BTW, Speaking about justice…

Why Health Care Costs So Much

Posted on: February 2, 2010



Read Chaos and Organization in Health Care by James Mongan and Thomas Lee, both doctors. Mongan is the recently retired head of Partners HealthCare System in Boston, and Lee is a senior manager. Partners is a network of two Harvard-affiliated teaching hospitals, six community hospitals and 6,000 doctors. From personal experience and studies, Mongan and Lee describe an increasingly fragmented system that often raises costs and lowers quality.

A typical primary-care doctor has 2,500 patients and works 50 to 60 hours a week. By some surveys, doctors have increased the time they spend with individual patients; but it often feels like less because there is “so much more to do than a generation ago,” Mongan and Lee write. Paradoxically, medical “progress”—better diagnostics, drugs and treatments—fosters “chaos” by increasing specialization. Information-sharing becomes harder, and patients find the system more impersonal. A typical Medicare recipient sees seven doctors in a year. In 1986, almost half of internists performed treadmill tests in their offices; by 2004, only 29 percent did. Tests had shifted to cardiologists.

Hospitals and outside doctors often don’t coordinate. One study found that two-thirds of patients leave the hospital without proper “discharge summaries” detailing tests and drug treatments. In early 2008, fewer than 20 percent of doctors used “electronic medical records” in their offices. High start-up costs were a major obstacle.


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Lishia Erza

Searching for answers about life, these are the ones I have found.

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