Health Spending in America – Self-Rationing Slows Cost Increases

Jane Sarasohn-Kahn

Posted 1/13/12 on Health Populi

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.

Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which negatively impacts providers and suppliers alike.

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Experience is not the Answer

Bradley Flansbaum

First posted 8/25/11 on The Hospitalist Leader

I assume, incorrectly perhaps, that mechanics have a basic knowledge of their craft such that routine auto repairs require little effort.  The tasks do not supersede the expected competency of the repairperson, and the customer can expect a car that operates at the time of pick up.  A small percentage of jobs may stretch that assumption, but that is okay by me.  Just like medicine, some mends are complicated. You need assistance from another mechanic or you refer the auto to a specialty garage.  No one is superman.

How does this relate to the practice of medicine?

I frequently notice pharmaceutical ads on Sunday AM television broadcasts, as well as newspaper articles that advertise a medical product, or report on a new device, surgery, or therapy—usually of the latest and greatest vintage.  As the data for these interventions is incomplete, or the costs unknown, the story concludes with a riposte conveying that the reader need not concern themselves with the alien facts—just “consult your health professional” and all will be well.

I also observe that politicians object to “meddling” when EBM-based policies from expert committees passively (or actively) affect the doctor-patient relationship, especially as it relates to decision-making and the counsel we provide.  Just watch the nightly news—sound bites abound.  This relationship is sacrosanct after all, and our advice is authoritative and 98.7% correct.  Who would question a physician after all?

Continue reading “Experience is not the Answer”