It isn’t what – it’s how much.
That’s a key finding of the Dartmouth Atlas of Health Care, which was recently released.
The study found that where there is supply, there is demand. Especially when people aren’t paying.
People tend to equate quantity of healthcare with quality, often throwing themselves at further tests and referrals in the belief that it will give them a better chance. Doctors, who lose nothing and gain plenty by referring, are uninhibited in complying.
Indeed, so profitable were referrals that at one point “Medicare Mills” were a popular money-maker. Doctors would refer a patient around a clinic, arranging consultations with a myriad of unrelated practitioners before dealing with the problem. Medicare fraud investigators have since shut down many such operations, but doctors have not yet ceased to abuse the system to line their pockets. And neither have patients ceased to do the same to get excessive, and often unnecessary, medical care.
The study suggests that facilities can reduce costs by being more efficient in the way they handle people with serious medical conditions. Instead of throwing the medical service book at them, arranging every possible test and every related treatment, it recommends an approach geared to maximizing results and efficiency. An overhaul of the system need not require cuts in the payment for services; just cuts in the pork barrel of services.