September 8, 2003
Technology improves outcomes, but adds greatly to cost
- by Ralph H. Weber, M.D., Vice president, medical affairs, Blue Cross and Blue Shield of Kansas
It is an understatement to say that technology has changed our health care system; in reality, technology has revolutionized every aspect of our system.
The use of technology has allowed us to virtually wipe out some diseases while making others curable rather than terminal. Technology has improved the way health care providers diagnosis and treat every ailment and condition, and how researchers develop new drugs and treatment options. Doctors, hospitals and insurance companies use new forms of technology to run their everyday business affairs more efficiently.
I have witnessed tremendous improvements during my 25 years as a doctor. When I first started out, for example, if a patient complained of pain in their lower right abdomen, we would do a blood test and send them home to wait awhile. If the pain persisted, we’d do another blood test to check for changes. If we eventually decided an appendectomy was in order, the patient would undergo a major surgery that required several hospital overnights and a long recovery period.
Today, if we suspect a problem with a person’s appendix, we can use a CAT scan to make a quick diagnosis. We can know earlier if surgery is required and if it is, we now have the option of laparoscopy. This less intrusive procedure greatly reduces the patient’s discomfort, length of hospital stay and recovery period.
While the CAT scan has lowered the risk of someone having their appendix burst prior to surgery, a host of antibiotics are now available to combat infection if it does. These still relatively new drugs improve the person’s chance for a complete recovery.
Collectively, we are better served by the use of technology in medicine. However, the downside is that medical advances come with a huge price tag. For instance, the average cost of an appendectomy has increased from several hundred dollars in 1978 to nearly $11,000 today.
A 2002 study by PriceWaterhouseCoopers concluded that new technology accounts for about 22 percent of overall increases in health care costs. That trend is likely to continue – or even grow – as each new generation of technology brings with it new and improved equipment and drugs.
Other studies suggest that consumers are willing to pay the price for state-of-the-art services. Nevertheless, we must still make sure the technology is used in an appropriate, cost-effective manner because as we use more and more expensive medical services, we will all be asked to pay more in premiums.
For example, the various generations of radiology – X-rays, CAT, MRI and PET scans – differ greatly in cost, ranging from hundreds of dollars to thousands of dollars. That is why it is important for a health care provider to use the technology that will most accurately and efficiently allow him or her to make a diagnosis.
We also must consider the quantity of equipment that is appropriate for our state. Health Care News reports that the United States has 7.6 MRI machines per one million people. Applying that ratio to Kansas, we should need about 19 machines to serve the people in this state. In reality, we have nearly three times that many machines. MRI units are expensive to purchase, and must generate revenue to pay for themselves.
As an individual consumer, you can save health care dollars by avoiding unnecessary medical tests and procedures. If you change doctors or go to a specialist, have the results of your previous tests forwarded so you don’t unnecessarily repeat them. Learn why tests and treatments are being done, if they are required and what other options are available.
While new technology advances medical care for all of us, health care professionals and consumers must be diligent in using the technology wisely.
Ralph H. Weber, MD, is vice president of medical affairs for Blue Cross and Blue Shield of Kansas. He spent 10 years in private practice in Salina before joining the health insurer in 1988. He was promoted to vice president in 1990.
Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross and Blue Shield Association. BCBSKS is the state's largest health insurer, serving all Kansas counties except Johnson and Wyandotte.