Money-Driven Medicine The Real Reason Health Care Costs So Much

ISBN-10: 006076533X
ISBN-13: 9780060765330
Edition: 2006
Authors: Maggie Mahar
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Description: Why is medical care in the United States so expensive? For decades, Americans have taken it as a matter of faith that we spend more because we have the best health care system in the world. But as costs levitate, that argument becomes more difficult  More...

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Book details

List price: $27.95
Copyright year: 2006
Publisher: HarperCollins Publishers
Publication date: 5/9/2006
Binding: Hardcover
Pages: 480
Size: 6.25" wide x 9.00" long x 1.25" tall
Weight: 2.002
Language: English

Why is medical care in the United States so expensive? For decades, Americans have taken it as a matter of faith that we spend more because we have the best health care system in the world. But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care -- yet few would argue that our health care system is twice as good. Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced. How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs. In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less. In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors (Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center--and indeed as the raison d'tre--of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine--based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

Acknowledgments
Preface
The Road to Corporate Medicine
The Cost of Competition: An Overview
For-Profit Hospitals: A Flaw in the Business Model?
Not-for-Profit Hospitals: "No Margin, No Mission"?
When More Care Is Not Better Care
"Too Little, Too Late": The Cost of Rationing Care
Doing Less and Doing It Right: Is Pay for Performance the Answer?
Device Makers, Drugmakers, and the FDA
Where We Are Now: Everyone Out of the Pool
Notes
Index

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