle them as proprietors ('Dear well-being Care Provider'), drugmakers and equipment makers see them as shoppers (someone you could take to lunch or a strip club), whereas . . . shoppers (aka sufferers) are inspired to determine their medical professionals as overpaid outlets. . . . earlier than sufferers can reclaim their rightful position because the center—and certainly because the raison d'être—of our overall healthiness care system," Mahar indicates, "we needs to once more empower medical professionals . . . to perform patient-centered medicine—based now not on company imperatives, medical professionals' druthers, or perhaps sufferers' demands," yet at the most sensible medical examine available.

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As usual, health care ignored the laws of supply and demand. “What no one seemed to notice was the trend in medicine toward specialization,” recalls Dr. George Lundberg, who graduated from the Medical College of Alabama in 1957. “By the time I was an academic physician in the late sixties and seventies—first at the University of Southern California and then at the University of California—a large percentage of [medical] students knew well before matriculation exactly what they wanted,” Lundberg adds.

Of all the sectors in the health care industry, only hospitals ranked in the middle of the list, with 70 percent of those surveyed saying they did a good job—and even so, hospitals had slipped in the polls, down from a 77 percent approval rating in 1997. 24 Hospital vs. Hospital Not only are hospitals sinking in the polls, many are swimming in red ink. ” 26 Backs to the wall, 21st-century hospitals have revived the “medical arms race” of earlier decades. 27 In the nineties, the arms race slowed as HMOs put their stamp on a new, more frugal marketplace.

The 1980s: A Market Solution The fact that some Americans were shut out of the system did not mean that medical spending was slowing. 61 As for the taxpayer’s share of the tab, over the course of the 1970s, Medicare and Medicaid spending had snowballed, growing by nearly 600 percent. “For too long, the federal government has had a blank-check mentality,” Reagan declared in 1981. ” 62 In 1983 Reagan strategists took matters into their own hands. Medicare, they declared, would no longer pay fee-for-service.

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