How Much for the Future’s New, Improved Aspirins?

Some time ago in a post titled ”Tech Helps Healthcare Fail a Sick Child“ I wrote about how the increasing use of technology in medicine has, for all the benefits it has delivered, driven up the costs of healthcare to the point where many Americans not only can’t afford it but are actually going broke trying to.

A recent article in FierceHealthIT “Is tech to blame for rising healthcare costs?” by Dan Bowman, editor of Fierce’s Health IT publications, commented on my post thusly:

Gibbs contends that [technology] also has led to an astronomical increase in costs, making care for some simply unaffordable.

“One of the results of medicine’s technology-driven cost inflation is the huge increase in health insurance premiums as I’m sure you know well from personal experience,”  Gibbs writes. “Not surprisingly, as a consequence of these vastly increased medical costs, many people go bankrupt when they get sick.”

Gibbs supports his claim by citing an American Journal of Medicine study from 2009 that found roughly 62 percent of all bankruptcies in 2007 were due to medical issues, up nearly 50 percent from 2001.

As a result, Gibbs says, Americans are increasingly “deferring medical procedures, not buying prescribed medications or taking lower doses to stretch out costs or simply foregoing health insurance altogether.”

Dan goes on to suggest

Recent comments by leaders in the industry, however, indirectly challenge Gibbs’ assertions.

Really? Dan’s article starts with a couple of statements that sort of make it sound like health technology is, de facto, cost-effective:

Technology enables more accurate patient care and allows providers to share data with one another–making for better coordination and bolstering medical research.

The first assertion (“enables more accurate patient care“) links to another article that discusses a single, limited use case where automated patient screening was found to improve preventative healthcare in busy urban clinics while the second assertion (“allows providers to share data … making for better coordination“) links to an article that cites two studies, one which supports the assertion and one which doesn’t with the article coming to no actual conclusion one way or the other.

I’m not arguing that these assertions are in and of themselves wrong and, in fact, I’d like to believe the assertions are true because I’d like to believe that IT can really deliver such benefits. On the other hand, making these kinds of generalized assertions and arguing limited cases proves nothing. Moreover, even if the assertions are true what is the cost versus delivered value?

The FierceHealthIT article continues:

Recent comments by leaders in the industry, however, indirectly challenge Gibbs’ assertions. For instance, in an interview with California’s KQED Public Radio, Robert Rowley–medical director of electronic health record vendor Practice Fusion–says that technology can better arm patients for taking on ailments. Additionally, Intel Chief Healthcare Strategist Eric Dishman–in an interview with Forbes–talks about health technology’s role in improving care, in particular for seniors.

In the first interview, Robert Rowley, who is medical director of electronic health record vendor Practice Fusion,  “says that technology can better arm patients for taking on ailments“. OK … and that has what to do with healthcare costs? Patients may well become better informed but what will it cost? Who will pay?

As for the second interview, Dishman wasn’t giving facts and figures about healthcare costs and the impact technology is having on them, he was telling us about all the exciting things that Intel is up to. Great stuff. But let’s not make the huge mistake of falsely correlating what medical technology might be able to do in the future with claims about its value or benefits.

Citing those two articles about the thoughts of Practice Fusion and Intel on the future of medical technology wasn’t addressing the cost-benefit issues at all; they were just hand-waving about “jam tomorrow” and saying nothing about what the jam will cost and how good it might be for you. And given that both interviewees were medical technology vendors it was also like asking burglars what they think about banks: They love ‘em ’cause that’s where the money is.

What annoyed me about the FierceHealthIT article was not that it challenged what I wrote but that it failed to do so.

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