"if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs."
Now here's my confusion: There are several reasons advanced for the need for health care reform, the primary of which are generally:
1) Millions of uninsured or under-insured Americans
2) Soaring premiums
3) The refusal of health insurance companies to authorize necessary tests, treatments, or hospital stays.
Number three accounts for [by my rough estimate] nearly 75% of the anecdotal horror stories about health care in America: refusing meds, nixing treatments, demanding that you leave the hospital early.
But it was Tom Baker in his highly regarded The Medical Malpractice Myth who argued that neither HMOs nor malpractice threats are causing physicians to order too many tests or engage in too many procedures. Instead, Baker argues, there actually aren't enough tests or procedures being done:
There is lots of talk about the heavy burden that “defensive medicine” imposes on health costs, but the research shows this is not true.
Yet what Mr. Obama appears to be advocating is fewer tests, fewer procedures, and fewer hospital stays.
I realize that he is making the best practices argument, but it seems to me that there is an inherent contradiction in his position.
Maybe it's just me.