October 29, 2009
Yesterday’s report by Thomson Reuters on the real causes of excessive costs in the US healthcare system make interesting reading. Centre stage is over-treatment generated by a litigious culture which encourages patients to sue and, from that, doctors to perform tests and procedures, not because in their clinical judgement the patient needs them but because a good lawyer can suggest retrospectively that the doctor was less than competent by not performing such a test or procedure. The second largest source of wasted money was identified as fraudulent claims on Medicare, Medicaid and other dubious practices involving kick-backs to various parties to the system. They go on to suggest that all of this is at the expense of preventive medicine and effective investment in the management of chronic diseases such that the downstream cost of sorting these unmanaged patients out is massively inflated.
The targets for funding reform of the system are suppliers to the system, whether they are the medical technology industry or the hospital managers and insurance companies. As I have said before, the current proposals threaten to “kill the goose that laid the golden egg” and our industry, on both sides of the Atlantic (and elsewhere in the world) must do a better job of demonstrating that we are part of the solution to the challenge of sustainable healthcare rather than the source of the problem.
Do the US challenges identified in this report translate to the European environment? Probably not. There is waste in Europe due to inefficient systems and obsolete practices but doctors in Europe are, by and large, treating patients based on their professional judgement of needs rather than with the thought of a future court appearance in mind. Long may that remain, and for any persons tempted to import US legal practices into Europe, let them dwell on the consequences and costs of the American system in which litigation is field sport.
John WilkinsonAuthor : MedTech Europe