Critical Condition

Empowering Patients Is Good Medicine

Presumably the whole point of health-care reform is to cover the uninsured in a cost-effective manner. Yet while supporters of the 1,000-plus-page, multitrillion-dollar legislation floating around Congress talk about the fantasy savings that will come from eliminating fraud and abuse (fantasy savings that have been touted for 40 years), they say nary a word about practical approaches to money-saving.

A few such practical approaches can be found in a recent (and excellent) Wall Street Journal article by Melinda Beck. The article asks, “What cures colds, flu, sore throats, sore muscles, headaches, stomach aches, diarrhea, menstrual cramps, hangovers, back pain, jaw pain, tennis elbow, blisters, acne and colic, costs nothing, has no weird side effects and doesn’t require a prescription?”

To some readers, this miracle cure may sound too good to be true, but I can assure you it’s not a trick question. Want a hint? Fine, I’ll just tell you: It’s . . . time. As Beck points out, most infections of the nose, throat, upper respiratory tract, and stomach are viral infections that do not respond to antibiotic treatment. These infections will resolve themselves with time. Antibiotics have no effect on clinical course except for exposing patients to possible side effects and potential antibiotic resistance.

Beck emphasizes that while time can be quite efficacious for many patients, it can also often be a tough pill for many to swallow. Patients want a quick fix. They seek the latest medications and the most technologically advanced treatment on the market. They do not want a provider that echoes their grandmother’s prescription of two aspirins and a hot bath. Refusing to give a patient an unneeded treatment may be good medicine, but it is not a good way to build a practice. Indeed, it actually can cause doctors to lose business, because some patients are hell-bent on receiving medication and will simply go to the MD across the street who will write the script.

Dartmouth Atlas researchers believe that one-third of the $2.4 trillion spent on health care in this country is wasteful spending. Other estimates place that amount even higher. Both sides of the political aisle contend that health-care costs are rising too rapidly and support reform, but they differ vastly on cost-control measures. Democrats support a public-plan option coupled with comparative-effectiveness research. This one-size-fits-all approach will establish clinical guidelines and dictate to patients by government fiat the procedures and treatment that they (the patients) can and cannot have. Down the line, it is possible that doctors will be punished financially or criminally for not following these mandates.

While liberals want to empower bureaucrats, conservatives want to put patients in charge. By too often isolating patients from the true price of health care, the current employer-provided insurance system has resulted in ballooning costs. Conservatives have proposed ideas such as expanding Health Savings Accounts, tort reform, a national market for health insurance, and tax deductions for individuals to buy health insurance as ways to give patients more skin in the game. These measures will make patients more sensitive to health-care costs, and thus make them more cost-conscience consumers. This approach will make patients more receptive to cheaper, commonsense solutions such as time and innocuous symptomatic therapies. Ultimately, it will allow medical decisions to be made by patients and doctors, not by President Obama and his army of bureaucrats.

– Jason D. Fodeman, M.D., is a former health-policy fellow at the Heritage Foundation.

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