August 24th, 2005
Just over-prescribe
If you're new here, you may want to subscribe to my RSS feed or email alerts. Thanks for visiting!
Malcolm Gladwell (Tipping Point, Blink) has a detailed analysis on the
ills of U.S. health care. Tyler Cowen comments briefly on the issue
by making some valid points. After sitting through an ominous session of health insurance during orientation and hearing clichéd horror stories of people having a mile-long medical bill, I had more reason to agree with Tyler’s conclusions. A case cited by the foreign advisor was that of a student who was involved in a minor accident and ended up with almost $40,000 in medical bills out of which only $12,000 was covered by her loophole-seeking insurance company. The hospital claims to have carried out a battery of tests including numerous X-rays and MRI scans. Similarly, a case always cited at GSU’s orientation is the case of the uninsured student spraining his ankle while visiting Stone Mountain and incurring a medical bill of almost $13,000. I simply cannot understand why an obvious case of twisted ankle would rack up such a huge bill. At other places, the doctor (or even the nurse) would wrap a crepe bandage and let you go after advising some rest.
I know that there are hundred of liability reasons for the doctors to conduct multitude of test just to cover their bases (and save their asses from malpractice suits). But as Tyler mentions, much of the excess spending is to make people feel that they have done everything [PDF link] (explains the numerous X-rays and MRI scans for a minor accident). But at the same time, it also removes the scope for a doctor’s educated diagnosis for which they have spent an awful lot of time in medical school and residency. Is their training purely to cover their bases and prescribe almost everything possible to avoid liability later? Isn’t that raising the cost of health care in America? I know that this neither a simple case nor am I making a detailed analysis of the issue but the root cause may be due to lack of trust in doctors due to some erroneous decisions, leading them to be overprotective.
by Patrix | on Wednesday, August 24th, 2005 at 6:00 pm | 
The world is ill, United States . You can follow any responses to this entry through the RSS 2.0 feed.
Both comments and pings are currently closed.
Article Tags >>
health care |
United States
If you did not find the information you were looking for or were not satisfied with this post then you might want to read the following related posts:
August 24th, 2005 at 9:01 pm reply
The health system in this country is fucked. Especially Pennsylvania. Do you know if I try to take a doctor’s appointment, when the earliest it is that I will get it? Take a guess. If it is something minor, it could be 3 months till I see a doctor. And the reason behind this is there are no doctors left here. Pennsylvania does not have a liability cap on medical malpractice lawsuits. No one wants to practice medicine here. Luckily, I have avoided getting sick for the time I’ve been here. Otherwise I would probably get an appointment after I’m dead and buried.
August 24th, 2005 at 9:19 pm reply
Medical Insurance is screwed up all over. CBS did a segment on medical tourism in “60 Minutes” earlier this year which spoke about how Americans are going to India and Thailand to get better service. The paid health service…services covered by insurance are completely outa control. And dont even get me started on public health.
Two years ago on thanksgiving day, my fiance had a severe ear ache and the only option was the Brooklyn Public Hospital. Agreed that it was Thanksgiving Day, but even then we waited for 7 hours to see a doctor. That too because she could not bear the pain anymore and was close to tears.
Conditions in UK are a bit contrary. Their paid system thrives but their National health system sucks. I may be wrong as its hearsay.
August 25th, 2005 at 6:37 pm reply
Gawker, it is a classic catch-22 situation. Insurance is high because medical costs are high and medical costs are high because insurance companies are paying. Moral hazard at its finest.
Arzan, that was a bad experience. Medical tourism is an undeniable fact nowadays.
August 26th, 2005 at 8:41 am reply
In US There are three ways to take revenge
1. You shoot your enemy.
2. You sue your enemy for libel
3. You shoot your enemy and sue his widow for mental anguish and harassment.
I had a first hand experience of this when I came to US for training. I developed severe skin allergy which was apparently not covered by insurance. My 3 months in US were pure hell.
I dont know what exactly is worng with US medical system, I will think fear of lawsuits, but it needs some overhaul.
By the way when I was in Texas they had some bill for limiting the damages for medical malpractices suits, which was passed.
I think by judging from it’s effect you can make a conclusion
Regards
August 26th, 2005 at 10:13 am reply
Gaurav, they are trying to fix something that is not causing it. Research has shown that malpractice suits account for just 1% of the healthcare costs, so capping the damages will not help in the long run.
August 26th, 2005 at 4:56 pm reply
Another horror story about medical insurance happened with my ex-roommate years ago. We werent roomates at the time of the incident. He got severe pain in the appendix region, and did not have insurance, as he had no job and had graduated so school did not cover. needless to say he had no money too.
The pain got so severe that he went to the ER in Brooklyn. They immediately had to operate on his appendix and remove it. They asked him to fill out paper work and sign etc. He told them he had no insurance. Since he was in ER, they did operate on him and keep him in hospital for a couple of days. They would send him a regular bill later. He knew this was coming. He had given them a fictitious address and a fictitious Social Security Number. I completely understand that there are major ethical issues in doing something like that. But at that point of time there was no option for him.
The surgery and the two day stay was gonna cost him close to 8000 $….fucking insane amount of money for spotty service at best.
I am sure there are many such instances like this and therefore the system is the way it is. Its a Catch 22. But i think the system needs to change.
I cant wait for the Michael Moore movie about HMO’s to come out.
November 5th, 2005 at 12:46 am reply
I think that those who are fed up with the current health system should get together and create their own Health Unions. Now, what is a health union (you might be asking yourself)? Well its kind of like a Credit Union. Of course we all have heard about how Credit Unions got started back when a group of people got sick of paying a monthly banking fee (that kept rising) for just having a checking account. Today most banks are charging nothing for having a checking account but back in the early 90’s banks were loosing a lot of their customers that were going over to Credit Unions. So banks started giving “free checking accounts” to compete with credit unions but not before they tried to sue the credit unions and put them out of business. Thankfully for the credit Unions the banks lost the battle. Anyways, how would all of this work? Well Credit Unions are owned by their members. Like wise if we create Health Unions we as members control and own the Health Unions and not the big insurance companies. It would be a NOT for profit Health Union and have the sole purpose of benefiting its members not some FOR profit corporation. We would pay fees and elect our own members to sit on OUR board of trusties. The Health Union would contract with Doctors who have no previous flagrant malpractice cases filed against them, who agree to work for the health Union only and keep their rates low. In return the Health Union would agree to a cap on damages from the doctors if they make a mistake. The rest of the damages would come from a fund that the Health Union would set up. The Union members would all agree that if a doctor made a mistake that no lawsuit would be filed but an arbitrator would settle the case of how much damages would be awarded to the victim. If any doctor makes a flagrant mistake then the Health Union would drop them permanently. The Health Union could also contract with Hospitals in other countries that have just as good of health care as they do here in the U.S. For example, Bumrungrad International Hospital in Thailand has doctors who were trained and board certified in the U.S.A. All of this is available for a fraction of the cost . In time, the health Union could possibly offer reasonably priced malpractice Insurance for doctors that have clean malpractice records. You know, kind of like car insurance, if you have a bad accident record then you pay more. If your a good driver then you have lower auto insurance rates. This in itself would drive bad doctors out of business and promote good doctors. Well I don’t have it all figured out but something on this line just might work. What do you think? Are Health Unions the way of the future?