More than 465,000 spinal fusions were performed in the United States in 2011, according to government data, and some experts say that a portion of them — perhaps as many as half — were performed without good reason….The Medicare agency every year audits a sample of the claims it has paid and determines how many of those have “medical necessity” errors. The agency estimated the amount of money spent improperly on spinal fusions was more than $200 million in 2011, for example, and most of that was because the treatment was deemed unnecessary, often because a more conservative course hadn’t been tried, officials said.
In Florida alone, according to the Post‘s own analysis, about half of the treatments were done “on patients with diagnoses that experts and professional societies say should not routinely be treated with spinal fusion.” This is just one example of the over-treatment that plagues US health care more generally.Fortunately, over-treatment can be reversed, or at least restricted. Medical authorities can make definitions of disease more precise, and improve best practice guidelines for care providers. American cancer treatment has already taken steps in that direction. Aggregating data on how doctors and practices perform can improve treatment standards still further. As long as it’s conducted in conjunction with consumer-oriented reforms, big data could be a big help.But health care reformers give far more attention to insurance policies, even though though reducing over-treatment hugely important. It doesn’t get wonks excited in the same way, as more abstruse issues like, say, the tax-exempt status of employer-based health care. But since it’s relatively less complex, there are plenty of “low hanging fruit” solutions that could significantly reduce health care costs—not to mention the suffering and stress Americans experience because of unnecessary treatments.[Photo of stethoscope and money courtesy of Shutterstock.]