By David Martin, president and CEO of VeinInnovations
The United States now spends close to 18% of our GDP on healthcare, a cost that is unsustainable. If our results were perfect, it would be worth the money, but sadly, our system is not without flaws. We pay more than almost any other country, yet statistics that measure health, such as mortality rates and lifespan, are often lower than countries that spend less than we do. Why?
One culprit is our tendency to test first and ask appropriate scientific questions later. Yesterday, the New York Times published an op-ed by H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. Welch posed a question that’s been stirring up medical circles recently – what tests aren’t working, and why are we still paying for them?
Much maligned in recent months is the standard Prostate-Specific Antigen (PSA) test. Until 2009, around 30 million American men took a PSA test each year, at a cost of about $3 billion. A couple years ago, my own PSA test was elevated, and my urologist recommended a biopsy. I choose to wait. Prostate biopsies come with their own set of risks, such as incontinence, impotence, infection, and nerve damage. I took the test again six months later, at which time my levels had returned to normal and no action was necessary. In response to the Times article, a Forbes contributor, Dan Munro, showed the Harding Center for Risk Literacy’s graphic showing the effects of the PSA test on mortality.
I realize that these results are still controversial. Some men have been saved by getting the results of their PSA test, but the data shows that overall the test is not a worthy measure. Welch’s op-ed asks why we don’t put more energy towards researching what works. It could raise our health as a whole, and stop us from wastefully spending our dollars on treatments and tests that don’t help. The Affordable Care Act does establish The Patient-Centered Outcomes Research Institute (to study the comparative effectiveness of different treatments) but it is already underfunded, according to Welch.
In our search to improve outcomes and lower costs, evaluating standard practices could help us in our goal.