[PHNUTR-L] UCLA expert blames American values for health-care crisis

[Kathrynne Holden]

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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 at mednet.ucla.edu
310-794-2272
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 David 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."

###

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).
-- 
Kathrynne Holden, MS, RD
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
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