June 7, 2009

Runaway Train- wrong way on a one way track

Posted in Uncategorized at 8:22 am by healthyacrossthenations

On the Economist.com jdcarmine posted a comment:

Can we PLEASE at least consider that much of the waste in health care is in that American pay vast sums for non-organic quackery? The DSM IV-V, for example, diagnoses virtually any momemtary unhappiness as a “mental illness,” and all treatments are virtually Big Pharma extortion. We currently pay for all variety of pseudo science from chiropractors to Lamaze to therapeutic touch to social worker talking cures. We now have a now 50% and climbing rate of depression and nearly 80% rate of ADHD for poor African American boys. Maybe, just maybe, we might want to be just a smidgen more judicious in what we call an illness. This is a place for some responsible quantitative science!! We need to spend our scarce medical resources on real organic illness and let the other stuff come out of our disposable income. Diagnostics has now eclipsed actually organic illness!!! I for one would jump at a la carte health care insurance and a medical savings plan to pay for trendy stuff. Remember when everyone was hypo-glycemic? Now we are all depressed and bi-polar…ish. And all that silliness ain’t cheap.

Here was my response:

jdcarmine-

While I see your point about phantom illnesses- my research has shown other areas to be the causes of runaway health inflation- which is just one problem (others include consumer abuse of health services, Doctor’s incorrect or expanded diagnosis, and the outrageous costs of Research & Development for Pharmaceutical products).

Health Care is not a perfect market, and as a result there are at least 2 parties that could have even non-intentional perverse incentives for unnecessary treatment and one party that has perverse incentives not to treat (insurance companies).  I do believe that health consumers could greatly benefit from more Health Education that could help them identify serious conditions, help them work with their Doctor to provide them with proper information, we are our own best experts.  Doctors should be provided with good IT in Health that could help them have faster and greater access to evidence based medicine- both within and outside of their communities- this would help them identify the most cost effective and appropriate medicines if necessary.

Moreover, computerized medical records can help manage patients cases more efficiently and effectively across the Health system. Insurance companies and Doctors will be able to monitor the quality of care being given to patients and find ways they can help improve upon that- and to see the story of the patients cases.

Re- medicines: Under a more universal coverage system the Insurers, Doctors, Government, pharmaceutical companies and Patients groups should hammer out a large basket of first and second line medicines they recommend. For instance some countries have made deals to work  with generic pharmaceuticals when they can to lower costs.  However, let us not forget that without the investment in R&D by big pharma there would not be Generics available. On this line- I do believe that there should be some sort of government public/private  fund directed to helping innovative research pharma labs plan R&D.

If the patients feel secure in their treatment in this way, and the Doctors also – there will be less phantom menaces. Moreover- there will be less diagnostic creep which is related to the phantoms. Pharma companies are already changing- becoming innovative and creative- I think they will adapt well- but in this- more universal- situation some form of public/private R&D fund will be needed. Its all about management 🙂

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