by TARA PARKER-POPE
A few years ago, my daughter sprained her ankle at dance camp. What happened next offers a glimpse into some of the problems in our nation’s health care system.
For years, we’ve been hearing that the United States spends more on health care than any other country, even as it lags far behind other countries in terms of quality of care.
The numbers are staggering. Health spending in the United States neared $2.6 trillion in 2010 – that’s 10 times the $256 billion spent in 1980. The Institute of Medicine estimates that in 2009, the most recent year for which data are available, the country spent about $210 billion on unnecessary medical services.
Broken down, this means that the United States spends about $8,000 per person annually on health care – that’s about 50 percent more than Norway and Switzerland. In the United States, hospital stays are far more expensive than those in other countries, averaging about $18,000 per discharge, compared with less than $10,000 in Sweden, Australia, New Zealand, France and Germany.
But what do these numbers really mean to the average patient? What’s going on in the doctor’s offices and hospitals around the country to create such bloated spending?
That’s where my daughter’s ankle comes in. At the time, the injury seemed unremarkable. Her pediatrician suggested waiting it out, but after a month with no improvement, I sought a second opinion from a sports medicine specialist, who ordered an M.R.I., but ended up referring her to a pediatric orthopedic surgeon.
The specialist examined the ankle and ordered another M.R.I. as well as extensive blood work. After seven vials of blood, my daughter nearly passed out.
A week later the doctor called. Some of the blood work looked uncertain, and he wanted to retest. After several more vials of blood, the results remained ambiguous. Even so, my daughter was referred to an eye specialist and a pediatric rheumatologist, who ordered more blood work and a third M.R.I. At the end of the appointment, the doctor noticed my daughter’s crooked pinkie fingers and, oddly, ordered an X-ray of her hands. Five months after twisting an ankle, my otherwise healthy daughter limped out of the radiology office carrying X-rays of her hands. “Mom,’’ she said, “my ankle still hurts.”
After years of reporting on health, I considered myself a well-informed patient, but it took my elementary-school daughter to state the obvious: She was the victim of too much medicine. Every new blood test, scan or X-ray raised new questions, which led to more lab work, scans and X-rays. I know the doctors had good intentions, but it’s a truism of modern medicine that the more you test and scan and look for problems, the more likely you are to find something wrong. My daughter’s case had spiraled out of control.
I canceled all her appointments with the various specialists, and went back to the sports doctor. We discussed a new approach that focused solely on pain relief. He consulted with my daughter’s pediatrician, and they agreed on a treatment. Within days, my daughter’s ankle had stopped throbbing, and soon she was back to sports and dancing. The cost of this ankle injury had reached well into the thousands of dollars — I had lost track because it was all covered by my insurance.
The New York Times for more