Five words that are at the very core of the health care crisis in America. Six more? “Out of an abundance of caution.”
See, the problem with these words are that the Doctor who is telling them to you, based on his experience and knowledge, is telling you that there’s nothing wrong with you. Whether it’s the stomach pain you went to see a GI for, or the chest pain you went to a Cardiologist for, these doctors know (not guess, know) that you don’t have a serious problem. That’s why you go to them, because they know that chest pain that’s cardiac related is general tightness and crushing pain in the entire chest area, not sharp localized pain in one spot. They know that a 29-year-old male that doesn’t have high blood pressure or high choelsterol isn’t likely to have heart disease.
But. There’s the key word. But. Right or wrong, if the doctor let the patient walk out of the office without any further investigation, and something that was otherwise not-knowable and a one-in-a-million chance actually happens, there will be a process-server at that doctor’s office dropping off some bluebacks. So the doctor, in order to cover his own ass, and since the patient has insurance and won’t pay for it directly, orders some unnecessary tests “out of an abundance of caution.” See, the important thing to note here, is that it’s not your health that he’s being cautious about, it’s his liability.
So now what? Well, the doctor orders the expensive test. You go for it. Maybe you miss a day or a half0day of work, so your productivity suffers. The staff at the hospital now has to slot you in for an appointment, possibly making someone else, who really needs that test and the attention of the medical staff wait, and then they bill your insurance for it. The hospital and doctor become over crowded, people have to wait for procedures, and the insurance pays out a couple of thousand unnecessary dollars. Your premiums go up, health care and health insurance prices go up, and getting adequate health care becomes harder.
Why? Because the medical malpractice law suit world makes that necessary. Because the doctor has to protect himself, so he introduces vast inefficiencies in the market.
Now, I’m not sugegsting that the medical malpractice world of litigation be eliminated completely (my doctor father and brother would like that, I’m sure), butI’m just pointing out that it’s an inefficient system (in terms of allocating responsibility for injury and harm) and it creates even bigger problems and inefficiencies in the provision of health care at all. Any reform to the system, including trying to make health care affordable and available to all, has to address this problem.
What the best way to address it is, in my opinion, is the subject of another post.