The most recent edition of the New Yorker magazine includes an important, post-ACA article about over-utilization in health care. Titled “Overkill,” the article by surgeon Atul Gawande is subtitled “An avalanche of unnecessary medical care is harming patients physicially and financially.” What can we do about it?” It provides example after example of the kind of unwarranted over-utilization of health services that has been well-documented and quantified since Dr. John Wennberg first published his observations in 1975. Less than a quarter of the 300-500% variation he observed in his small-area variation analyses was due to patient need. But can the American health system (or “hodge-podge” as Dr. Wennberg referred to it) really be that wasteful? Really? Apparently so. As quantified by a study published in the Mayo Clinic Proceedings and reported in the New York Times, “More than 40 percent of established practices studied were found to be ineffective or harmful, 38 percent beneficial, and the remaining 22 percent unknown.” Imagine that! Only 38% were clearly and demonstrably beneficial.
We recommend Dr. Gawande’s article. He does a terrific job of explaining in everyday terms the kind of everyday waste that’s being generated every day.