More Technology, Higher Costs

We have a slavish reliance on technology to get us out of fixes. It’s almost an irrational belief system. We’re counting on technology to fix global warming, inefficient automobiles, to cure diseases and so on. But in our patent-bound world technology may not be the answer to all our problems and may actually costs without changing anything.

President Obama seems to think technology is the answer to our medical non-system’s problems. For example, integrated electronic medical records are a technological tour de force. They improve communication between physicians and marginally makes life easier in the paperless physician’s office, but do they improve patient care? That remains to be seen. The cost of the new technology, however, is tremendous both for the initial installation and the yearly maintenance. Guess who gets to pay? Savings, I doubt it.

Scientific American has doubts as well and cites this article in Health Affairs by Lawrence Baker. The abstract notes;

“As anticipated by previous research, increases in the supply of technology tend to be related to higher utilization and spending on the service in question. In some cases, notably diagnostic imaging, increases in availability appear associated with incremental utilization rather than substitution for other services.”

Consider PET scan technology. This diagnostic test does add to our information for certain cancers at a cost of $5000/test. Previously a patient had a CAT scan and/or MRI to image the tumor. With the advent of the PET, we now, in many instances, do all three. Figuring about $1000 for the CAT scan, an average of $2000 for an MRI and $4000-$6000 for an MRI, the cost of imaging alone today exceeds what it cost for the entire treatment, including surgery, 25 years ago. It’s debatable whether patient outcomes (survival) are better but what is not debatable is that costs are higher. We need better guidelines for use of these procedures.

The same can be said for other technology in the medical field, including new drugs. Their use may not improve outcomes but they will increase costs. This has to change.

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