It was for $1,877, and it’s emblematic of our health care spending mess
(NEWSER) – “Overuse” may seem like a benign word, and that’s kind of the problem. In its latest piece on health care waste, ProPublica defines overuse as an umbrella term for a type of waste that includes things like unnecessary tests or surgeries. And it kicks things off with an extreme example: that of Margaret O’Neill, whose 5-year-old was scheduled for an outpatient procedure at Children’s Hospital Colorado that involved snipping a band of tissue under her tongue. The surgeon suggested that, as a treat, the girl’s ears be pierced while she was under. O’Neill agreed, expecting it to be a sweet freebie. Then came the bill: $1,877.86 for “operating room services” tied to the piercing. She fought the bill, which insurance wouldn’t cover, and ultimately prevailed. (The kicker: One hole was askew, so it was repierced at the mall for $30.)
ProPublica dishes up a bigger number: About $210 billion is spent annually on unneeded procedures or ones that are expensive when a cheaper one could do. It gives a long example involving a 34-year-old with a history of noncancerous breast cysts who needed to rule out cancer; doing so involved a mammogram and three ultrasounds, as well as draining her cysts and sending the clear fluid to pathology. Her bill was $2,361. She viewed a lot of it as unnecessary, but her efforts to fight it failed. Experts ProPublica spoke with had varying opinions, but in general they agreed fewer procedures would have sufficed. There are often multiple options for care, patients can’t really shop by price, and it’s often unclear what’s discretionary. Says one doctor, “It’s sort of this perfect storm where no one is really evil but the net effect is predatory.” Read the full piece here.