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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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