Over-treatment – How much healthcare is wasted and what it’s costing YOU.

It’s safe to say that I use a regular amount of healthcare. I’ve never been dramatically ill, but have undergone a few minor surgeries here and there. Members of my family have had more major procedures, and may again in the future. As a common healthcare consumer, I definitely don’t feel like most articles or news stories are written with me or my family in mind. They are about as distant as a Dow Jones report, written for investors in suits, reading it from a far away office with lots of shiny glass.

A recent article published by NPR explores the extensive waste in medical care – a longstanding issue that has recently gained some extra media attention. It seemed prudent to look a bit further into the issue from the perspective of a healthcare user (like you and I), not a healthcare policy writer or Fortune 100 executive.

Let’s take a look at a few statistics taken from the study.

  • 600,000 people (of 1.3 million, or 46%) received unnecessary treatments
  • 85% of pre-surgery lab tests were unnecessary, costing $86 million
  • 75% of cervical cancer screenings were performed on patients who had recently undergone the screenings. This wasted $19 million.

It’s not unreasonable to say that our health system is wasteful. Rough estimates place over-treatment and unnecessary care at about 1/3 of all care administered. At the national level, that means that about $1 trillion of the $3 odd trillion spent is wasted. Now, what does that mean for you and I? It means that you’re wasting about $3,500 per year, and gaining nothing from it. It means that the average care that you, yourself, receive is being overcooked by 1/3.

Take, for example, this young girl who was charged almost $2,000 to have her ears pierced. Her mother was offered this service (despite being a very weird thing for a surgeon to do) and she took the doctor up on it. Now this is an extremely odd example, but one that illustrates how little we typically know about pricing before getting anything done. See how easy it is for a little bit of unnecessary care to slip in?

Why does this matter?

The $1 trillion question is this – does waste actually impact my insurance? My healthcare costs? Does it cost me money?

The answer is an overwhelming “yes”.

Whether you’re looking at your healthcare as an individual, a member of a family, or the executive of a company that pays your the healthcare bills, you’re paying 1/3 too much money.

Over-treatment for the average person

What does overtreatment look like?

  • Overtesting – An estimated $4 billion is wasted on mammograms and false-positive breast cancer diagnoses alone. This is due to overtesting, patients wanting to go the extra mile in all tests and by doctors fearing a malpractice suit. As a result, significant funds are lost to multiple testing.
  • Autonomy at the doctor level – Doctors have their own way of doing things. Some are confident in this test, other doctors prefer that test. There’s no 1 way of doing things, and depending on your procedure, your doctor is going to choose what path you take. This makes it hard to know when and where you‘re getting “too much” care.
  • Too many medications – According to this study, over 20% of medications are over prescribed. Meaning that the patient doesn’t need them and that it won’t help them. We all know
  • Fear of Malpractice – Almost 90% of doctors are afraid that if they don‘t go the extra mile to prove that you do or don’t have a procedure, they’ll be the victim of a lawsuit.
  • Misdiagnois – If you’re getting treated for the wrong thing, your treatments are 100% waste. Medical errors, like misdiagnoses, are the 3rd leading cause of death in the USA. Not to mention, it’s extremely expensive.

What can you do about it

This is the part that I’ve got a bit more experience with. Ultimately it’s up to you to make your decisions and choose to have or not to have a procedure/test/treatment. You can ask you doctor questions about whatever procedure or test they’re recommending. Make sure you’re comfortable with “why” the test is being performed. For example, will it potentially change your diagnosis? What happens if you don’t undergo the test? Check out the links below for a more detailed rundown of managing this process. 

  1. Avoiding Misdiagnoses
  2. Health Literacy
  3. Comparing Healthcare Costs
  4. Getting a Second Opinion