We're regularly reminded that America is a rich, but wasteful society. When the topic is energy, we're advised from every side to use less, as the ad below from an oil company argues:
But our response to our exploding medical bill, where experts estimate that 20-30% of spending is wasted, is quite different, as the ad below on local bus shelters indicates:
The second ad is an effort from the Agency for Healthcare Research and Quality, which wants more men to subject themselves to colonoscopies and other helpful tests. There's no doubt we'd live longer, healthier lives if these ads succeeded.
But such efforts strike me as a bit one-sided. They only tell half the story. Where are the ads suggesting places where people can safely use less? Where are the medical versions of the car pool energy-saving ads that counsel people on how to identify minor aches and pains that don't justify a visit to the emergency room?
The disparity between the two ads may explain why gas prices are dipping while medical costs continue to climb.
Our government mandates labeling to help us select an air conditioner with lower energy costs, but fails to mandate information about the average cost of a colonoscopy or educate us that, on average, a virtual colonoscopy will cost substantially more than the old-fashioned type.
Instead, the government simply piles on along with all the other players ranging from the drug firms that keep the nightly network news shows afloat to the hospital ads that promise they can quickly and competently cure whatever ails us. All these heads move us in the same direction - toward greater consumption. More is healthier, we're told. It isn't surprising that we respond to this relentless barrage by using more.
And there's constant speculation about whether we should increase consumption still further, perhaps by having millions more become habitual statin users in our quest to drive down the average cholesterol level or maybe by having millions of aging men avoid prostate cancer by taking a drug now typically prescribed in response to baldness.
Given this environment, it is hardly surprising that our emergency rooms are jammed with less severe problems. The advice lines insurers run automatically suggest an emergency room visit if you're in pain, rather than explaining when watchful waiting or a visit to the local minute clinic might be a better response.
Articles about procedures that don't make medical sense are rare. When's the last time you saw an AHRQ ad pointing out that cough medicines don't work, or that arthroscopic knee surgery for osteoarthritis of the knee is a waste of money. Obviously, providers aren't going to pay for these messages.
So our government joins our providers in telling us we should use more and we do. Our national medical bill balloons and our worries about paying it increase. Perhaps its time to start educating the public that the same logic we accept in the world of energy - using less reduces the bill - would work in medicine as well.
Why hasn't that happened yet?