Overtreating patients increases health care costs

by John G. Agno

Published on this site: October 13th, 2005 - See more articles from this month

Relentless bombardment by messages from pharmaceutical and health care industries make Americans believe that their personal symptoms are conditions that can and should be cured immediately.

However, there is compelling evidence that more health care and more aggressive treatment across the spectrum of illnesses is not necessarily better. A classic case of overtreating patients is tonsillectomy. In the early 1970s, studies showed that some hospitals removed tonsils 10 times as often as others. But the children in areas with low rates weren't worse off, so the operation fell out of favor.

The U.S. spends 2.5 times as much as any other country per person on health care, but that doesn't translate into better outcomes, according to studies that compare such indicators as fatality rates after a heart attack and length of survival after a kidney transplant.

The latest thinking on heart attacks explains why the overwhelming number of heart procedures done these days do not affect patients' life span at all. In the traditional view, the slow accumulation of plaque inside arteries gradually narrows the vessels. Reduced blood flow causes chest pain, or angina. Eventually, the arteries are blocked, bringing on heart attacks. Newer evidence, however, pins the blame not on this gradual narrowing but on unstable plaque that breaks off and causes clots. The clots are what obstruct the arteries, causing the heart attacks which is why so many such events are unexpected and why there is no evidence that opening chronically narrowed arteries reduces the risk of heart attack.

Large clinical trials are now under way comparing bypass and angioplasty surgery with cholesterol-reducing drugs and other medical treatment. If the trials show no benefit to surgery compared to medicine, coronary-intervention may only be used for patients with severe heart disease... thereby reducing the costs of health care services in the U.S.

To reduce health care demand, many companies are offering Consumer Driven Health Plans (CDHPs) to their employees. Here in Southeastern Michigan, CDHPs were offered in 2004 by 4% of employers with 500 or more employees and by 12% of employers of 20,000 or more employees. Nationally, 1% of all covered employees enrolled in a CDHP in 2004.

Sources: BusinessWeek, July 18, 2005 and 2005 ASE Health Care Insurance Benefits Survey, SE Region



John G. Agno, certified executive & business coach Signature, Inc., PO Box 2086, Ann Arbor, MI 48106 Telephone: 734.426.2000 (US Eastern Time Zone) Email: mailto:[email protected] The most critical knowledge is self-knowledge. http://www.MentoringandCoaching.com