A recent article in the New York Times discusses a very interesting topic at the heart of the debate over health care reform and controlling health care costs.  The article asks if the issues we are facing today with out of control health care costs aren’t really an issue of an inability to say no to unnecessary treatments on the part of the doctor and the patient?  Americans seem to have a “more care is better care” outlook and will accept recommendations for all kinds of unneeded and potentially dangerous treatments.  This try-anything approach has had some benefits for people but it has also had some major problems, including dangerous treatments like radiation and surgery being used or overused unnecessarily.

The main problem, the article argues, is that patients are often terribly uneducated about their treatment options.  Many just blindly do whatever their doctor tells them without asking questions or finding out about other options.  Frequently there are less expensive, less invasive options that may not cost as much (or be reimbursed as well) but would be most beneficial to the patient.   Firstly we need to know which treatments work and which do not in certain cases, or which have possible problems that outweigh the possible benefits, and then educate patients about all options. 

But at the heart of the problem is how doctors are paid, which causes them to recommend the more expensive and sometimes unnecessary treatments.  A change in reimbursement policies that award better care rather than more care is crucial.  The current reform takes some steps in that direction, but ultimately more change will be needed.  It seems that the answer for now lies in patients own decisions to limit their care to the most beneficial procedures and medications.  Who knows how many billions of dollars could be saved if people were able to make smart decisions about their own health care?

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