Re: More Medicine Is Not Better Medicine

"Bettina" <[EMAIL PROTECTED]> wrote in message
news:[EMAIL PROTECTED]
> "Founding Father" <[EMAIL PROTECTED]> wrote in message
news:<[EMAIL PROTECTED]>...
> > By ELLIOTT S. FISHER
> >
> > HANOVER, N.H. ? No one in Washington is completely satisfied with the
> > Medicare legislation that Congress approved last week. For many
> > conservatives, the shift toward private health plans is too limited; for
> > many liberals, the new prescription-drug benefit is too stingy. Yet
almost
> > everyone agrees that the current bill worsens the program's long-term
> > financial stability.
> >
> > Constructive debate about Medicare's costs, however, is hampered by a
flawed
> > assumption that both helps and is reinforced by the health care
industry:
> > that more care ? and more expensive care ? is better care.
> >
> >
> > The difference in spending is almost entirely due to the way medicine is
> > practiced in high-cost regions. Compared with similar patients in
Portland,
> > Medicare enrollees in Manhattan spent more than twice as much time in
the
> > hospital and had twice as many doctor visits per year. The additional
> > services provided in higher spending regions are largely discretionary,
like
> > more frequent visits to specialists, longer hospital stays and more
frequent
> > use of diagnostic tests and minor procedures. Remarkably, more spending
does
> > not lead to more people receiving expensive and proven treatments, like
> > cardiac bypass surgery or hip replacement.
> >
> >
> > What was surprising is that quality was actually somewhat worse in
regions
> > that provided more care, with less frequent use of proven treatments for
> > heart attack patients and of preventive services. Meanwhile, access to
care
> > and satisfaction were worse or no better than in regions that provided
less
> > care
> >
> >
> > Better information will allow us to get the incentives right. The
backlash
> > against "managed care," which was evident in the Congressional debate
over
> > Medicare, has been driven largely by the fear that beneficial treatments
> > were being denied because doctors were paid more to provide less. But
> > unmanaged care and unfettered growth can also be dangerous. If health
care
> > organizations were held accountable for improving the quality and
efficiency
> > of care, patients might believe that excellent care and lower costs are
> > compatible.
> >
> >
> > Our study suggests that perhaps a third of medical spending is now
devoted
> > to services that don't appear to improve health or the quality of care ?
and
> > may make things worse. It also shows that we have sufficient current
> > capacity to cover the uninsured ? without necessarily increasing
spending.
> > (All that would happen is that the well-insured would see their doctors
less
> > often and, perhaps to their benefit, spend less time in the hospital.)
> >
> > Members of Congress are right to be concerned about increases in federal
> > spending. The debate over Medicare underscores the challenge: how to pay
for
> > better care, not just more care.
> >
> >
> > Elliott S. Fisher is professor of medicine at Dartmouth.
>
>
> It's true that "more" doesn't mean better. Unnecessary high-tech
> tests, overmedication (much of it due to overmarketing by
> pharmaceutical companies), and more emphasis on invasive and expensive
> interventions late in deisease than on early preventative care -- all
> these are examples of more being worse, and all are encouraged by our
> market-driven health care system.

  Too much medical care is harmful to your health.