Health Care Cost

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Consumers Don’t View Curbing Costs As Their Job in Treatment Choice

by Michelle Andrews, Kaiser Health News

Consumers don't want to factor costs into their health care decisions (Alex E. Proimos/flickr)

Consumers don’t want to factor costs into their health care decisions (Alex E. Proimos/flickr)

In recent years, consumers have increasingly been encouraged by employers and insurers to help control rising health care costs. That may be by avoiding unnecessary tests, buying generic drugs and reducing visits to the emergency room, among other things. The hope is that a patient better educated and more engaged in health decisions will choose options that will promote better health and decrease costs.

Such “patient engagement” efforts assume that patients welcome the opportunity–or at least are willing–to get more involved in their own care. But as a study published last month in the journal Health Affairs found, a majority of patients didn’t want to factor costs into their medical decisions, nor did they want their doctors to do so.

“One of the beliefs people expressed was that you get what you pay for, that more expensive care is by definition better.”
The study investigated the attitudes of focus group participants in Washington, D.C. and Santa Monica, California. They were asked about weighing their own out-of-pocket costs and the costs borne by their insurer in medical decisions. The participants, researchers said, did not generally understand how insurance works and felt little personal responsibility for helping to solve the problem of rising health care costs. They were unlikely to accept a less expensive treatment option, even if it was nearly as effective as a more expensive choice.

Study co-author Susan Dorr Goold is a professor of internal medicine and health management and policy at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. Dorr Goold says her team was surprised at how frequently people talked about not wanting cost considerations to factor into decision-making at all.

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Who Should Pay for Lung Cancer Screening?

A CT imaging system. (Derek K. Miller: Flickr)

CT imaging system. (Derek K. Miller: Flickr)

Looking for unique ways to spend your money? Straight outta Compton this week, an announcement: CT scans available at a local medical center for people who are at risk for lung cancer. Cost is $295.

Or, if you live near San Jose, you can walk into a free-standing imaging center that will charge you $349, but according to the center’s website, “check for promotional pricing.” The private imaging center started offering this test six years ago, even though the test was only validated by the medical community last year.

CT — Computed Tomography — is a type of powerful X-ray that makes 3-D images. It has been successfully used since the 1970s to visualize structures inside the body, including abnormalities like tumors. These exams are usually painless.

Only some insurers cover the scan. The rush to provide the test was reignited in June with the publication in JAMA of findings from several studies. There was good news, for sure: as previously reported the National Lung Screening Trial (NLST) showed that lung cancer deaths could be reduced by 20 percent by screening people at high risk — mostly those with a serious cigarette addiction. Continue reading