Tuesday, October 13, 2009

Experts Estimate - or Making Stuff Up Again

Readers noted the Monday Morning Edition report that blames rising health costs on patients who demand too many pills and procedures.

Alix Spiegel runs this unique story and makes this claim:
"Experts estimate that anywhere from 10 to 20 percent of the health care costs are driven by patients in this way."
Has anyone seen any such research? I couldn't find any matching reports or studies. If it exists, I'd love to know who funded it and who published it? If anyone can find it, please post in the comments.


lapsedlawyer said...

Same place he gets all his "studies": The deepest darkest recess of his anus.

gopolganger said...

That's an occasion to use my newly coined word: factulence. It's like truthiness with a toot.

Anonymous said...

Experts estimate that anywhere from 10 to 20 percent of the health care costs are driven by patients in this way."

Maybe he is talking about the cost of gas for driving (patients) to the doctor, or the extra cost of car insurance for demented patients who drive (see google search below).

In that case, maybe the experts are fuel economy experts or car insurance experts, not health care experts at all.

In other words, perhaps the reason you have not found anything is that you have been making your google search too narrow: "health care experts patients driving cost"

try just "patients driving"

here's what I get, in order of ranking

1) Parkinson Disease Patients' Driving Skills Affected by Low Visibility

2) Health Populi: Revisiting NPR's story on "Modern Patients" driving ...
Oct 13, 2009 ... Revisiting NPR's story on "Modern Patients" driving up health costs; time for the Journal of Participatory Medicine ...

3) #
uropean Patients Driving Turkish Medical Tourism
Apr 24, 2009 ... European Patients Driving Turkish Medical Tourism. Medical tourism industry of Turkey is anticipated to record a significant growth at a ...
www.prlog.org/10223718-european-patients-driving-turkish-medical-tourism.html - Cached - Similar
Tests may judge dementia patients' driving safety | Health | Reuters
Feb 9, 2009 ... NEW YORK (Reuters Health) - A battery of cognitive tests may help predict which people with mild dementia can still drive safely,

gopolganger said...

I listened to that segment again. Painful. The idea is that 10-20% (they actually take it to 30% of the doctor being interviewed's costs) are driven by patients demanding tests that are not needed.

First of all, I have to confess how personally enraged I am by this fatuous factulence. I had a close friend and colleague some years ago who was denied tests that would have found his esophageal cancer much earlier and perhaps would have saved his life. I remember him describing to me how he literally grabbed the doctor by the lapel and demanded the test. Clearly the HMO was pressuring the doctors to keep costs down and deny treatment.

Second, it's extremely hard to find good 411 on this stuff, precisely because groups like Kaiseredu.org, a major funder of NPR, are in the business of fogging the water. They claim that administrative costs consume only 7% of the health care dollar, when more reliable estimates peg this at closer to 31%.

Finally, notice how the insurance and pharma corporations are pretty much absent or passive players in her entire discussion. These ads for drugs on TV just magically started to appear somehow. The insurance paperwork is just kind of an act of god.

bIG!pINK!fUZZY!bUNNY! said...

Factulence: truthiness with a toot.

Yah, Gop'ms. And a lingering repulsive afterstench at that.

Anonymous said...

The idea is that 10-20% (they actually take it to 30% of the doctor being interviewed's costs) are driven by patients demanding tests that are not needed.

I find that humorous.

I got bit by a tick several years ago and developed a rash, fever, stiff joints, stiff neck and all the classic symptoms of Lyme disease.

I actually was treated with antibiotics for a very short (10 day) period right after I got the bite but the symptoms persisted afterward.

Anyway, I ended up going to 3 different hospitals before I got a doctor (an expert on Lyme disease) who put me on an extended antibiotic treatment plan (that worked, by the way).

The cost of the antibiotics amounted to nothing compared to all the batteries of tests the different hospitals put me through (I am convinced, to boost their bottom line).

I explained my symptoms to each doctor and TOLD them I was pretty sure it was Lyme disease because all the symptoms started shortly after the tick bite.

but because one (notoriously unreliable) test for Lyme kept coming back negative in my case, most doctors would simply not give me the antibiotics! Instead they gave me every bllod test in the book, neck Xrays (because of my stiff neck), a CAT scan (because of the headaches) and a bunch of other stuff that was completely unnecessary.

Luckily, I had health insurance at the time because all the specialists, tests, etc amounted to thousands of dollars.

If they had given me the antibiotics that I requested at the start, the health insurance company would have saved THOUSANDS.

of course, the hospitals would have made MUCH less.

I am convinced that the ONLY real solution to this problem is single payer, which would allow a single entity with no vested interest (the government) to monitor what was going on.

larry, dfh said...

With Lyme, I've heard that it's possilbe for a Blood antibody test to be negative while a Urine antibody test is pegged. The spirochete is very tricky, and can produce lots of dummy antigen to soak up the host sntibody. Not all MD's are fluent in Lyme.

Anonymous said...

Not all MD's are fluent in Lyme."

You can say that again.

many of the doctors i saw were basically clueless. One fellow at Lahey Hitchcock Medical center (a well respected hospital in the Boston area) actually told me that the test for Lyme was 95% accurate, which I already knew at the time from my own research was total BS. As soon as I heard that, I said "later" to Lahey Hitchcock" and went looking for a doctor who actually knew something about Lyme.

given its prevalence in New England, there is no excuse for ANY doctor in new England NOT to have familiarized him or herself with the disease.

but that's not the only or even primary problem.

There is real resistance among many doctors to prescribing antibiotics for more than the usual 10-20 days, which is often the ONLY thing that is effective in treating Lyme disease when one has had it for awhile.

Also, many doctors simply will not listen to anything a patient tells them and since the test for Lyme is not reliable, clinical diagnosis based on patient symptoms is critical.

Some doctors (and even "news" organizations, if you can imagine that) are critical of the fact that people are becoming more actively involved in researching their own health problems.

I can say from personal experience that some even feel threatened by it.

But I happen to think it is a very good thing.

If I had not done so when I contracted Lyme disease, I probably would still have it.

I get really ticked off now when i hear BS on NPR and elsewhere that tries to blame health care costs on patients. It may be true in some cases, but I think blaming the health care crisis on the patient is really a diversionary tactic that takes the focus away from where it should be: on those who have made "health care" [sic] a billion dollar industry for which the patient means only $$.

Anonymous said...

"Experts estimate that anywhere from 10 to 20 percent of the health care costs are driven by patients in this way" is textbook propaganda.

Reminds me of "9 out of 10 doctors prefer brand X"

Companies are actually now forbidden from making such statements without evidence to back it up because it has been deemed "false advertising".

so, apparently we have higher standards for advertising in this country than we have for journalism.

That is a sorry state of affairs indeed.

Christopher L said...

How can anyone bear to listen to Alix Spiegal's pieces for long enough to even be annoyed by their content? Her voice and delivery is incredibly grating, the least 'radio' of any I've heard. Her angles to be inane, stories plodding, etc. That 20 minute piece last Thursday blaming MD groupthink for high costs was so horridily paced that I couldn't help listening to see how much worse it could get. How did she get hired for a radio job? is what I think whenever I hear her voice, and who got turned down?...

Jacob said...

I remember listening to This American Life's Healthcare Reform (Part 1) and finding that it made a pretty convincing case that the doctors and patients--because they had no incentive to not order more tests--were a big part of the escalating cost problems. Did you guys at NPR Check do a post on that segment? I'd be curious to know what was wrong with the reasoning there (aside from passionate anecdotes of doctor's not ordering tests).

Anonymous said...

Doctors see patients as ATM machines. They would rather run costly tests to earn more.