The first in a three-part series of articles on high health-care costs in the
U.S. appears in this month's issue of _Consumer_Reports_.  It's a long one.
They discuss, among other things, what they consider to be the three big
contributors to high costs:  unnecessary procedures; bureaucratic costs,
and physicians' controlling their own demand.

Please,
  --  read the article, if you're interested in the subject;
  --  I know this might generate some discussion of the issues; but
  --  don't flame ME if you don't agree with the editors of _Consumer_Reports_.

While I would agree with them that those 3 are biggies, they
have conveniently forgot the malpractice and defensive medicine
cost.  You can measure the costs of malpractice insurance, but
the defensive medicine cost is very hard to pin down, since
doctors never write that they are ordering a test to cover their
asses.  But, since my CR hasn't come yet, I haven't read the article,
so maybe they did cover it.  Now that Ralph Nader is off their
board and his influence may be waning, CR may begin to admit
that the legal system has it costs for consumers.
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Gordon Banks  N3JXP      | "Skepticism is the chastity of the intellect, and

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   >The first in a three-part series of articles on high health-care costs in the
   >U.S. appears in this month's issue of _Consumer_Reports_.  It's a long one.
   >They discuss, among other things, what they consider to be the three big
   >contributors to high costs:  unnecessary procedures; bureaucratic costs,
   >and physicians' controlling their own demand.
   >
   While I would agree with them that those 3 are biggies, they
   have conveniently forgot the malpractice and defensive medicine
   cost.  You can measure the costs of malpractice insurance, but
   the defensive medicine cost is very hard to pin down, since
   doctors never write that they are ordering a test to cover their
   asses.  But, since my CR hasn't come yet, I haven't read the article,
   so maybe they did cover it.  Now that Ralph Nader is off their
   board and his influence may be waning, CR may begin to admit
   that the legal system has it costs for consumers.

They spent about a page talking about malpractice and
defensive medicine.  I thought the article well written,  
and they tend to be evenhanded in their coverage.  In
addition to talking about the magnitude of malpractice
insurance,  they talked about various estimates of
other defensive medical costs.  

They reviewed one (more?)  critique of medical care that examined
apparent malpractice in hospital records vs. suits brought.  One of
the things they mentioned was that only a minority of apparent
malpractice led to suits,  and that many suits had no apparent
basis in malpractice.

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Snail:         11 Cambridge Center,  Cambridge,  MA  02142
Disclaimer:    I don't know if OSF agrees with me... let's vote on it.
Amateur Radio: KC1KJ

Thanks for the info.

And, while we're reading, let us keep this in mind:
  [ from today's Wall Street Journal (24Jun92) ]

"The American Medical Association's (AMA) governing body endorsed the
 practice of doctors' sending patients for tests at labs in which those
 physicians have a financial interest.  The endor{*filter*}t runs counter to
 a trend by both federal and state governments to prohibit such
 self-referrals."
  ...
"Sidney Wolfe, head of the Public Citizen Health Research Group in
 Washington, said a Florida study showed that doctors who engage
 in self-referral `are twice as likely to order tests.'

 `We estimate that in Florida alone, this leads to $500 million in
 unnecessary tests each year,' Dr. Wolfe said."

      To your health,
        Brent Byer

                "Now, now; there's nothing to worry about.
                 I'm extremely proficient at walletectomies."

        (Don't use up all your ammo on the lawyers.)

They do in fact mention malpractice and defensive medicine (in a
sidebar).  They claim that malpractice suits have actually
decreased while medical costs are increasing.  They mention that
it is difficult to determine the amount of defensive practices,
but they claim that much of defensive medicine is disguised
unnecessary medicine.  I wonder whether the two can ever be
separated?

-----

Todd Heatherton
Psychology
Harvard University