The New York Times offered an editorial by David Leonhardt, one of their economic writers, concerning the reason healthcare in this country is so expensive. Here’s his take:
The main reason so many people lack health insurance is because of its cost. And a big reason for that cost is the explosion of expensive, medically questionable care, be it knee replacement, preventive angioplasty or lumbar fusion
The example he cites is of lumbar fusion. Apparently, a tiny town in Idaho accounts for a disproportionate number of spinal fusion surgeries, and that the data on its efficacy is mixed. He also says that it cost Medicare 600 million dollars to provide these surgeries in 2003.
A large number, to be sure. I would note that after this introduction, Mr. Leonhardt abandons the topic of disparate medical procedures and manages to focus on Democratic presidential candidates’ plans for universal health care. I’m not sure why Republican candidates’ policies aren’t mentioned. Must be that ol’ “liberal bias” that seems to land George Bush in the White House every four years like clockwork.
But I digress. I have no idea if lumbar spinal fusion is medically questionable. I have not looked at the data. My personal feeling is that back surgery, in general, has disappointing outcomes. The newest one is “kyphoplasty”, but the data I was shown looked promising, as long as an orthopedist didn’t get greedy and try to do multiple vertebrae.
The point I want to make is that, while there may be too many lumbar fusions, that isn’t the biggest expenditure we should be focusing on. It’s EXPENSIVE ELECTRIC WHEELCAHIRS and other frauds! Consider this quote from a CNN article:
Medicare's 80 percent share for power wheelchairs grew from $22.3 million in 1995 to $663.1 million in 2002. That total already has been surpassed in the first nine months of 2003.
Some of these wheelchairs cost as much as used cars! Should a wheelchair cost so much? Of course not. I mean, a baby stroller is maybe a few hundred dollars. How does a wheelchair cost 5000 dollars? Isn't that what a Segway costs?
And I can’t count how many patients in my resident clinic asked me for a letter so they could get disability. One said to me that she couldn’t do her job because her “feet hurt”. I said “Why don’t you get a job on the phone.” She looked at me like I was crazy and said “Oh, I got schizophrenia, I don’t think so good.”
With so many “hard working” Americans sucking at the teat of Medicare and collecting disability and SSI, no wonder the system is going broke. If some of these deadbeats went to work and stopped defrauding their own government, maybe Mr. Leonhardt wouldn’t have to write this article. Why is so little attention devoted to this topic? I guess because it’s more fashionable to solely blame doctors and hospitals for exploding costs.