« Pap and HPV | Main | MICU misdiagnosis »
May 02, 2007
Why is Medical Care so Expensive?
Cleaning out piles of articles, I ran across this piece on the cost of medical care. This topic is naturally one I am forced to think about every day. And a friend just asked about a particular bill he had unnecessarily and unwittingly incurred. One of the social costs of our current medical model is this defensive medicine. In this case, a skin tag was sent off for biopsy, even though the dermatologist was fairly certain it was not cancer. No one takes responsibility for the action. "It is the law."
I suppose this is an example of what Illich calls "specific counterproductivity." It is the "frustrating overproduction" that results from industrialization of medicine. He distinquishes it from direct costs (which some might see this example as) and from negative externality (social costs not included in the monetary price). The intended result (improved health) is actually subverted.
This is one way, indirectly, that government programs (Medicaid and Medicare),
have contributed to high costs. A certain expectation was set and the costs were paid directly. Then the level of expectation was raised to perfection, since the government cannot be made to look like it is skimping. Malpractice followed suit (pun accepted though not intended). So a doctor's judgment and a patient's individual expectations are overridden.
And we end up with GAO Comptroller David Walker's much-publicized complaint that medical costs are a national security issue.
There is way too much in the area of costs to address it all in one post. Sennholz' piece is a good place to start.
| By Robert Maddox | 12:06 PM