Despite health care industry concerns about wasteful and unnecessary care, it’s nearly impossible for patients to overrule their doctors when they think they’re getting a procedure they don’t need, a prominent patient care advocate argued Tuesday.

“I’ve had four unnecessary EKGs,” Daniel Wolfson, executive vice president of the ABIM Foundation, said at a POLITICO Pro Health Care breakfast briefing at the Newseum. “I think it’s an uphill battle for the patient to talk a physician out of a procedure.”

Continue Reading

Overtreatment and preventable medical errors are huge drivers of health care costs and lead to thousands of unnecessary deaths every year, but action to reverse both continues to lag, noted Leah Binder, CEO of The Leapfrog Group, a health safety advocate that represents employers.

(CARTOONS: Matt Wuerker on Obamacare)

“We are not seeing progress the way we should,” she said. “Given that we have a problem where safety is one of the leading causes of death in this country, we would expect to see some massive change.”

“Thirty people are going to die by the time this session is over from preventable errors,” Binder continued. But the health care world’s response has been tepid, in part because there’s so little transparency about health care costs and who pays when fatal mistakes occur.

The drive toward more transparent costs is critical to helping people make often complicated choices about their health coverage, from choosing a high-deductible insurance plan to figuring out which plan delivers the best value at the lowest cost, the panel agreed.

But panelists stressed that patients, who are often sick when they’re faced with important health care decisions, aren’t in the best position to be assertive with their doctors.

(Also on POLITICO: Full health care policy coverage)

“When you’re sitting in a hospital with a johnny on and your butt hanging out, you are not in the position to be a powerful chooser,” Binder said.

Panelists also agreed that a tectonic shift in the way health care is delivered and paid for — with an emphasis on bringing costs down — is underway, fueled in part by the Affordable Care Act. But it will only pay off if transparency follows suit.

Yet that, too, is changing rapidly, argued Jeanne Pinder, CEO of ClearHealthCosts, and it’s driven by consumer fury — particularly among women.

“There’s actually a revolution going on in this country that defies the sort of easy abstractions,” Pinder said. “Consumers are in flames about this issue, and it turns out to be, perhaps not surprisingly, about women’s behavior in the marketplace.”