Reflections on Healthcare Economics

In addition to the recent highly publicized rollout of the individual mandate provision of the Affordable Care Act, there has been an extensive amount of press coverage of the contribution of physician salaries to the cost of healthcare in the United States. For example, in a recent New York Times article (Click Here), Ms. Elisabeth Rosenthal highlights some examples of the often exorbitant costs incurred by patients pursuing specialty care for seemingly minor procedures. She presents evidence in the form of "median annual compensation rates" for several specialties and the unfortunate experience of a patient, who apparently had very little say in the choice of expensive, and likely unnecessary procedure options. While I agree that every physician should ALWAYS communicate the various treatment options, including risks, benefits, alternatives, and his/her professional recommendation for a patient's unique circumstance, a fixation on physicians' salaries as a major contributor to healthcare cost is incomplete and short-sighted. 

Several factors must be taken into consideration and each individually addressed with at least incremental and ideally monumental changes. Over the next few weeks, I will be briefly expanding upon the following areas that experts believe are ripe for reform, with some reflections from personal experiences:

1) The Skewed Incentives of a Third-Party Payer System
2) Inadequate Insurance Coverage and the Emergency Medical Treatment and Active Labor Act (EMTALA)
3) Tort Law and the Costs of Defensive Medicine
4) Escalating Medical Education Costs
5) Tackling the Shortage of Physicians
6) Evidence-Based Medicine vs. Economic Use of Medicine and Procedures
7) The Opacity of Healthcare Pricing

Stay tuned..
#scrublife