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Medicine Biotech Science

America's Doctors Are Performing Expensive Procedures That Don't Work (vox.com) 233

"The proportion of medical procedures unsupported by evidence may be nearly half," writes a professor of public policy at Brown University. An anonymous reader quotes his article in Vox: The recent news that stents inserted in patients with heart disease to keep arteries open work no better than a placebo ought to be shocking. Each year, hundreds of thousands of American patients receive stents for the relief of chest pain, and the cost of the procedure ranges from $11,000 to $41,000 in US hospitals. But in fact, American doctors routinely prescribe medical treatments that are not based on sound science.

The stent controversy serves as a reminder that the United States struggles when it comes to winnowing evidence-based treatments from the ineffective chaff. As surgeon and health care researcher Atul Gawande observes, "Millions of people are receiving drugs that aren't helping them, operations that aren't going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm"... Estimates vary about what fraction of the treatments provided to patients is supported by adequate evidence, but some reviews place the figure at under half.

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America's Doctors Are Performing Expensive Procedures That Don't Work

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  • No Money (Score:5, Insightful)

    by Anonymous Coward on Sunday December 31, 2017 @01:41PM (#55839457)

    Duh, there is no money in actually healing people. Take the profit out of medicine and it will start actually work again.

    • Re:No Money (Score:5, Interesting)

      by VeryFluffyBunny ( 5037285 ) on Sunday December 31, 2017 @04:47PM (#55840507)

      In the UK, where the NHS is the only real game in town and health insurance is a national govt. system, doctors are allocated budgets for the numbers of patients that they have enrolled on their books. It's in their interests to spend as little as possible on keeping their patients as healthy as possible in order to conserve their budgets. The NHS is one of the best health services in the world in terms of outcomes for per capita spending. Well, that's the last time I heard. The current UK right-wing* administration are doing their best to wreck it.

      *right-wing in the UK is still thankfully far left of the Democrats in the USA.

    • Double negative (Score:5, Interesting)

      by petes_PoV ( 912422 ) on Sunday December 31, 2017 @06:27PM (#55840979)
      The point of those operations was not to heal people. It was to avoid a lawsuit. It is much better for a hospital or a doctor to put a patient forward for some treatment than to do nothing. That leaves them open to malpractice or negligence claims. And since they aren't the people paying, it makes no difference to them if the procedure works or does nothing.

      Avoiding a cost is just as good as making a profit, if someone else is paying.

  • Remember when this famous politician [youtube.com] claimed that doctors were cutting off limbs instead of employing more effective treatments to combat diabetics?

  • by known_coward_69 ( 4151743 ) on Sunday December 31, 2017 @01:45PM (#55839481)

    People want to destroy their bodies then run to the doctor looking for magic. Then they complain it costs money and doesn't fix the root issue and sue the doctors if they don't like the results

    • by whoever57 ( 658626 ) on Sunday December 31, 2017 @02:04PM (#55839565) Journal

      This simply isn't the real problem.

      Doctors in the US over-treat illnesses, use outdated and ineffective treatments and generally run up the costs of medicine.

      The above statement is based on my wife's treatment in the USA and in the UK.

      In my own case, I had a problem for which one of the treatments is surgery. I was referred to a hand specialist who only discussed the surgical option with me. When I asked about the alternative treatment that I had discovered using Google, his response was that he didn't do that treatment and I would have to see another doctor. Had I not researched it for my self, I would never have known that there was an alternative. That's on top of the fact that I had to pay for a completely useless consultation with the hand surgeon.

      Summary, even if you have good insurance in the USA, you may not be getting the best treatment.

      • by Shoten ( 260439 )

        This simply isn't the real problem.

        Doctors in the US over-treat illnesses, use outdated and ineffective treatments and generally run up the costs of medicine.

        The above statement is based on my wife's treatment in the USA and in the UK.

        In my own case, I had a problem for which one of the treatments is surgery. I was referred to a hand specialist who only discussed the surgical option with me. When I asked about the alternative treatment that I had discovered using Google, his response was that he didn't do that treatment and I would have to see another doctor. Had I not researched it for my self, I would never have known that there was an alternative. That's on top of the fact that I had to pay for a completely useless consultation with the hand surgeon.

        Summary, even if you have good insurance in the USA, you may not be getting the best treatment.

        Question...and this is a real question, not a retort, because I am curious. Did the alternative therapy work? I don't know what the problem was with your hand, or what the alternative to surgery was, and I could see this going either way.

        I see and hear all the time about alternatives to X or Y medical procedure, but usually I haven't seen them turn out so well. But on the other hand, I totally agree that a lot of doctors follow a narrow path and get a bit heavy handed with surgery and drugs. I think I'v

        • Question...and this is a real question, not a retort, because I am curious. Did the alternative therapy work?

          Absolutely, although there is a somewhat higher chance of re-occurrence with the treatment that I chose, but surgery involves risks such as nerve damage.

          Google Xiaflex.

          • Is Xiaflex not one of the standard procedures in the US? It's been approved as a standard procedure here in Sweden since 2011 due to overwhelming scientific evidence that it works.
            • by whoever57 ( 658626 ) on Sunday December 31, 2017 @03:07PM (#55839923) Journal

              It's approved, but the first doctor I consulted about my hand did not mention it as an option. That's my point: medicine in the USA is frequently bad.

              • by dmr001 ( 103373 )

                It sounds like the GP had Dupuytren's contracture, a common thickening of connective tissue in the palm, with a time course of years that can result in inability fo extend (unbend) one's fingers.

                As a primary care physician, I don't think I've yet referred anyone for surgery for this (in 17 years) and instead have people do stretching exercises, but surgery may make sense in severe cases. Collagenase injections (the Xiaflex referred to above)looks like it may be useful for patients who don't do well with s

        • At the end of the day, doctors are service providers...they are vendors. Just as with buying a car, a house, or even a pizza, you have to consider your vendor and choose wisely. The fact that they have all taken the Hippocratic Oath does not guarantee quality, intelligence or skill. The good ones are doing the best they can now, and always trying to improve the definition of "best." The bad ones can be lazy, narrow-minded, or just plain greedy.

          ...and for the greedy types, we need a system that sets up the incentives properly. This is not a solved problem, government-run or funded systems also have this problem in various forms. In ones where doctors work for a fixed salary or have a fixed budget (NHS-type system) the lazy ones will just seek to do as little work as possible since there is no monetary benefit to them in serving 5 vs. 10 patients in a work day for example. In systems where the prices of health services are fixed and doctors charge

      • by arth1 ( 260657 ) on Sunday December 31, 2017 @02:29PM (#55839695) Homepage Journal

        Doctors in the US over-treat illnesses, use outdated and ineffective treatments and generally run up the costs of medicine.

        Running up the costs is an inherent problem with for-profit medicine.
        The last time I went to a doctor, it was for a broken arm. They wanted to do full blood panel and urine tests and follow-up appointments for those. I asked them what for, and they said that they always had to do that if there weren't recent results on file. I asked whether it would change the treatment of the broken arm from a sling to something else, and the doctor said no, but it could discover unrelated issues. Well, I was not there for unrelated issues or to look for could.
        I ended up switching doctors, because of the money grab.

        Fuck the doctors and their affiliations.

        • by chooks ( 71012 )

          That's what being in a sue-happy environment will get you. If there was something more serious going on that a simple and cheap blood test can shed light on, and they missed it, the malpractice headline would be merciless. Generally you would only follow up on abnormal lab tests, but that distinction may not have been communicated (although for a broken arm you would have to have clinical follow up at some point anyways...unless you had another plan for managing your broken arm). As for lab testing, bel

      • In my own case, I had a problem for which one of the treatments is surgery. I was referred to a hand specialist who only discussed the surgical option with me. When I asked about the alternative treatment that I had discovered using Google, his response was that he didn't do that treatment and I would have to see another doctor.

        Wow, a hand surgeon that specializes in hand surgery? Wow, that's amazing... it's almost like he's a specialist, focusing on one particular field of study.

        Did you ask your general practitioner, the one that referred you to this hand surgeon about the alternative treatment? That would have been the doctor to ask.

        You could have cancelled the appointment with the surgeon and investigated alternatives first, but instead you decided the hand surgeon should be up on all alternatives and save you the trouble of ha

        • Neither my GP nor the first surgeon mentioned the Xiaflex alternative to me. As medical professionals, I expect that somewhere along the line, this options should have been offered without me having to ask for it. They are the professionals. They are the knowledgeable ones providing a service.

          As for the hand surgeon: do you think that I should have to research all the options for treatment, and ask his office if he can offer all of these treatments before my appointment? Really?

          No, you just have an expectat

          • by dmr001 ( 103373 )

            I think this is a good point: a good primary care clinician should provide a good gatekeeping service for referrals. We should refer you only when it's likely to help, and to a competent specialist. I do think some PCP's refer more than they should because they feel pressed for time and/or think that it's simply easier to send the patient for a specialist to give a more detailed opinion. That opinion can be blinkered, though.

            In my mind, competency for specialists includes knowing not just the full range

      • by rtb61 ( 674572 )

        Put simply, a system driven be nothing but greed will eat itself, after it has eaten everything else and die as a result, not sometimes but every fucking time. USA make no mistake you are now eating yourselves alive.

    • I've been through this with doctors. It's hard to find a good one. I started waking up with aches and stiff joints and went to a few to try it and get it solved. One told me it was a virus and the other did some more testing. Once they caught wind that I use a computer at various times throughout the day it was "carpal tunnel you need surgery". How about my stiff knees and limping down stairs? In the end I figured out my blood sugar was dipping while sleeping and causing the problem. Most doctors are lazy a

    • People want to destroy their bodies then run to the doctor looking for magic. Then they complain it costs money and doesn't fix the root issue and sue the doctors if they don't like the results

      What about people who *don't* want to destroy their bodies?

      What about people who try to take care of their bodies: aren't obese, exercise, and don't do drugs, smoke, or drink to excess?

      There's an *awful lot* of these people. I don't think the "destroy their bodies" crowd is quite as big as your implication "all people".

      And yes, I would like my doctor to fix the issue, which is what I expect from *any* expert I hire to fix a problem, and if they charge me lots of money and it doesn't fix the root issue then

  • Follow the money (Score:5, Informative)

    by mspohr ( 589790 ) on Sunday December 31, 2017 @01:46PM (#55839487)

    Unfortunately, we have an unrestrained free enterprise system for medicine in the US. Doctors have rigged the payment system (CPT codes) so that specialist procedures are reimbursed many times their worth in time and training. The result is that most doctors train to become specialists and focus on doing highly remunerated procedures such as those enumerated in this report. There is no effective regulation of these procedures and so as long as you're not killing a large number of patients, anything goes. It means big bucks for the doctors and hospitals (insurance companies pay but then just tack on their % O&P so they don't really care either).
    Of course, people pay more for inflated cost of medical care and insurance and taxes to subsidize the whole system. The result is that we pay about twice per capita what other developed countries pay for health care but end up with poor quality care (lower health indicators than most other developed countries).
    Totally corrupt system.

    • Just try blocking access to "Bleeding Edge Research" medical procedures and watch people get upset. We frequently hear news stories about people having to go to some third world country to get a "medical procedure" that heartless American doctors won't perform.
      • by mspohr ( 589790 )

        New (unproven) treatments are a different issue. There are good arguments for and against these.
        The issue highlighted here is that doctors are continuing to do procedures where there is no evidence of benefit (and, in many cases, evidence of harm). They do this, not because they are ignorant, but because they are greedy.

        • Why do insurance companies refuse new (unproven) treatments yet cover old (unproven) treatments as this article states?

          The article says that stents for heart problems are 'unproven' yet year after year people get the $11-40K procedure done, presumably paid for by their insurance company.

          • by mspohr ( 589790 )

            There is a defect in the regulation system.
            New unproven treatments are not covered until they are accepted. This typically only requires small safety studies and not effectiveness studies. This is to ensure patient safety.
            Old treatments are grandfathered in after their use has become common medical practice. Unfortunately, sometimes these treatments have not been rigorously studied and they are not effective or safe. The case of stents is illustrative. Stents came into common use after a few small studies s

    • if you don't want a stent then take care of your body so your blood doesn't clot up inside your arteries

      • by mspohr ( 589790 )

        As you point out, prevention is better than treatment.
        The problem is that people do get heart disease (diet, exercise, etc.), have chest pain and then go to the doctor who has a strong financial incentive to put in stents. He ignores the research we now have that stents don't work because his pocketbook depends on it.

    • Re: (Score:2, Interesting)

      Quite corrupt, I agree, but that has nothing to do with "unrestrained free enterprise", which we don't have. If we had that, health care provisioning would not be tied to employers and their selection of insurance plans due to government mandates and tax incentives that distort the market. If we had that, I could do proper comparison shopping for medical goods and services based on price and quality. If we had that, I could research what drugs would best treat my condition(s) and buy them without having to

      • by mspohr ( 589790 )

        It is unrestrained free enterprise. We need to add government regulations to certify which treatments are effective and will be reimbursed. We need to restrain free enterprise and that is government's job.
        As far as your comment on insurance goes, it's a bit difficult to follow. We do have free enterprise insurance markets where you are not forced to buy insurance from any particular provider. Any insurance company can sell you insurance.
        You have a good point about comparison shopping. It would be a better m

        • How is it unrestrained free enterprise when you agreed with at least some of the restrictions I listed? Government is really good at setting up bureaucracy, wasting lots of money in the process, but really bad at preventing bad things from happening.

          I agree that my argument about insurance wasn't the best; I'm not expert enough on the topic to put together a great argument quickly. I will say that the insurance model is there to mitigate risk, so it is not surprising that it does a bad job when it is transm

          • by mspohr ( 589790 )

            We need more government regulations to restrain the evils of unfettered free markets.
            People are demanding access to price information (and they are not getting it).
            The AMA doesn't regulate the practice of medicine. It is a trade union for doctors. They have no power to prevent people from practicing medicine without proper training. That is the government's job.

            • The government regulation catechism is common enough, but that doesn't make it true. And I believe we've already established that we aren't talking about an unfettered free market. I didn't even mention Medicare and Medicaid which are major market distortions.

              As long as most of the money goes though insurance, there is little incentive for providers to pay attention to the few demands for pricing information. There are exceptions, of course. Some providers have decided not to accept insurance and either pro

              • by dmr001 ( 103373 )

                The AMA isn't a trade union (they don't negotiate pay and benefits for physicians, and only 25% of US physicians are members). The AMA contracts with the feds to develop a list of the relative values [ama-assn.org] of chargeable medical procedures (which then get modified by insurance companies, who decided actual remuneration.

                The AMA does come up with a code of ethics [ama-assn.org], but ensuring US physicians meet acceptable standards of competency is up to your state or territorial medical board, which are all quasi-governmental e

            • by dmr001 ( 103373 )

              I agree with most of the foregoing. I am a primary care physician, and when people ask me for the prices of things —even when I'm able to spend 20 minutes downloading their formulary from some terrible website and then figure out the math of their deductible and out of pocket maximums I typically get it wrong. Every individual plan from every distinct insurance provider is structured differently, and the negotiated prices for the different billable procedures I do are considered (as I understand it)

    • Unfortunately, we have an unrestrained free enterprise system for medicine in the US. Doctors have rigged the payment system (CPT codes) so that specialist procedures are reimbursed many times their worth in time and training. The result is that most doctors train to become specialists and focus on doing highly remunerated procedures such as those enumerated in this report. There is no effective regulation of these procedures and so as long as you're not killing a large number of patients, anything goes.

      So what your saying is healthcare is hardly different from any other business. Getting forced to process patients in 1/3 a reasonable time while getting a consistent stream of complaints dosent doubt like my ideal job, it sounds like any production job. But to each thier own. This is what market pressure does to healthcare.

      • by mspohr ( 589790 )

        Yes, unfortunately you're right.
        Medicine is big business and is driven by money.
        The few idealistic people who went into it to "help people" are soon co opted by the money. They look for opportunities to bill more and work less... just like everyone else.

    • Doctors have rigged the payment system (CPT codes) so that specialist procedures are reimbursed many times their worth in time and training.

      The doctors didn't rig it. They're reimbursed far over cost because hospitals are required by law to treat emergency room patients regardless of ability to pay. Consequently, when you (with insurance) pay for a procedure, you're not just paying for your own procedure. You're also paying for the same procedure for the uninsured guy who was carted into the emergency r

      • by beckett ( 27524 )

        despite the numerous visits from Canada Health Services representatives

        Unless you are referring to Health Services in correctional facilities, There is no such federal governmental organization named "Canada Health Services".

        Additionally, In Canada, the responsibilities of healthcare management are devolved to the provincial government, not the federal government. I can't speak to any of your other anecdotes, but your Canadian info is incorrect.

      • by mspohr ( 589790 )

        Doctors (through their specialty societies) set charges. They have monopoly control of prices.
        The "free ER" treatment is a myth that has been debunked many times (GoogleIt).
        Lawsuits and malpractice insurance has been studied to death. It's only a rounding error in the high cost of medical care (your father's experience notwithstanding).

        • by dmr001 ( 103373 )
          Doctors (these days largely through their large, single or multi-speciality practices) in the US negotiate charges with each individual insurance carrier, each in a race to be bigger in order to exact more negotiating power. Or, more precisely, groups and hospitals come up with a "charge master" list of prices which is really just the start of negotiating tactics:
          • Medical group: We charge $590 for a checkup.
          • Insurance company: If you want access to the patients in our Sapphire Plus Horizons Extra plans, we'l
  • Damn stupid story (Score:5, Insightful)

    by Anonymous Coward on Sunday December 31, 2017 @01:51PM (#55839513)

    Stents WORK for heart disease - that’s proven and the story stupidly misleads it for click bait (and slashdot editors happily repeat)

    The study in question showed that stents don’t necessarily reduce heart pain in patients with narrowed arteries which is contradictory to the theories about how heart pain/disease work.

    Regardless a clogged artery will still kill you and a stent resolves that problem!

    More piss poor science “reporting”

  • by kenh ( 9056 ) on Sunday December 31, 2017 @01:52PM (#55839515) Homepage Journal

    The recent news that stents inserted in patients with heart disease to keep arteries open work no better than a placebo ought to be shocking.

    So we will suspend all stent treatments, save tremendous amounts of money AND survival rates will be EXACTLY the same?

    Sounds great - one question though, why are insurance companies reimbursing for these expensive, ineffective treatments? Perhaps there is evidence they are effective after all?

    • Why are they paying? It fits right in with their strategy: Provide what the market wants (not necessarily what patients need) and try to look useful doing it, to justify their continued existence and all the corporate welfare payments. It was probably calculated that "They denied my heart surgery!!" would hit them harder than just paying and jacking up their rates accordingly. Listen to any of their recent radio ads if you want it laid bare that they are spending serious money for nothing more than good PR.
      • Perhaps some highly-specialized doctors who only perform stent surgery kick a little extra back to the insurance company, for sending all that business their way. That sort of arrangement plays out all the time.

        Grow up - exactly howeould this happen, how would a stent doctor 'kick back' to the insurance company? Do they meet in a parking lot and hand over wads of cash? Are they sending crypto-currency back and forth?

        Just because you can imagine something doesn't mean "it happens all the time"...

    • by mbkennel ( 97636 )
      "Sounds great - one question though, why are insurance companies reimbursing for these expensive, ineffective treatments? Perhaps there is evidence they are effective after all?"

      Insurance companies are interested in reducing health care spending to exactly the same degree that casinos are interested in reducing gambling, and for the same reason.
  • by ravenspear ( 756059 ) on Sunday December 31, 2017 @01:56PM (#55839531)

    The medical literature clearly indicates that the US is one of the few western countries remaining that routinely extracts nearly all asymptomatic wisdom teeth.

    There is no medical reason why this is necessary unless the teeth are severely impacted or arranged in such a way that it is difficult to brush them.

    Yet wisdom teeth extraction is a huge multibillion dollar industry for the dentistry practice in the US.

    • Sure, but by the time you're in your teens, X-rays can give you a very good idea of whether or not you're going to have problems with your wisdom teeth down the road. In my case, I (with my parents' guidance) chose "wait and see" even though the doc said that I'd likely have wisdom teeth problems later on -- and I did, but not until age 40 (and then, only with two instead of all four they originally wanted to take out). The question is, essentially -- do you want to pull them before they're fully grown an
  • ....but the FDA evaluated these procedures and said they were effective and safe. No way that couldn't be the case. The government NEVER fucks anything up
    • Even if procedures are effective and safe doesn't mean there aren't alternatives that work better and are cheaper.

      For example, many diabetics can be helped by simply encouraging them to eat a low carbohydrate diet. Instead we recommend a low-fat diet, and prescribe medicines for the rest of their lives.

      • Even if procedures are effective and safe doesn't mean there aren't alternatives that work better and are cheaper.

        The abstract above compares $11-40K stent procedures to placebo, with identical outcomes. Identical. If an equally effective treatment for heart disease is a placebo, then the original treatment is ineffective...

        Of course, US insurance companies don't pay for unproven treatments, and almost every stent procedure in the US is covered by health insurance, so I find HUGE fault in this story.

        • by ceoyoyo ( 59147 )

          Of course US insurance companies pay for unproven treatments. They may delist coverage for treatments that are proven to be ineffective, although there's huge momentum there too. And there's always the fudge factor. Even greedy US insurance companies pay for lots of antibiotics for otherwise healthy people who get colds and annoy their physicians until they prescribe them.

        • by mspohr ( 589790 )

          US insurance companies pay for unproven treatments all the time. The only regulation is about safety, not effectiveness.

    • How wonderful is the libertarian way of thinking, where if a corporation is comitting fraud, the government is still the main culprit.

      • How wonderful is the libertarian way of thinking, where if a corporation is comitting fraud, the government is still the main culprit.

        How wonderful is the authoritarian way of thinking, where if a government assists thousands of corporations in committing fraud, the government isn't even part of the problem, and giving it more power is the solution.

    • You're one of those wackos I see

    • by ceoyoyo ( 59147 )

      Yeah, about that.

      The medical community only decided that doing randomized controlled trials (i.e. scientific ones) was necessary in the very late 80s. There was a LOT of resistance to that idea (what the hell do statisticians know about medicine?). Things take a while to ramp up, work the bugs out, etc. So treatments that were approved prior to the 90s-2010s (depending on how cynical you are) haven't necessarily been tested very well.

      Even then, some drug or procedure might be evaluated as generally safe,

    • Don't confuse 'safe' with 'effective' - avacados are a 'safe' treatment for heart problems, but not particularly 'effective'.

  • Wallet Biopsy. If you haven't heard of it, it's when a doctor evaluates your ability to pay and denies care. Remember, emergency rooms are only good for emergency care. A close family member experienced this when a doctor didn't order CAT scans that should have been done because the insurance was kind of crappy. If you've used any serious amount of care in the American healthcare system I can almost guarantee you've experienced this
    • that what really makes the practice a problem is the for profit insurance companies. See, if a Doctor orders a test and it comes up blank, the insurance company will refuse payment on the grounds that the test was unnecessary. Heck, they'll site studies like this one to back it up. Eventually, when the problem is so bad that any test will show it, they'll order the tests and begin treatment, often months or years too late. Basically, private (and tacit) 'death panels'

      The tacit part is important. Nobody
      • See, if a Doctor orders a test and it comes up blank, the insurance company will refuse payment on the grounds that the test was unnecessary.

        Doubtful - you have a very simplistic view of the way the health industry works.

  • by Vinegar Joe ( 998110 ) on Sunday December 31, 2017 @02:07PM (#55839593)

    Doctors call this situation "defensive medicine"..........When lawyers make the rules, everyone ends up paying.

  • It's odd that America tends to sustain its position as one of the best medical systems in the world

    These latest studies tend to confirm that it's simply the best at marketing the appearance of being one of the best.

    I guess if you're gonna be a bullshit artist, don't just be a good one. Be the motherfuckin' best.

    • by ceoyoyo ( 59147 )

      I don't think anyone says the US has one of the best medical systems in the world, except maybe the US. The WHO says you're #37, behind Costa Rica and ahead of Slovenia.

  • They could improve long-term survival without improving chest pain, which is a benefit as well...
  • Tell people they "deserve" healthcare services without having to worry about cost and they'll demand all sorts of needless things.

    Pay medical practitioners by the procedure and they'll find all sorts of reasons to waste someone else's money.

    Get government out of medicine and you might have people making rational decisions again.
    • by HiThere ( 15173 )

      Did you ever try negotiating payment with a broken arm?

      Even with good insurance I once had to negotiate coverage with a broken thumb, because the insurance didn't want to pay. Ever since then I haven't been happy to trust insurance companies, or any other group that has an incentive to not cover your medical problem. And I do recognize that such is essential. Your proposed solution seems to mean the in every medical situation you need to negotiate coverage, which is just about the worst possible approach

      • No, it means you
        1. Buy the coverage you need and not the coverage someone else tells you you need. As a man in his 30s, I don't need gynecological services, nor do I need breast cancer screenings. But the Obamacare Version 0 we have in Massachusetts says any health insurance I buy in the state must cover those services.

        2. Don't elect to have things you don't need. Your flu shot doesn't need to come from an MD, or even an RN. It can come from a trained monkey at less cost. Dentistry is a model here. Don't
        • by HiThere ( 15173 )

          I *HAD* the goddamn coverage I needed. I just needed to stand there bleeding while I tried to convince some damn office worker several states away that I had an injury that needed the coverage, and he appeared to be under pressure to decide that I didn't need it without knowing anything about the case. The insurance did, eventually, pay, but by god I'm not going to do anything to support that kind of system when I have a reasonable choice otherwise.

          • And what alternative is that? Stand there bleeding and negotiating with that same office worker several states away, except he's now a federal employee can't be fired and who's under pressure to cut *taxpayer* spending on the biggest and most expensive government program anywhere ever?
    • Tell people they "deserve" healthcare services without having to worry about cost and they'll demand all sorts of needless things.

      Yeah, most medical procedures are so pleasant to go through. In fact, I’d have a stent put in just for the heck of it, if only I could figure out how to get my insurance to cover it! And I’d get a c-section done, if only I were a woman!

  • Infant circumcision (Score:3, Interesting)

    by Stormwatch ( 703920 ) <rodrigogirao AT hotmail DOT com> on Sunday December 31, 2017 @03:19PM (#55839991) Homepage

    Pointless procedures? Infant circumcision comes to mind. Medically worthless, known to reduce man's sexual capacity, occasionally very destructive or even fatal. Without any doubt, it is a heinous violation of one's essential human right to bodily integrity.

  • by SlithyMagister ( 822218 ) on Sunday December 31, 2017 @03:51PM (#55840173)
    and not much else.
    I was hoping for a list of treatments and statistical comparisons of their outcomes.

    Best wishes for a peaceful, prosperous 2018,
  • by reboot246 ( 623534 ) on Sunday December 31, 2017 @04:44PM (#55840487) Homepage
    Doctors perform a LOT of tests and procedures simply as a guard against getting sued. Their malpractice insurance providers insist that the doctors cover their asses.

    I know several doctors personally, and one told me that slightly over half his cost of doing business (and medicine IS a business) was malpractice insurance. Next time you walk into a doctor's office, understand that whatever you pay to the doctor goes to rent, salaries, utilities, insurance, supplies, and some $$ to the doctor himself.

    It's been suggested many, many times that the solution to the rising cost of healthcare is tort reform or loser pays. Why won't anybody listen?
  • I read the article and agree with their argument that Americans are over-prescribed and over-treated relative to their ailments. However, I did not see a solution to this which would make a significant impact. I've also read about the Ornish study, which describes the results from the only diet known to prevent and revert heart disease. It's a shame that the notion of a low-fat, whole-plant-based diet is only now starting to get noticed in the media, but I am grateful to see it happening. Drs. John McD

    • I read the book "The Pleasure Trap" after seeing it recommended in a comment right here on Slashdot.

      The dietary advice inside is based on the works of Doctor Dean Ornish, so for those of you not familiar, here is the dietary advice:

      - No alcohol or tobacco

      - No meat or seafood

      - No added sugar

      - No added salt

      - No heated oils

      - No white rice or white bread

      - No exceptions, ever, under any circumstances.

      In addition to the above, the author recommends at least 10 hours of sleep every night.

      Just le

  • You can get a stent now and take your chance with the chronic process to follow, risk sudden death syndrome, or you can just fucking die right now. Well maybe not now, but soon. Youâ(TM)ll save a lot of money, however.

The following statement is not true. The previous statement is true.

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