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Who’s Really to Blame For Skyrocketing Health Care Costs?

The Chief Medical Officer of the American Cancer Society is disputing the prevailing explanation for runaway health care costs. Dr. Otis Webb Brawley suggests insurance companies aren’t the only parties guilty of our current heath care cost debacle.

When President Obama signed the Patient Protection and Affordable Care Act, Americans were told the PPACA would fix for the health care problem. The basic premise, which most of us seem to believe is that insurance companies are solely to blame.

Another favorite target of blame has been the 50 million uninsured in the United States. Health care given to the uninsured, some say, has been a major cause of higher insurance costs for everyone.

Dr. Brawley agrees that both the greed of some insurance providers and the glut of uninsured patients being afforded heath care are part of the problem. But they are more symptom than cause.

The Chief Medical Officer of the American Cancer Society believes doctors as much, if not more, to blame than anyone. His new book, How We Do Harm: A Doctor Breaks Ranks About Being Sick In America, takes aim at physicians’ failure to adhere to the Hippocratic Oath.

As a top oncologist in the world, Dr. Brawley has witnessed first-hand what he calls a “rush to treat” patients by unproven and often unnecessary means. Consider these selected excerpts from his new book.

  • “There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.”
  • “Medical gluttony, the inappropriate use and overuse of medical treatment, is not just adding unnecessary cost to health care. It can actually be harmful to the individual.”
  • “Health care providers and the public often overlook the emotional and financial conflicts of interest of health care professionals.”

A recent CNN article recounts a story told by Dr. Brawley of a woman named Helen. She had been diagnosed with early stage breast cancer.  A common practice in the early 1990s was to prescribe surgery followed by high dose chemotherapy and a bone marrow transplant.  The article quotes Dr. Brawley:

“The therapy Helen received was expensive and commonly given to women with breast cancer in the early 1990s. During this time, numerous women sued insurance companies who did not want to pay for the therapy and nearly a dozen states passed laws saying insurance companies had to pay for it.  There was one really good reason why the health insurers did not want to pay for high dose chemotherapy and bone marrow transplant for breast cancer:  No study had ever been done to prove it beneficial.

Even without evidence, some patients and their doctors had faith that it worked. The procedure was common because some doctors taught that the transplant was beneficial to patients. Truth be told, it was very beneficial to the doctors and hospitals offering it.

By 1999, well after Helen had recovered, three well-designed clinical trials were completed. They showed that bone marrow transplant and high dose chemotherapy, a treatment now common for nearly a decade and a half, was not better than the standard therapy and there were indications it was more harmful.”

Dr. Brawley’s final prescription:”The cold hard reality is America does not need to reform health care, we need to transform health care.” Our healthcare system focuses on expensive specialty care and all but ignores primary preventative care.

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Forbes Magazine reports these startling statistics. In 1960, nearly half of medical expenses were paid out-of-pocket by patients. Private health care paid 21% and government paid 25%.

In 2009, out-of-pocket had shrunk to 12%, insurance payments had grown to 32%, and government (including Medicare/Medicaid) had ballooned to almost 50%.

There is systematic failure in our healthcare system that cannot be fixed by a government that blames only one element of that problem. And truthfully, it will not be fixed until all parties, including patients, are willing to accept their part in the solution.

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  1. Don’t forget malpractice insurance. Doctors having to practice defensive medicine adds to the cost. We also have generations now who demand their free lunch and its catching up to us. The numbers of low life types who swamp our ERs with runny noses with absolutely no intention of paying anything will break the system.

  2. The cancer society is another phony…those people have blocked so many cures for cancer over the years its unbelievable! They will stop anything that will cut into their donations…..they are without credibility imho!

  3. One of the other drivers is the fact that there is no cap on ‘puitive’ damage awards. These are awards such for “pain and suffering”, ” mental anguish” etc., not actual, quanitifiable damage. This is where the trial lawyers make their money. They need to be capped. The figure does not matter, make it $5M if you want, indexed to inflation. By doing so, it gives the actuaries at insurance companies a set upper they can use in calculating their rates. Currently this number is unknown and unpredictable with any degree of accuracy. With capping, you would see malpractice insurance costs level, which would help with rising medical costs.

    The doctor is correct, however, there are many things we give way too much trust to the medical community for. I have one freind who changed their path in the military from medical services because they opened their eyes to the misinformation being put before the american people. Many years ago, early in my career, one of my coworkers was fighting cancer. An engineer, he attacked his medical issues with the same vigor he would an engineering problem. I am sure his doctor felt like he was back in school, as my coworker made him justify each measure of his treatment. He ultimately lost the fight, but I admired how he fought it.

  4. The third party payer “effect” is the main problem. Most of my friends and family members have their employer or the government paying for their health care. As a result they are blithely unaware of the true costs of the services they receive. That has the further effect of making them prone to consume more services than they need.

  5. Nowhere in medicine do we treat a problem. We only treat symptoms. Even heart bypass surgery does not “treat” a problem- it just resets the clock… the underlying process goes on. The nutritionists know that virtually every problem (including psychiatric) is diet, diet, diet
    The problem is there is no money in curing someone

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