Much worse than rationing: Overtreatment

"Rationing" is a handy label for opponents of government involvement in health care to throw around. It connotes hardship during wartime and not being able to use water during a drought. Things we hate.But the problem in health care in this country is more often about having too much rather than too little. A Consumer Reports column in the Washington Post (Excess medical care can be bad for your health, especially if it's not coordinated)  describes four very real aspects to this problem:

• Medication problems. Taking too many, often duplicate medications. This often comes about from seeing too many doctors. In a well integrated model --like a true Accountable Care Organization-- the duplicates would be noticed, and so would the excess number of doctors involved. Actually a good pharmacy system or pharmacy benefit manager could also tackle this trouble
• Too many tests. Docs like to repeat tests doen by others and patients go along in the hopes of ruling things out. But tests too often lead to false positives and more invasive tests that can be risky in and of themselves. Suspicious chest x-ray? Watch out for a collapsed lung upon biopsy
• Waste of time and money. People might think twice before taking off a half-day from work or leisure to hang around the clinic racking up co-pays. Too often they don't
• Too much stress. Ever been sick with worry waiting for results of a test you shouldn't have had in the first place? Think about it next time