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WP Insists – Less Healthcare Is Better

From a shameless Washington Post:

In Delivering Care, More Isn’t Always Better, Experts Say

By Ceci Connolly
Tuesday, September 29, 2009

A dirty word in health-care reform is "rationing," a term that conjures up the image of faceless government bureaucrats denying lifesaving therapies in the name of cutting costs.

But what if the real issue is not the specter of future rationing, but the haphazard, even illogical, way in which care is delivered today?

Medical professionals say the fundamental problem in the nation’s health-care system is the widespread misuse and overuse of tests, treatments and drugs that drive up prices, have little value to patients, and can pose serious risks. The question, they say, is not whether there will be rationing, but rather what will be rationed, and when and how.

"More is not necessarily better," said Bernard Rosof, chairman of the board of directors of New York’s Huntington Hospital and a board member of the independent National Quality Forum. "In many cases, less is better."

When the Senate Finance Committee resumes its consideration of health-care legislation Tuesday, the lawmakers will be wading into one of the most complex, emotionally charged aspects of today’s $2.4 trillion system. Democrats, feeling politically singed by this summer’s talk of "death panels," are struggling to explain how a bill that would take hundreds of billions of dollars out of the system would not affect care.

Republicans, sensing a political opening, intend to highlight provisions they say could lead to the denial of medical services, or rationing

Others, however, see problems of misalignment in the American system, fueled by industry advertising, physician fears about malpractice lawsuits and a culture that craves the latest, greatest everything. The situation here, they argue, is that there is not enough care for some, and too much for others.

Often, people with generous insurance plans can run up large bills and face life-threatening complications from unnecessary care: back surgeries that result in wound infections, when physical therapy might have been a more effective treatment; imaging scans that expose patients to radiation; medication-caused side effects that must be treated.

As much as $850 billion spent on medical care each year "can be eliminated without reducing the quality of care," according to a 2008 report by the New England Healthcare Institute. That is enough money to extend insurance coverage to more than 30 million people, according to the Congressional Budget Office.

The misuse and overuse runs from simple antibiotics to sophisticated surgeries, Rosof said. More than $58 billion is spent on inappropriate drugs, such as antibiotics for upper respiratory infections that do not respond to medication, according to the institute report. About $21 billion is spent treating non-urgent cases in the emergency department, where physicians rely more on duplicative and costly tests because they are unfamiliar with their patients’ histories.

The largest potential area for savings — up to $600 billion a year — is the great "unexplained" variation in hospital procedures such as the number of Caesarean sections and coronary bypass surgeries performed. Vaginal delivery is far safer than a C-section, and prescription medicines can stabilize many heart patients without dangerous surgical complications, Rosof said. Less invasive and risky alternatives are also less expensive.

"We will eliminate a lot of harm that comes from the overuse and inappropriate use and misuse of medical interventions," he said. "This is not about rationing. This is about practicing evidence-based medicine."

In today’s system, doctors face increasing pressure to perform expensive tests and procedures they know may not be necessary, or even advisable, said Arthur Kellerman, an associate dean at Emory School of Medicine in Atlanta and a physician at that city’s Grady Memorial Hospital

As he put it: "In the United States today, we give you all the care you can afford, whether or not you need it, as opposed to all the care you need, whether or not you can afford it."

When it comes to carrying Mr. Obama’s water, the Washington Post makes Gunga Din look like a slacker.

"More is not necessarily better," said Bernard Rosof, chairman of the board of directors of New York’s Huntington Hospital and a board member of the independent National Quality Forum. "In many cases, less is better."

Yes, the history of the world has surely taught us that less medical care is better. Look at the success of Africa if you have any doubts.

As much as $850 billion spent on medical care each year "can be eliminated without reducing the quality of care," according to a 2008 report by the New England Healthcare Institute. That is enough money to extend insurance coverage to more than 30 million people, according to the Congressional Budget Office.

How convenient. And, of course, we believe it.

The situation here, they argue, is that there is not enough care for some, and too much for others.

Karl Marx could not have put it better.

In today’s system, doctors face increasing pressure to perform expensive tests and procedures they know may not be necessary, or even advisable, said Arthur Kellerman…

Sorry, but we have missed where any of the proposed healthcare reform bills mention tort reform.

The largest potential area for savings — up to $600 billion a year — is the great "unexplained" variation in hospital procedures such as the number of Caesarean sections and coronary bypass surgeries performed. Vaginal delivery is far safer than a C-section, and prescription medicines can stabilize many heart patients without dangerous surgical complications, Rosof said. Less invasive and risky alternatives are also less expensive.

And if you (or your doctor) think a C-Section or a coronary bypass would be better for you, that is just too bad.

The White House will make these calls.

This article was posted by Steve on Tuesday, September 29th, 2009. Comments are currently closed.

10 Responses to “WP Insists – Less Healthcare Is Better”

  1. Petronius says:

    “More is not necessarily better…. In many cases less is better. … there is not enough care for some, and too much for others.”

    This is madness. More evidence (as if any more evidence were needed) of the Liberal Death Wish. Complete and utter madness.

    The first principle of practical reason tells us that if something is good we should pursue it, and if it is bad we should avoid it. The consistent pursuit of what is bad––either for oneself or for others (and especially for those to whom one owes a duty of care)––constitutes the kind of bad behavior that psychiatric clinics are designed to prevent or cure.

    Consistently injurious behavior is an indication of serious psychological disorder. Note that the occasional pursuit of bad or harmful things is normal. People often make irrational choices. But to do so repeatedly and consistently, and to insist emphatically upon it, is a sign that the person is mentally deranged.

    It may be argued in his defense that this person is being deliberately destructive for personal reasons that seem good to him. For him, on a subjective level, the destruction feels good. He takes delight in destruction. In that case, however, his behavior is still irrational, and his actions are still wrong. If he persists in such behavior, we would be justified in recognizing that he is a madman, although perhaps we might also call him a criminal.

    We may of course argue over what is good and what is bad. But about some things there is little room to argue. For example, we may all agree that human life is a basic good. It is in fact the primary good. It is good to be alive. Life is to be preferred to death (for individuals) or to annihilation (for nations or peoples). No reasonable and impartial person would seriously dispute this. This is why we expend precious resources on everything that is useful and advantageous to the preservation of human life––this is why we have medical schools, physicians, nurses, hospitals, medicines, pharmaceutical companies, medical technology and devices, and ambulances.

    It is irrational to want to reduce those life-preserving medical resources. It is irrational to wish to replace them with a system of equal distribution of a more limited supply of medical resources. It is irrational because human life is a basic good. The goal of equal distribution is bad, because it results in unnecessary suffering and death––although perhaps it may seem to be subjectively good to particular individuals who operate on an irrational level––such as people under the delusion of Marxist ideology and other psychopathic criminals.

    Madness.

    • proreason says:

      Petronius,

      It’s only madness from the perspective of a person who wants to live a long life.

      From the perspective of a power mad Statist, it’s entirely rational. From that perspective, nothing is more satisfying that having the power of life and death over other human beings.

      Plus, there is the side benefit that once you have that power, you are very difficult to displace. It took from about 600 AD to Oct 19, 1781 before anybody in the Western world was able to do it. And it still hasn’t happened anywhere else in the world.

  2. proreason says:

    “Medical professionals say the fundamental problem in the nation’s health-care system is the widespread misuse and overuse of tests, treatments and drugs that drive up prices, have little value to patients, and can pose serious risks. The question, they say, is not whether there will be rationing, but rather what will be rationed, and when and how.”

    So if that’s the fundamental problem, wouldn’t it be a good idea to fix it.

    Pass tort reform, and that problem instantly goes away.

    But it can’t happen.

    If it did, how would Democrats steal enough money to live like princes and rule over us like emperors?

    • caligirl9 says:

      It boggles my mind that tort reform is not being discussed. I’m an advocate of baby steps in any sort of reform.
      People go to the doctor expecting him or her to “DO SOMETHING!!” It’s true that sometimes less is more, and usually those situations are pretty obvious (going to the doc for a cold asking for antibiotics, for example). But until doctors are allowed to use their best judgment and not feel they have to overtreat, there will be no reform.

  3. P. Aaron says:

    Imagine if they could deliver less legalese and goverment interference with every medical procedure. Less in that case, may result in more.

  4. Tater Salad says:

    The White House is true Marxism to say the least.

  5. Tater Salad says:

    The real way this should read: “Less White House will be better”!

  6. NickB says:

    Their real statement is that YOU MUST give some (most) of YOUR health care that YOU pay for to people who REFUSE to pay for it or want it handed to them free.

    The absolute gall of the media never ceases to amaze and disgust.

  7. Mae says:

    It must be remembered that everything boils down to whether you would want less for yourself. Can Ceci Connolly claim this? If so, she can start today by refusing health care for herself and her family; by purchasing health care for someone who has no insurance and making a commitment to do so for the rest of his/her life; by not deducting any medical expenses from her taxes. If she will pledge to do these three things today, then, perhaps, she will be believed and commended.

  8. BillK says:

    Less health care is better, but more government is always better.

    Got it.

    Where are the Republican ad makers with this stuff? Why isn’t this being spouted on TV ads 24/7 the way it would be if it were a Republican health plan and Fox News had said this?


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