TRUE AND FALSE
Medical advances increase costs. = TRUE
Some health care experts assert that new medical technology may account for about one-half or more of long-term spending growth. It’s not hard to imagine this might be true. Consider the major medical advances of the last several decades:
- New treatments for previously terminal conditions, including long-term maintenance therapy for diabetes and AIDS and bypass surgery for heart disease
- New procedures for treating secondary diseases within a disease, such as for anemia in chemotherapy patients
- Extending the scope of medicine to treat mental illness and substance abuse
- High-tech diagnostic tools and surgical methods like MRI, mammogram, CT Scan, laparoscopy, etc.
Doctors are over-relying on expensive scans and tests. Part of this is as a defense against malpractice lawsuits – “CYA” medicine. That insurance incentives reimburse for procedures at higher rates than for primary care office visits also promotes the use of testing, which promotes the purchase of testing equipment by hospitals. As a result, the use of CT scans, for instance, has more than doubled since 2000 and has soared from 20 million scans in 1995 to 63 million in 2005.
The scans do give doctors clearer, more detailed pictures of the body, and even now faster scanners that take more comprehensive pictures are in development: a Boston hospital recently bought one of the first scanners in the world that can take a picture of the entire heart and surrounding blood vessels in seconds.
But as great a diagnostic as it is, as much as it helps us monitor the patients’ response to treatment, do we really need to use CT scans in all patients complaining of headaches, abdominal pain, and chest pain? Though it may be as effective as the invasive and unpleasant colonoscopy for finding polyps that could lead to colon cancer, and may help screen for lung cancer in smokers, does this mean tens of thousands more people should get regular CT scans?
Technology has its costs – and they’re not always just financial. Doctors are becoming concerned about radiation exposure from the expanding use of CT scanning. A chest CT, for example, exposes a patient to 80 to 400 times the radiation from a chest X-ray. Even as scans are becoming useful for more and more things, doctors are actually adopting practices to reduce the number of patients scanned and the number getting repeat scans.
Medical advances increase costs. = FALSE
Not all medical developments necessarily increase the nation’s health expenditures. Some are new tactics that increase efficiency and reduce costs. Anything that can help us diagnose illness more quickly can save us money by reducing hospital stays, visits to the doctor, and lost work hours.
Given the size and complexity of our health care system, it would be very difficult to determine the direct effect of any new technology on overall costs.Technology does add cost in some cases, and decrease it in others, and the outcomes are not always measurable or measured. It is safe to assume that new technologies can extend life expectancy and this may increase the costs of medical care as people live longer and may need more expensive end-of-life care.