NYT: Wasteful health care spending

Argument that we spend way too much federal money on health care treatment that doesn't work any better than less expensive treatments. Example: Stents. Example: Colonoscopies for people 75 and older:

http://www.nytimes.com/2011/08/23/opinion/cut-medicare-help-patients.html?ref=opinion&gwh=85E30976D2C0E3B101D3DBAE1718C41D

This very well-reasoned piece, by two policy academics, reminds me a little bit of the New Yorker piece last year on "death panels" by Atul Gawande, which also argued that we waste money, in that case on late-term cancer patients who would be better served with less expensive, less painful end-of-life care.

 

Transplants and bypasses for anyone over 67.

 

The person who is dying might not think it's a waste of money.

 

It is when the data shows that people live just as long or longer with comfort care than they do with some of these practically useless treatments.

 

So who gets to decide if the treatment is useless?

 

Insurance corporations.

(that seems to be the ultimate answer no matter who putting forth the overhaul plan).

 

Hospitals and doctors, according to the NYT op-ed. They should be making better decisions about treatment. (This probably now, policy-wise, bumps up against defensive medicine/tort reform.)

 

We're already there. Have seen where physicians viewing an advanced-age case enduring burgeoning complications will decline performing surgery which might extend life. That's a combination of protecting a surgeon's batting average, not expending fringe resources, and making a cold-blooded percentage call . . . a form of death-paneling, in an informal way.