Warped Incentives That Harm YOU
Some perverse reasons why our medical system fails to support natural prevention.
Insurance companies and the U.S. medical system fail to encourage natural preventive medicine because those treatments, no matter how successful, simply aren't profitable enough.
That disturbing conclusion comes from an insightful article on the diabetes epidemic appearing in in The New York Times -- a newspaper serving a city with an estimated 800,000 people suffering from diabetes. The newspaper clearly laid out how a warped incentives structure harms human health and absurdly raises medical costs.
Consider these examples:
() Insurers will refuse to pay $150 so a diabetic can see a podiatrist and prevent foot problems caused by diabetes, yet the same insurance company will cover the $30,000 cost of amputating a food lost to diabetes.
How can that be? It's a familiar pattern. The insurance industry figures that preventive measures "are often so far into the future that many people will have already switched jobs or insurers, or have even died, by the time that medical complications hit. As a result, any savings from preventive measures will only go to their competitors."
() Rather than spend $20 per person on nutritional counseling to help diabetics and potential diabetics manage their insulin levels through proper diet choices, hospitals will spend $50,000 on the quick-fix of bariatric surgery to shrink a diabetic's stomach size to control food intake. Once again, when insurance companies or Medicare are covering the bills, physicians and hospitals opt for the most expensive alternatives.
() A simple and relatively inexpensive test in a doctor's office can screen people for their risk of developing diabetes, yet that test is rarely covered by insurers or even encouraged by physicians. Symptoms of diabetes can take 7 to 10 years to manifest, but by that point the disease is irreversible and becomes a huge cost burden to consumers but a huge profit cash cow for the medical and pharmaceutical industries.
"It's almost as though the system encourages people to get sick," conceded Dr. Matthew Fink, former president of Beth Israel Medical Center in Manhattan, in what must rank as a classic understatement. Another of his medical colleagues put it even more bluntly: "our financial success depends, in part, on our medical failures."
These perverse incentives that blind people to future repercussions have a parallel in another aspect of American life – bank savings rates. Compared to most other industrialized nations, the U.S. has one of the lowest investment savings rates. That situation, when combined with the failure to embrace preventive health care, are symptoms of a society that views life as a sprint instead of a marathon.
Such chronic short-sightedness insures that we will remain slaves to our habits of mind.