My husband is always getting on me about the number of tabs I have open in my browser at any one time. I think one time I had more than 100 open.
Within the past few days, at least 10 of those tabs dealt with the same topic: medical tests and procedures that we either don’t need or that don’t work. There are simply too many for a single blog, so I’m focusing on one here and will write more about others in the coming days.
The lucky winner? Births.
Seems like an obvious medical procedure, doesn’t it? Baby is delivered when mom goes into labor or, if problems develop or mom goes over her due date, labor is induced. So why, as Kaiser Health News recently reported, are 10 to 15 percent of U.S. babies delivered early without medical cause, up to 40 percent in some hospitals?
Early delivery increases the risk that the baby will have feeding and breathing problems, infections, and developmental problems, requiring a stay in costly neonatal intensive care units. It also increases the risk that mothers will need caesarian sections (indeed, many of these births are scheduled c-sections).
Why the early deliveries? Convenience for mom and her doctor.
How to stop these elective early deliveries? Do what the South Carolina Medicaid program and BlueCross BlueShield of South Carolina did last year: Stop paying for them. Voila! As the Kaiser story reported and data from the quality organization Leapfrog showed, the rate of early elective deliveries in the state’s hospitals fell by half, from 19 percent in 2011 to 10 percent in 2012.
Massachusetts hospitals are also stepping up to the proverbial plate, with some banning–yes, banning–elective deliveries before 39 weeks.
You’d think women would be grateful for efforts to reduce the risk of costly and potentially deadly complications. But as one mom quoted in an article about the Massachusetts’ hospital ban said: “You’re already out of control of your body, so at least to know if you go to your doctor’s office and say, ‘Look, we’re at 37 weeks, and I feel like I’m ready . . .To know that I would have that choice would just make me feel better. But to take it away from me just adds to the pressure of being pregnant.”
How about the pressure of out-of-control health costs?
We need more insurers and hospitals to step up to the plate and stop paying doctors for unnecessary or ineffective procedures and tests. More doctors telling patients “no,” or, at the very least, refusing to provide the requested service. No, you cannot have an MRI for a headache. No, you cannot demand a procedure (like an induced birth) that is not only costly but dangerous. And if you still demand either, be prepared to pay out of pocket.
Watch this space in the coming weeks for more on just how much we waste in our healthcare system and how it’s not just the fault of the doctors–but ours, as well.