UCLA expert blames American values for health-care crisis

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Public release date: 4-Dec-2008

http://www.eurekalert.org/pub_releases/2008-12/uoc--ueb120408.php

Contact: Elaine Schmidt

eschmidt@...

University of California - Los Angeles

UCLA expert blames American values for health-care crisis

Reforming the system will require strong medicine, tough choices

To heal our ailing health care system, we need to stop thinking like

Americans. That's the message of two articles by UCLA's Dr. Marc Nuwer,

a leading expert on national health care reform, published this week in

Neurology, the journal of the American Academy of Neurology.

" Americans prize individual choice and resist limiting care, " says

Nuwer, a professor of clinical neurology at the Geffen School of

Medicine at UCLA. " We believe that if doctors can treat very ill

patients aggressively and keep every moment of people in the last stages

of life under medical care, then they should. We choose to hold these

values. Consequently, we choose to have a more expensive system than

Europe or Canada. "

Consider these statistics:

* The United States boasts the world's most expensive health care

system, yet only one-sixth of Americans are insured. Medical

expenditures exceed $2 trillion annually, making health care the

economy's largest sector, four times bigger than national defense.

* By 2015, the U.S. government is projected to spend $4 trillion on

health care, or 20 percent of the nation's gross domestic product.

* An aging population will boost spending. Half of Medicare costs

support very sick people in their last stages of life, and experts

estimate that Medicare funds will be exhausted by 2018.

* 31 percent of U.S. health care funds go toward administration.

" We push a lot of paper, " Nuwer says. " We spend twice as much as Canada,

which has a more streamlined health care system that demands doctors

complete less paperwork. "

* 10 percent of U.S. expenses are spent on " defensive medicine " —

pricey tests ordered by doctors afraid of missing anything, however

unlikely. " Doctors don't want to be accused in court of a delayed

diagnosis, so they bend over backwards to find something — even if it's

a rare possibility — in order to cover themselves, " Nuwer says.

Reforming the U.S. health care system with the goal of providing

universal, affordable, high-quality care will require rethinking our

overall values and paying greater attention to care-related

expenditures, according to Nuwer.

Part of the current problem, he says, is that doctors are oblivious to

the price tags of options they're prescribing for patients. He

recommends educating physicians about the costs of care, including

imaging, blood tests and specific drugs.

" Does a fancy electric wheelchair cost $500 or $50,000? " Nuwer asks.

" Most doctors have no clue. We need to give physicians feedback about

the dollar signs behind their orders. "

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Nuwer's co-authors on both articles include Dr. G.L. Barkley (Henry Ford

Hospital, Detroit); Dr. G.J. Esper (Emory University School of Medicine,

Atlanta); Dr. P.D. Donofrio (Vanderbilt University School of Medicine,

Nashville); Dr. J.P. Szaflarski (University of Cincinnati Academic

Health Center); and Dr. T.R. Swift (Medical College of Georgia, Augusta).

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

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