Modern Medical Practice

Arnold Kling comes up with a thoughtful piece on Health Care. I don’t agree with him on the necessary separation of Business and Government from health care, but I agree totally about the need to cut unnecessary health care costs. The current usage of placebo Proscriptions must be stopped (Proscriptions which have small chance of providing relief, but are proscribed so Patients feel like their Doctors care). Proscriptions are written about Six times as often as before the introduction of Medicare and Medicaid, and one can question whether health care on a basic level has improved over the interim. Doctor Visits have also increased dramatically over this period, though these sessions have decreased dramatically in amount of investigative procedures. Hospital stays used to be for care of sick people, now they rely on medical Testing procedures of high Cost, without a true economic Saving in reduction of illness or Health treatments by reductions of future replications. The only Scorecard on which American health care soars is in longevity of life, but other nations express equal gains at much reduced Cost.

Proscriptions could be aided by legislation demanding Doctors inform Patients in percentage terms the likely benefit of such Drug use; most truly sick Patients can understand a Doctor who says this Drug will make you feel 10% better at $12/day. They could also understand a Doctor who states this Testing procedure at $800/per Test will give the Doctor a 7% greater surety of what is actually bothering the Patient. Other Patients might achieve greater comprehension hearing a Doctor state: Chemotherapy and Radiation treatments at $40,000 per year might keep you alive the two Years which I think you will live, but you will feel worse than you ever have before in your life; this combined with a 90% chance you will die in two years, and a 40% chance you will not last out the year anyway.

Laws could be enacted curtailing a Doctor’s use of expensive Testing procedures, and equally the adoption of expensive Treatment procedures. Something like a law stating a Doctor is allowed 50 MRIs per year, with Patient, Insurance company, and Government escape from payment past that point; where Doctors will themselves have to foot the bill. A limit can be set on other things like only 30 Radiation treatments, and 30 Chemotherapy treatments allowed per Doctor per year. Patients would be allowed to search out other Doctors who would not provide such if recommended. Doctors would be forced to allocate expensive procedures among their Patients who possess the best chance of success. Government and Health Insurance could put a Cap on the spendthrift activities of medical professionals. lgl