Recently, Dr. R. Adams Dudley, director of the UCSF Center for Healthcare Value, circulated a picture illustrating rapid growth in the use of tests and other imaging procedures between 2000 and 2013. I thought it deserved further circulation. It reveals 60-80% expansion of testing and imaging, with only – only? – a 40% increase in…
The other day I posted a picture on job growth in the United States, in healthcare versus other parts of the economy. It showed that most growth was healthcare related. Well here is another picture, from the Wall Street Journal, showing just how the U.S. economy has changed, and how much healthcare has come to…
Here is a quick review from the Commonwealth Fund showing what happened to jobs in the United States since 2000. A dramatic growth in healthcare jobs, and almost no growth in the rest of the economy: Something to keep in mind, because if we ever get healthcare costs under control, we had better hope to…
People like me, trained to be physicians, have pushed hard to promote health insurance in the United States because we believe, with some evidence to back up our claims, that good health insurance promotes better health. When people don’t have insurance, they delay necessary medical care for too long, and their health suffers as a…
It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under…
In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not…
She didn’t talk like a stroke victim. “I…I…I…k…kkk…can…can…can’t…t…t…t…talk.” She struggled with her words, struggling on early syllables, only to then spurt out full and correct words. “N…N…N…No.” Recognizing this unusual speech pattern, the neurologist Allan Ropper, author of Reaching Down the Rabbit Hole, expertly queried the patient and her loved ones, and determined she had…
Cholesterol pills are one of the great medical advances I’ve witnessed during my professional career. I am talking specifically about a category of medications called statins, drugs like Lipitor and Pravachol. These drugs have prevented probably hundreds of thousands of heart attacks and strokes. Only one problem with these drugs, however: statins won’t help people…
David Asch and I recently published an article in Health Affairs on the challenge of getting healthcare practitioners to stop doing things they are accustomed to doing, even when the evidence that those things are harmful becomes overwhelming. Here is a teaser from that article, and a link to the full piece: As hard as…
Bend a resilient object and it will spring back with a vengeance once released from your grip. Is that what is about to happen to healthcare spending? For years now, experts have been debating ways to “bend the cost curve ” – take the sharp rise in healthcare costs, picture a rapidly ascending line on…