In a recent newspaper article the chief of the Congressional Budget Office was quoted as saying that 20% of all healthcare services are unnecessary, and contribute significantly to our inability to control costs.  This figure represents more than $500mm in annual expenses that aren’t helping make us healthier or have better outcomes – ouch!

So we have to ask ourselves why do we do all these tests, take all these drugs and require so much service if it isn’t contributing to our health?  The short answer is because we can.  The longer answer is that a market economy that actually works along the lines of supply and demand to determine pricing, is masked by third party payors in the healthcare industry.  In other words, because we don’t know the cost of our care we aren’t forced to make prudent decisions about what is an acceptable level of care.

It’s true that if we were responsible for our total healthcare bill, and knew the costs beforehand, we more than likely would make different decisions.  For instance, let’s say you have a stomach ache and go to the doctor.  He/she says they can do a colonoscopy on you and see if anything is going on.  You say yes because you’ve never thought of questioning your doctor or asking if there are other options.  The test results are indeterminate, but the doctor says you may have irritable bowel syndrome.  He/she then prescribes an IBS drug that works on some women, but not all.  So you’ve now committed to a monthly medication and an invoice for your portion of the test.

What would have happened if you asked your doctor upfront what your portion of the bill would be, and you decided your stomach didn’t hurt that much?  What if you talked things through with your doctor and decided to try a nutritional change first?  These questions get at the crux of the Congressional Budget Office’s concerns, which is that patients need to become more involved in managing their care and costs.  We need to partner with our providers to make informed decisions that don’t compromise our health, or overburden the healthcare system.  We need to be prudent in managing the cost of our care.

This is definitely a responsibility of both the patient and the provider.  Just as we hear stories of doctors’ over prescribing, there are similar stories of patients demanding treatment when none is needed.  The big differentiator as we go forward is the need to care for our health and our wallets – a change that will be good for individuals and our national budget.

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