Add easy profits from needless tests to defensive medicine and no cost controls or real competition, and we have the perfect formula for waste, fraud, profiteering, bad medicine and dysfunctional, unaffordable healthcare.
Why is sickcare (a.k.a. “healthcare”) absurdly unaffordable in America? There are many structural reasons which I have covered in depth for years, but one that most of us can relate to from personal experience is needless, hyper-costly scans and tests.
Even those of us who have never had a CT or MRI scan (and I hope I never will) know the drill from friends and family: practically every injury is now scanned by one device or another at enormous expense–not for treatment, as M.D. Ishabaka explains, but as defensive medicine to ward off future lawsuits or in response to patient demands.
Ishabaka (M.D.) walks us through the maze of CT and MRI by using his own injuries and treatments as examples of how our system has become unaffordable and ineffective.
“When I first got into the hospital as a medical student in 1977, MRI scanners did not exist, and the Royal Victoria Hospital in Montreal had the first CT scanner in Canada. A scan took an hour, and the images were blurry as heck, compared to modern scanners which take a few minutes and produce crystal clear images – but it was MAGNIFICENT. All of a sudden, we could see brain problems that could only be seen by operating, or doing a cerebral angiogram – a good but somewhat dangerous test (up to 3% of patients who have one suffer a stroke caused by the test).
When used appropriately, CT scans save lots of money and lives. One example is head trauma. Most people who are knocked out just have a concussion, but a few have bleeding either around or inside the brain that will kill or permanently disable them unless they are operated on ASAP.
In the old days, just when I was starting practice, most hospitals did not have a CT scanner. People who had been seriously knocked out were ALL admitted to the hospital for “neurological observation” – a nurse would check on them every hour to see how alert they were.
Two problems with that: for most patients it was a total waste of time and money (and hospitalization is way more expensive than a CT scan), and for some with a bleed – it wasn’t detected until too late.
