To heal our ailing health care system, we need to stop thinking like Americans. That's the message of two articles by UCLA's Dr. Marc Nuwer, a leading expert on national health care reform, published this week in Neurology, the journal of the American Academy of Neurology.
"Americans prize individual choice and resist limiting care," says Nuwer, a professor of clinical neurology at the David Geffen School of Medicine at UCLA. "We believe that if doctors can treat very ill patients aggressively and keep every moment of people in the last stages of life under medical care, then they should. We choose to hold these values. Consequently, we choose to have a more expensive system than Europe or Canada."
Consider these statistics:
Reforming the U.S. health care system with the goal of providing universal, affordable, high-quality care will require rethinking our overall values and paying greater attention to care-related expenditures, according to Nuwer.
Part of the current problem, he says, is that doctors are oblivious to the price tags of options they're prescribing for patients. He recommends educating physicians about the costs of care, including imaging, blood tests and specific drugs.
"Does a fancy electric wheelchair cost $500 or $50,000?" Nuwer asks. "Most doctors have no clue. We need to give physicians feedback about the dollar signs behind their orders."
Nuwer's co-authors on both articles include Dr. G.L. Barkley (Henry Ford Hospital, Detroit); Dr. G.J. Esper (Emory University School of Medicine, Atlanta); Dr. P.D. Donofrio (Vanderbilt University School of Medicine, Nashville); Dr. J.P. Szaflarski (University of Cincinnati Academic Health Center); and Dr. T.R. Swift (Medical College of Georgia, Augusta).
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