Most excessive costs are due to non-indicated use of various medications or excess testing to alleviate anxiety on the patient or physician’s part. I think Americans in general are less tolerant of mistakes of omission. We thus pay a premium in our healthcare system to know that “we looked at all possibilities” rather than “we looked at the most likely possibilities”, be that in diagnosing or treating a disease. It’s part of our culture of feeling that we are all unique and different (when those differences within a biological gender are in the grand scheme of things relatively minor). Also our culture of never accepting death unless it makes us.
Some good examples in diagnostics:
- Excess surveillance imaging for various cancers (not screening - that has good evidence and is much cheaper).
- excess lab tests to ‘rule out’ rare diseases that mimic much more common diseases.
Examples in treatment:
- emergency thoracotomies for trauma patients
- ventricular assist devices for non heart-transplant candidates
- ICU for people with no recoverable cognitive function
- certain cancer treatments with median 1-2 month survival benefit.
All of us pay for this because us doctors don’t want to miss something, and then be sued. I work in a field where it’s generally clear what does and doesn’t work, and am somewhat insulated from that, but in fields where treatment has a huge range of good and bad outcomes for reasons that aren’t well understood, the risk of lawsuit is fairly high.
The other part is so many uninsured people compared to other developed countries. We pay for them anyway, federal law requires it.
Good info. But there actually arent that many uninsured people, 8.6% of the population in 2020, i mean 8.6% is a lot but there are probably a lot of special circumstances there too. A bigger concern to me is underinsured people, people with plans that get around ACA standards.
And is'nt only life saving emergency care to stabilize a patient required? For example, a person with no money/no insurance cant actaully sit down with a doc to develop a treatment plan to treat their cancer can they? Almost none of my family's care would qualify as "emergency/life saving/to stabilize the patient".
My employer offers long term care insurance, just looked it up roughly $60 month premiums for 100k of long term care. For such a relatively small benefit (100k) I think most of us would self-insure by keeping that amount available in savings.
I cant belive that my health insurance offers no long term care benefits but I dont know what it covers regarding long term care.