Monday, March 26, 2007

More on Angioplasty

The Washington Post’s Rob Stein writes about angioplasty and its effectiveness:

The study of more than 2,000 patients found that those who underwent the expensive procedure, known as angioplasty, in non-emergency situations were no less likely to suffer a heart attack or die than those who only took aspirin and other medicines to thin their blood and lower blood pressure and cholesterol, along with adopting life style changes.

I have written on this topic before. This article gets my hopes up in the possibility that the US can start to turn the corner on being able to bring healthcare costs lower. If we can continue to find out what procedures are not worth it under certain circumstances, then maybe doctors can continue to prescribe less costly procedures. However, as Arnold Kling has said many times before, doctors don’t always have an incentive to tell their patients to take a less costly approach. This is especially true if their patients are insistent on having a certain procedure because they simply believe in only the latest and greatest. If the procedures had more of an impact on what we pay, then maybe healthcare consumers would be more discouraged from unnecessary procedures.

Maybe, for angioplasty, if the procedure weren’t done immediately after a heart attack (after 12 hours, angioplasty is not much more affective than other less costly treatments) but much later, the patient would have to pay more. The problem with that though is that we don’t even know if it was the patient’s call, so why should we make them pay for it. As I said before, the doctor doesn’t have much incentive either way in terms of costly procedures. But all that might change so long as these studies continue to prove that costly procedures aren’t always the most effective.

2 comments:

Emily DeVoto, Ph.D., said...

Actually I think it's the doctors who should get reimbursed less with increasing time from diagnosis! That would be a rather extreme form of pay-for-performance, wouldn't it? Personally I am convinced that it's the docs who are driving overuse of angioplasty, since they get a lot of profit from it.

Anonymous said...

i don't know... the idea of playing balloon time inside your veins is pretty sweet....