Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel. He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together.
Lena Wright’s best friend was hunched over like a character from a French novel, with spinal bones so thin they would fracture with a fit of sneezing. Determined to avoid that fate, Wright (a pseudonym) asked her primary care doctor to test her for osteoporosis with a DEXA scan, also known as dual energy x-ray absorption. The scan would send two x-ray beams through her bones, one high-energy and the …
Health care is often really costly. And with increasing frequency, a significant chunk of those costs is being passed on to patients in the form of high deductibles, copays, or other out-of-pocket expenses. As a result, millions of Americans struggle to pay medical bills each year.
What’s a poor patient to do?
For starters: They can talk to their doctors about these costs. According to a study my colleagues and …
The United States far outspends peer countries on health care. When American politicians complain about these high health care costs, they often vilify pharmaceutical and insurance companies for profiting at the expense of the general public. As I wrote earlier, such vilification is misguided, pushing too much of the blame on individual actors rather than on the system that incentivizes individuals to act those ways.
So what it is …
She came to the urgent care center with a sprained ankle. The primary care provider gave her excellent care, expertly applying evidence-based evaluation guidelines to her situation, and, thereby, avoiding unnecessary x-rays. By all measures, the provider’s care was excellent, but the interaction still ended up reducing his salary. You see, that patient’s only medical interaction that year was for this ankle sprain, and the provider was therefore held accountable …
Cancer drugs have become increasingly expensive in recent years. No one blinks anymore when a new lung cancer or colon cancer treatment comes to market priced at more than $100,000 per patient. In part, we don’t blink because we have simply gotten used to such prices — the shock has worn off.
Moreover, many of these new treatments are targeted therapies that only work for patients whose cancers express specific mutations, …
If she had been eligible for Medicare, the hospital would have charged the government $10,000 for the services it provided to her, with Medicare picking up most of the tab. But lacking insurance, she was billed directly from the hospital, and not for a mere $10,000. The total charge: $120,000!
That 1,200 percent markup is extreme. But out of the 50 U.S. hospitals with the largest price markups, 49 are for-profit …
The federal government is currently debating whether the big six health insurance companies in the U.S. will soon become the big four. Aetna and Humana have announced plans to merge, as have Anthem and Cigna. The American Hospital Association and the American Medical Association strongly oppose the mergers, saying they will reduce competition in consumer markets.
Meanwhile, health care provider groups continue to consolidate. Small hospitals either get swallowed up by …
Karen Vogt’s breast cancer journey began like many others, with her breasts painfully squeezed into a mammography machine. At age 52, it was far from her first mammogram, but this scan would be the most consequential by far. It revealed microcalcifications, little areas of breast tissue speckled with deposits of calcium that her radiologist worried were suspicious for a nascent cancer, especially since these specks hadn’t been so conspicuous twelve …
California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how health care consumers, otherwise known as …
Paying someone to mow your lawn is a pretty straightforward affair. Ryan the lawn guy will look at the lawn size and maybe the hilliness of your yard, and you’ll settle on a price for mowing and trimming it. When you decide to contract for Ryan’s services on a more regular basis, payment might get a little more complicated. If you pay Ryan every time he mows your lawn he …
If you were a cancer center trying to get patients to come to receive care at your facility, what message would you send them? In other words, what would you as a cancer center director think people would value in choosing a place to receive cancer care?
One way to answer this would be to survey cancer center directors. You could conduct face-to-face interviews or written surveys. You could hold focus …
Can beliefs make you fat?
The answer to this question might seem pretty obvious. If I believe that the best way to lose weight is to super-size five meals a day at McDonald’s, while consuming bags of Doritos to tide me over between meals, that belief is probably going to make me fat. If I believe that the best way to get in shape is to watch other people exercise, I’m …
In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not through the sheer volume of their sales, but as a result of their staggeringly high …
It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under the trade name Capoten. After making a fortune for the company, captopril went generic in 1996. …
Cholesterol pills are one of the great medical advances I’ve witnessed during my professional career. I am talking specifically about a category of medications called statins, drugs like Lipitor and Pravachol. These drugs have prevented probably hundreds of thousands of heart attacks and strokes. Only one problem with these drugs, however: statins won’t help people who don’t take them. And according to a study in the Annals of Internal Medicine, when …
Two problems loom large over the American medical care system. First, we spend outrageous amounts of money on health care, with too many patients receiving too many services at too high a price. Second, our malpractice system is an international embarrassment, with too many health care providers sued by too many patients for too little reason.
Many experts have pointed out that these problems are two sides of the same coin. …
It is an oft-recited paradox that Americans like the men or women representing them in Congress while hating Congress as a whole. In fact, respect for Congress is near all-time lows. In what has to be seen as a bad sign for the medical profession, people’s attitudes towards physicians are beginning to look downright Congressional.
Most Americans like their doctors, with surveys …
India is not, yet, a wealthy country. Nevertheless its people experience many of the same expensive-to-treat illnesses as wealthier populations in the U.S. and Europe. Therefore, the country has made a series of policy decisions designed to lower the cost of medical treatments.
For example, until 2005, it offered no — I repeat, no — patent protection for pharmaceutical products, thereby spurring the development of its robust and relatively inexpensive generic …
Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal?
As it turns out, this lack of satiety is not merely a function of the …
So many foods beckoning us from the grocery store shelves — but which ones are healthy for us to consume? We could study nutritional facts labels, but that feels as challenging as the math portion of the SAT, with so much numerical information to process. The label tells us how many calories are in the food in question — how many grams of protein, how many grams of fat, and …
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