Sunday, June 3, 2012

No Bones about It: Low Cost Medicine Has Arrived
No bones about it.
Robert Louis Stevenson (1850-1894), St. Ives (1894)
"Historically" Low Health Care Spending Growth Expected for 2013.

John Cummins, HealthLeaders Media, June 1, 2012
June 3, 2012 -  No bones about it.   The era of lower health costs has arrived. Suddenly,  the general public, the medical profession, and employers are showing no reluctance, no fuss, and no scruples about cutting costs.
A sense of reality has set in among all parties. They, and the nation as a whole, have realized we can no longer afford health care at any cost. 
A number of factors contribute: 
·         a sluggish economy with less personal income

·         mounting personal and national deficits

·         fear of being unable to pay for care

·         a feeling that it is what you do for yourself rather than what doctors do for you is what matters  most

·         a focus on cost containment  by health care organizations and insurers

·          remarkable spread of health savings accounts

·         recognition that Medicare   may go broke  and the Medicaid safety net may be shredded, unless something is done  

·         sheer pragmatism
·         Growing acknowledgement that sometimes more care doesn’t bring better health.
Today’s New York Times has a list of “10 Tasks to Jettison,”  things not to do that may be unnecessary, too costly,  and not worth the yield of better health.
These include:
1.      Annual physicals

2.      Annual EKGs

3.      Annual blood work

4.      Annual cholesterol tests

5.      Annual Pap smears

6.      Prostatic specific antigen tests

7.      Pre-operative chest X-rays

8.      Bone scans to detect osteoporosis for women under 65
9.      Imaging for low back pain of short duration

10.  Imaging for common headaches
Sources: American Board of Internal Medicine, National Physician Alliance, Consumer Reports
Summing Up

Just because heretofore you’ve done something  yearly,
Doesn’t mean you must still do it when it cost you dearly.
Just because it might occasionally reveal something rare,
Doesn’t mean  doing it routinely is good for health care.
Tweet:   The era of bare bones medicine has arrived, and the cost of health care is beginning to slow for the right reason - sometimes less is more.

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