extract from an article on reducing medical costs by Geroge Lundberg.
>
> "
> Seven Ways to Reduce Unnecessary Medical Costs -- Right Now! >
>
> An alliance of informed patients and physicians can widely apply recently
> learned comparative effectiveness science to big-ticket items, saving vast
> sums while improving quality of care.
> 1. Intensive medical therapy should be substituted for coronary artery
> bypass grafting (currently around 500,000 procedures annually) for
> many patients with established coronary artery disease, saving many
> billions of dollars annually.
> 2. The same for invasive angioplasty and stenting (currently around 1
> million procedures per year), saving tens of billions of dollars
> annually.
> 3. Nonindicated prostate-specific antigen screening for prostate cancer
> should be stopped. Radical surgery as the usual treatment for most
> cases of prostate cancer should also cease because it causes more
> harm than good. Billions saved here.
> 4. Screening mammography should be stopped in women younger than 50 who
> have no clinical indication and sharply curtailed for those over 50,
> because it now seems to lead to at least as much harm as good. More
> billions saved.
> 5. Computed tomography and magnetic resonance imaging scans are
> impressive art forms and can be useful clinically. However, their
> use to guide therapeutic decisions is unnecessary much of the time.
> Such expensive diagnostic tests should not be paid for on a
> case-by-case basis but could be bundled together with other
> diagnostic tests by some capitated or packaged method that is
> use-neutral. More billions saved.
> 6. . We must stop paying huge sums to clinical oncologists and their
> institutions for administering chemotherapeutic false hope, along
> with real suffering from adverse effects, to patients with
> widespread metastatic cancer. More billions saved.
> 7. Death, which comes to us all, should be as dignified and free from
> pain and suffering as possible. We should stop paying physicians and
> institutions to prolong dying with false hope, bravado, and
> intensive therapy that only adds to their profit margin. Such
> behavior is almost unthinkable and yet is commonplace. More billions
> saved.
>
> "
> Seven Ways to Reduce Unnecessary Medical Costs -- Right Now! >
>
> An alliance of informed patients and physicians can widely apply recently
> learned comparative effectiveness science to big-ticket items, saving vast
> sums while improving quality of care.
> 1. Intensive medical therapy should be substituted for coronary artery
> bypass grafting (currently around 500,000 procedures annually) for
> many patients with established coronary artery disease, saving many
> billions of dollars annually.
> 2. The same for invasive angioplasty and stenting (currently around 1
> million procedures per year), saving tens of billions of dollars
> annually.
> 3. Nonindicated prostate-specific antigen screening for prostate cancer
> should be stopped. Radical surgery as the usual treatment for most
> cases of prostate cancer should also cease because it causes more
> harm than good. Billions saved here.
> 4. Screening mammography should be stopped in women younger than 50 who
> have no clinical indication and sharply curtailed for those over 50,
> because it now seems to lead to at least as much harm as good. More
> billions saved.
> 5. Computed tomography and magnetic resonance imaging scans are
> impressive art forms and can be useful clinically. However, their
> use to guide therapeutic decisions is unnecessary much of the time.
> Such expensive diagnostic tests should not be paid for on a
> case-by-case basis but could be bundled together with other
> diagnostic tests by some capitated or packaged method that is
> use-neutral. More billions saved.
> 6. . We must stop paying huge sums to clinical oncologists and their
> institutions for administering chemotherapeutic false hope, along
> with real suffering from adverse effects, to patients with
> widespread metastatic cancer. More billions saved.
> 7. Death, which comes to us all, should be as dignified and free from
> pain and suffering as possible. We should stop paying physicians and
> institutions to prolong dying with false hope, bravado, and
> intensive therapy that only adds to their profit margin. Such
> behavior is almost unthinkable and yet is commonplace. More billions
> saved.
