USA Today Examines Back Surgery, Overuse Of Medical Procedures

In the second installment of its week-long "Prescription for Change" series, USA Today on Tuesday examines back surgery and how it "reflects a larger issue in medicine": how to balance "major drivers of health care inflation," such as new technology and treatments, "without overusing them." Experts say such surgery is "just one example of how a complex set of conditions, which include expensive new technology, varying doctor preferences, financial incentives, patient expectations and a lack of data on what works best, is helping drive demand for medical care and raising costs," USA Today reports. Lower back pain treatment costs an estimated $25 billion in medical care each year, according to Duke University researchers, and workers compensation and lost work time cost an additional $25 billion annually. According to a study that will be published next month in the journal Spine, researchers found spinal surgery rates were almost eight times higher in some parts of the U.S. than others, even though the percentage of people who have back problems does not vary widely between regions. Mark Chassin, professor and chair of the Department of Health Policy at Mount Sinai School of Medicine in New York, said, "Physicians and hospitals, by and large, get paid by the piece for what they do, so they have no financial interest in looking hard at the issue of overuse." Chassin added, "The U.S. health system does a great job in developing new and innovative treatments, but it does not do a good job in thoroughly and rapidly evaluating those innovations to find out when they work and when they don't" (Appleby, USA Today, 10/17).

Editorial
A survey by ABC News, the Kaiser Family Foundation and USA Today "finds the nation stuck in denial, pointing fingers at various demons and unwilling to accept the idea that they can't have today's cutting-edge drugs, innovative surgeries and cancer cures without rising costs," a USA Today editorial states. The editorial continues that in "today's climate of political demonization," any plan for sweeping health care reform would be "demolished by assorted interests" who would "rus[h] to point out what the public would lose," and "no leader dares propose one." The "most daunting problem" is that "telling people the truth about the difficulties they face," including rising health care costs, "is not in style these days," the editorial states. "So people are left in the dark -- hurting, confused, discontented and blinded to the truth. There is no easy cure for that," the editorial concludes (USA Today, 10/17).

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