Soaring Medical Costs Pinned on Medical Devices

Merrill Goozner

First published 6/07/11 in The Fiscal Times

While squabbles over the rules for approving new medical devices rarely attract much attention outside the insular world of manufacturers, regulators and medical professions,  a fight is brewing that could have a major impact on efforts to control health-care spending.

The device industry has launched an aggressive campaign to avoid tighter Food and Drug Administration rules that would help generate the information needed to show whether newer devices are actually superior to the ones they replace. The latest devices – from heart valves and defibrillators to artificial knees and hips – are usually significantly more expensive than older devices, and the intense marketing surrounding the introduction of new devices has become a major driver of rising health care costs.

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Prevention Politics Injures Patients

Kenneth Lin

First published 5/31/11 on Common Sense Family Doctor

PPIP is an acronym that officially stands for “Put Prevention Into Practice,” which serves as both the name of the Agency for Healthcare Research and Quality’s programs to disseminate the preventive care recommendations of the U.S. Preventive Services Task Force as well as the tagline for a series of case study questions about these recommendations that I wrote for the journal American Family Physician from 2008 to 2010. Given theunfortunate events that have occurred since the USPSTF became inextricably linked to the Obama health care reform bill, however, I now propose a new meaning for PPIP: Prevention Politics Injures Patients.

In a recent New York Times editorial, “Squandering Medicare’s Money,” Archives of Internal Medicine editor Rita Redberg, MD pointed out that the Medicare program paid physicians more than $40 million in 2009 for screening colonoscopies in patients over age 75, and $50 million in 2008 for PSA screening in men age 75 and older and Pap smears in women age 65 and older. That’s nearly $100 million alone for 3 tests that the USPSTF concluded have few or zero health benefits and have a high potential to cause harm, and it doesn’t count the additional millions (billions?) of dollars of additional testing and procedures that result from these unnecessary screenings. Dr. Redberg writes:

Our medical culture is such that if the choice is between doing a test and not doing one, it is considered better care to do the test. So while Medicare is obligated to follow the [U.S. Preventive Services] task force’s recommendations to cover new preventive services, it has no similar mandate to deny coverage for services for which the task force has found no benefit.

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An Important Article in the New York Times

Today’s NY Times has a terrific op-ed by Rita Redberg MD, a Professor of Medicine at the University of California in San Francisco, that clearly describes the massive waste that occurs in Medicare (and the rest of health care) from incentives for care services that have no basis in evidence. The article provides concrete examples of blatantly unnecessary or incorrect services that have become commonplace and immensely costly, without clinical benefit.

Dr. Redberg has an interesting bio. A Cardiologist, she is Chief Editor of Archives of Internal Medicine. Even more provocative, she “has spearheaded the journal’s new focus on health care reform and “less is more”, which highlights areas of health care with no known benefit and definite risks.

Please read today’s piece and then rebroadcast to your professional network. In it, Dr. Redberg has encapsulated the core of America’s health care cost crisis. Appreciating this reality is the predicate to changing health care and its threat to the larger American economy.