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Avalanche of unnecessary medical "care" is harming patients physically and financially


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2018 Mar 2, 10:28am   2,760 views  9 comments

by Patrick   ➕follow (55)   💰tip   ignore  

https://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

The researchers called it “low-value care.” But, really, it was no-value care. They studied how often people received one of twenty-six tests or treatments that scientific and professional organizations have consistently determined to have no benefit or to be outright harmful. Their list included doing an EEG for an uncomplicated headache (EEGs are for diagnosing seizure disorders, not headaches), or doing a CT or MRI scan for low-back pain in patients without any signs of a neurological problem (studies consistently show that scanning such patients adds nothing except cost), or putting a coronary-artery stent in patients with stable cardiac disease (the likelihood of a heart attack or death after five years is unaffected by the stent). In just a single year, the researchers reported, twenty-five to forty-two per cent of Medicare patients received at least one of the twenty-six useless tests and treatments.

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1   NuttBoxer   2018 Mar 2, 11:31am  

Patrick says
In just a single year, the researchers reported, twenty-five to forty-two per cent of Medicare patients received at least one of the twenty-six useless tests and treatments.


WHAT!? Socialist government programs are susceptible to corruption and abuse!?!?
2   zzyzzx   2018 Mar 2, 11:33am  

My ex-dentist wanted to replace 3 crowns that didn't need to be replaced. I have a new dentist now!
3   RWSGFY   2018 Mar 2, 12:23pm  

Witnessed this with one of my elderly relatives. Bunch of tests and doctor appointments then a surgery for something that turned out to be not a problem at all. Good thing there were no out-of-pocket costs, but the state paid a pretty penny.
Also the primary care physician requires an office visit for a simple renewal of presriptiond. No reason except to get paid by the state again and again.

Oh the wonders of Single Payer....
4   Patrick   2018 Mar 2, 12:36pm  

This does seem to show the inherent advantage of Kaiser and similar HMO's.

They have no incentive to run unnecessary tests since they are both insurer and provider. The provider part just isn't going to get extra cash out of the insurer part because they are the same company. Also, they probably are not going to be getting more money out of the patient beyond the monthly premiums.
5   Eric Holder   2018 Mar 2, 1:04pm  

Patrick says
This does seem to show the inherent advantage of Kaiser and similar HMO's.

They have no incentive to run unnecessary tests since they are both insurer and provider. The provider part just isn't going to get extra cash out of the insurer part because they are the same company. Also, they probably are not going to be getting more money out of the patient beyond the monthly premiums.


With Kaiser the problem is the opposite: they have the incentive to minimize care even if it doesn't lead to the best outcome for the patient. One anecdote to this end I'm aware of is the story of one of my co-worker's father who was pretty much told by Kaiser to go home and die as there is nothing they could do for him and he's only got a month or two to live. His kids intervened and managed to move his care to Stanford clinic and the guy lived another 5 or 6 years with what seemed to be a decent quality of life. It's all based on "water cooler" conversations of course, so I might be missing some important details.
6   mell   2018 Mar 2, 7:15pm  

Eric Holder says
Patrick says
This does seem to show the inherent advantage of Kaiser and similar HMO's.

They have no incentive to run unnecessary tests since they are both insurer and provider. The provider part just isn't going to get extra cash out of the insurer part because they are the same company. Also, they probably are not going to be getting more money out of the patient beyond the monthly premiums.


With Kaiser the problem is the opposite: they have the incentive to minimize care even if it doesn't lead to the best outcome for the patient. One anecdote to this end I'm aware of is the story of one of my co-worker's father who was pretty much told by Kaiser to go home and die as there is nothing they could do for him and he's only got a month or two to live. His kids intervened and managed to move his care to Stanford clinic and the guy lived another 5 or 6 years with what seemed to be a decent qu...


That's the flip-side, yeah. If you want to run care at a lower cost, you will have to do cost-benefit analysis, esp. with older patients. It sounds cruel and it is, but that is the reality of most single-payer health-care systems. Everybody gets care which is great, but the care itself isn't that great and certainly doesn't have the incentive of maximizing your life span.
7   Booger   2018 Mar 2, 7:26pm  

Satoshi_Nakamoto says
Also the primary care physician requires an office visit for a simple renewal of presriptiond. No reason except to get paid by the state again and again.
.

8   Ceffer   2018 Mar 2, 7:38pm  

Who said OldFucks weren't useful?
9   Ceffer   2018 Mar 2, 7:59pm  

The line between Offensive Medicine and Defensive Medicine is a blurry one.

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