We want the best and we want it now! As The New York Times reported today (A Hurdle for Health Reform: Patients and Their Doctors, Mar 3, 2009), what fundamentally drives the costs in America's health care system is the desire on the part of doctors and patients for the best--meaning the costliest to most--new treatments and medicines. It doesn't matter if the upside is slim to none. Stick a high price on something and a few slick ad pages and Bam ! you've got a winner on your hands. Ever check out the number of beta-blockers out there? How about ACE inhibitors? Gazillions and none of them work appreciably better than the first ones out of the block twenty-five, thirty years ago. The Times cited a 2004 study (published in The American Journal of Public Health) that showed that only 1 in 16,000 people benefited from recent technology as regards their health. Today I finally convinced someone not to bother with Tamiflu for her daughter. Was I being too harsh? You decide. Her...
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