Testing, testing, 1, 2, 3
From the Wall Street Journal:
Worried that unnecessary diagnostic tests are adding to the nation’s soaring medical costs, federal health-care officials are moving to shrink loopholes that let doctors profit from referring patients for MRI scans and other costly medical tests.Medical imaging is one of Medicare’s fastest-growing costs, rising an average of 20% a year since 1999. In 2005, the federal health-insurance program for the elderly paid $7 billion for imaging scans. Some studies have shown that doctors with a financial interest in big-ticket machines for magnetic resonance imaging or other tests are more likely to order those tests.
It is not surprising that doctors will order more tests if they profit from testing. However, even if doctors get no profits from tests a huge problem remains – doctors are ordering tests using “other people’s money” and have little incentive to economize. Spending due to tests being seen as costless is likely to be much greater than spending due to doctors profiting from testing.
This is not a simple problem to solve, but financial incentives to patients and medical professionals to save money by economizing on tests will get doctors to spend more time thinking and looking things up and less money testing.
Non-financial initiatives can work as well, such as educating patients about the dangers of radiation exposure from too many CTs and about the harm that can result when a false positive on an unneeded blood test is followed up with increasingly invasive tests.November 14, 2006