In my readings about health care and health policy, I’ve been noticing more and more references lately to the idea that early detection of cancer isn’t all that it’s cracked up to be, and that excessive screening tests in general might be causing more harm than good in terms of false positives and aggressive treatment for conditions that might have cleared up on their own. Maggie Mahar’s thoughts on our fear of cancer is a good read for anyone, and should make us stop and pause before agreeing to a slew of screening exams at every checkup.
I mentioned yesterday that the executive director of the Colorado Consumer Health Initiative, Dede de Percin, pointed out that the recent double digit rate increases submitted for review by Anthem Blue Cross Blue Shield were likely justified, based on the 12% increase in the cost of care for insureds. I see a lot of connections between that 12% increase in the cost of care and the excessive fear of disease that Maggie Mahar is talking about. Is it our fear of diseases like cancer that is driving the huge increase in medical costs? Are the extra costs from one year to the next driven by increasing costs for existing treatments, or by additional treatments and testing that weren’t being done in the prior years?
In order to control health care costs (which is the only way that we’ll ultimately control health insurance premiums), we need to look closely at whether all of the care we’re paying for is really improving the overall health of the American people. An AARP article notes that prostate cancer is treated more aggressively here in the US than it is in the UK, and yet our mortality rates are about the same (that article has a lot of interesting details about health care costs in the US, and is well worth a read).
We’ve definitely got a “more is better” attitude when it comes to health care. If we go to the doctor with an ache or pain, we somehow feel better if the doctor orders a battery of tests to rule out a range of possibilities. And if a health insurance company is paying for those tests, why not? The problem is that health insurance companies are paying for care with premium dollars collected from insureds, and as costs go up, so do premiums. Until we shift our attitude to a “less is more” mentality, we’re going to continue to see an increase in the cost of care, and subsequently in the cost of health insurance. But it’s not just about money. Articles like Maggie’s should give us a reason to question excessive screening and testing, simply from a standpoint of having a better quality of life. The fact that it could drive down health care costs is a bonus.
Many thanks to Jason Shafrin, who hosted this week’s Health Wonk Review, where Maggie’s article was published.