That's what Atul Gawande thinks. His most recent article in The New Yorker discusses how it is lowering the incidences of excessive services, which are a major factor in our having the highest medical costs in the world. Some examples: doing an EEG for an uncomplicated headache (EEGs are for diagnosing seizure disorders, not headaches), or doing a CT or MRI scan for low-back pain in patients without any signs of a neurological problem (studies consistently show that scanning such patients adds nothing except cost), or putting a coronary-artery stent in patients with stable cardiac disease (the likelihood of a heart attack or death after five years is unaffected by the stent).
"In 2010, the Institute of Medicine issued a report stating that waste accounted for thirty per cent of health-care spending, or some seven hundred and fifty billion dollars a year, which was more than our nation’s entire budget for K-12 education. The report found that higher prices, administrative expenses, and fraud accounted for almost half of this waste. Bigger than any of those, however, was the amount spent on unnecessary health-care services."
Each year do we really need to have around fifteen million nuclear medicine scans, a hundred million CT and MRI scans, and almost ten billion laboratory tests.
Gawande recognizes that simply eliminating unnecessary care is not enough. We need replace it with necessary care.
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