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business newsWhy Cost Containment in Health Care Is Impossible
By
Ron Sen Jun 16, 2011 8:00 am
The government can't get cost control without goring the oxes of patients, physicians, pharmaceutical companies, insurers, device manufacturers and hospitals.
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Physicians generally emerge from their initial education (four years of college, four years of medical school, four to six or more years of advanced training) with a lot of debt and hopes to improve their standard of living. Who can calculate what "delayed gratification" is worth?
Years ago (when I was in the Navy), an Army physician asked why I was in medicine, "ego or money?" I never had any money, so I guess you can draw your own conclusion.
Day to day, medicine presents fascinating challenges in solving complex problems, and physicians can earn (via piecework) a very good income. Clearly, in Massachusetts, where I practice, it isn't as good as in some places, and whether the hours worked compensates physicians for their time is a subject without a clear answer. The work often provides other rewards, but medicine has unhappiness associated with it as well. (I don't see any point on dwelling on that.)
One issue that arises is cost containment, which comes in two forms: volume and cost per procedure. Some physicians simply take the attitude, "if I can justify it, then I can do it." Certainly, with imaging a big driver of costs, physician-owned imaging is a factor (I don't have a financial interest in any imaging, with the exception of my wife working for GE, which has a large medical division). If you own that scanner (hammer), then you're searching for nails. For example, if a person has a full body scan, there's a pretty high chance that you will find something (lung nodule, soft tissue lesion, major organ cyst) that will require follow-up. It's not so different than bringing your car in for a tune-up, and they tell you that you need brakes, a muffler, belts, or whatever. You want to be driving in a safe vehicle.
No positions in stocks mentioned.
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