Book Description (From Amazon)
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'être--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.
