It's not helping our health

Over-testing, over-medicating and over-diagnosing people—turning them into patients in need of treatment—has not improved the health of Americans. The Department of Health and Human Service’s program, called “Healthy People 2010,” reported that, between 1999 to 2002, healthy life expectancy (the number of years Americans live free of disease) had fallen from 48.7 to 47.5 years. People have gotten sicker. On top of that, unnecessary tests add an estimated $150 billion each year to the health care budget.

Americans spend more than $2.5 trillion on health. Are we getting our money’s worth? Hardly. The United States ranks forty-fifth in life expectancy, behind Bosnia and Jordan. We also rank near last in infant mortality compared with other developed countries. And, according to the Commonwealth Fund, a health care research group, we rank last place in health care quality, access, and efficiency among major industrialized countries.

What’s more, areas of the country that have the most doctors also have the most per capita utilization of doctors’ services and testing. (In one New Jersey hospital, Medicare beneficiaries will see on average seventeen physicians and receive more than fifty physician visits during the last six months of their lives.) But here’s the thing: health care expenditures don’t translate into better outcomes. In fact, health outcomes in the highest-spending regions of the country may be worse, mostly because of the negative results of hospital stays.

It’s true that the average lifespan of people in the US has, since 1900, lengthened by greater than 30 years. But, according to the U.S. Centers for Disease Control, most of this gain (25 years) is attributable to advances in public health, such as sanitation. Of the remaining five years’ increased longevity, 18 or 19 months is attributable to preventive care, such as immunizations and blood pressure checks; and the final 44 to 45 months is attributable to medical care for illness, such as heart attacks, trauma, and cancer treatment.  Remember, this longevity increase is for the entire 20^th century.

Next week: Why I refuse to have my cholesterol checked.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.