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Overtreatment

Shannon Brownlee’s guest-blogging at The Washington Monthly about the aspect of the health care issue I don’t see any politicians wanting to tackle — the fact that doctors frequently overtreat patients in ways that are sometimes directly harmful and even when not harmful per se, contribute to a terrible maldistribution of health care resources. That’s not to say that America has “too much health care,” but rather that at the same time as many Americans have too little health care other Americans are, in fact, getting too much. Doctors are, in essence, prescribing all the treatment that will get paid for — which means too much treatment for people with a large ability to pay, and too little for people with little ability to pay.

Brownlee’s alternative is to turn doctors into salaried employees charged with doing the job of keeping people healthy, rather than into fee-for-service professionals whose level of compensation depends on how much treatment they prescribe. That seems appealing to me, but it’s considerably more radical than anything being contemplated in the political system right now.

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