Two Common Sources of Overtreatment
By Jim Sabin Experts, most recently former CMS administrator Don Berwick, tell us that no less than 20% – 30% of medical care is “waste.” At the very least, “waste” is harmful to all those who pay for Medicare. But often it’s directly harmful to the patient as well. I recently saw a friend at a party. Since we’d last seen each other my friend’s spouse had died. (I’m deliberately avoiding gendered pronouns and omitting other identifying details.) My friend contrasted the excellent hospice care the spouse received with problem-ridden hospital care. Here are two examples of...
Read MoreMedical Educators Need to Take Charge and Help Deflate Medical Bills
By Neel Shah, MD, Christopher Moriates, MD, and Vineet Arora of Costs of Care. At a time when one in three Americans report difficulty paying medical bills, up to $750 billion is being spent on care that does not help patients become healthier. Although physicians are routinely required to manage expensive resources, traditional medical training offers few opportunities to learn how to deliver the highest quality care at the lowest possible cost. While the gap is glaring the problem is not new. In 1975, the department of medicine at Charlotte Memorial Hospital initiated a system to...
Read MoreA Student’s Summer Reflections on Price Transparency
Jeffrey Herman is a sophomore at Brandeis University and just completed a summer internship with Costs of Care. I can’t think of a single industry that is more inherently personal—more emotional than health care. Everyone has a story of how the health care system has impacted their lives. My family’s experience with the healthcare system had both positive and negative results. Thankfully, my brother survived a brain tumor as a young child and my father’s heart disease was treated early enough to prevent a heart attack. However, the bills for these procedures were astonishing. Perhaps...
Read MoreFraction of the Pie
The following anecdote is from Eric Lespin, a patient from Alaska. A torn meniscus. It did not disable but it impaired, and unpredictably. My stomach learned quickly to tighten at the sound of A.’s peculiar whimper in response to a crippling pain that would shoot through her at seemingly innocuous movements of the afflicted leg. We have health insurance of sorts, the type that will help you keep your home if tragedy strikes, but that does not shield you from the brunt of what most of day-to-day health care cost is about. We’re well practiced in deferring and foregoing care. Here...
Read MoreCosts of Care in the National Press
As the director of Costs of Care and a practicing doctor, I occasionally have the opportunity to offer public commentary on healthcare costs from the doctor’s perspective. I recently spoke with national media about the role (or lack there of) of costs in medical decision making. I’m quoted in last week’s New York Times, for a great article entitled “Teaching Physicians the Price of Care”. The same article was syndicated here on National Public Radio, hereon Kaiser Health News, as well as several regional newpapers and radio stations around the country. The...
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