An Annual Checkup Could Do You More Harm Than Good
Drug costs are skyrocketing. As leading pharmacy benefits manager Express Scripts reports, last year 576,000 Americans had prescription drug costs totaling more than $50,000. That’s a 63% jump from the year before. Meanwhile, the number of patients who ran up $100,000 or more in drug costs nearly tripled!
So much for the Affordable Care Act’s “affordability.” We predicted in these pages before its passage that Obamacare would be a boon to drug makers and a boondoggle for patients and taxpayers. Sure enough, it has been.
Many of these Obamacare-subsidized drug prescriptions aren’t even medically necessary (and most wouldn’t be with a sensible prevention strategy). Unnecessary medical tests, prescriptions, and procedures are a major driver of medical cost inflation. Not only are they a waste of money; they can be downright dangerous.
For example, every year hundreds of thousands of patients are needlessly prescribed antibiotics. Some doctors will prescribe them for patients suffering from the common cold, which is a viral infection. Antibiotics are useless against viral infections. Worse, antibiotic drugs disrupt the digestive system by destroying gut bacteria. Every year, 14,000 Americans die from severe diarrhea caused by antibiotic drugs. Antibiotics may also confuse and weaken the immune system.
Some doctors will order unnecessary tests “just to be safe” from the threat of a malpractice claim. Hospitals may put patients through all sorts of unnecessary procedures when Medicare or insurance are footing the bill.
Even before Obamacare’s implementation, a panel of prominent medical groups found that “Americans are being over tested and over treated with alarming frequency,” as Men’s Journal reported.
Don’t Be Afraid to Question Your Doctor’s Judgment
The American Board of Internal Medicine (ABIM) has launched a “Choosing Wisely” initiative to try to educate doctors and medical professionals about how to avoid unnecessary medicine. But it’s an uphill battle. Especially as Obamacare forces insurers to cover more types of conditions for more people, and the ranks of “entitled” Medicaid and Medicare patients rapidly expand.
Among the commonly ordered procedures that are commonly unnecessary are emergency room CT scans of the head after a minor injury. “If your head injury is not serious, a CT scan does not give useful information to the doctor,” according to ABIM. “CT scans use radiation, which can increase the risk of cancer. Children, especially infants, have greater risks because their brains are still developing.” Another reason to question the necessity of a CT scan: it can cost more than $2,000.
Ask your doctor whether a test he wants to run or drug he wants to put you on is absolutely medically necessary.
Here’s a List of Medical Procedures You Can Probably Do Without
Below is a list of medical tests and treatments that ABIM has identified as being of questionable value. They may be necessary in some cases, but they should still be questioned.
- Allergy Tests
- Alzheimer’s Disease Testing
- If you’re having memory problems, your doctor should look for other causes before ordering a brain scan.
- Antibiotics for Pink Eye
- Antibiotic eye drops or ointments don’t usually help with conjunctivitis. In fact, they can do more harm than good.
- Antipsychotic Drugs for People with Dementia
- Blood Transfusions for Anemia
- Bone-Density Tests
- Cancer Tests and Treatments
- Some tests, treatments, and procedures are not only unnecessary, they can even prove harmful.
- Cardiac Imaging
- Care at the End of Life for Advanced Cancer Patients
- Chest X-rays before surgery
- If you don’t have signs or symptoms of heart or lung disease, think twice about having a pre-operative X-ray.
- Cholesterol Drugs for People Over 75
- If you are age 75 or older and you haven’t had symptoms of heart disease, statins may be a bad idea.
- Even a very good test can be done too often.
- Drugs for Migraine Headaches
- Think twice about treating migraine attacks with opioids or butalbital.
- Drugs for Rheumatoid Arthritis
- The older, “non-biologic” drugs are a better first choice for treating rheumatoid arthritis.
- Drugs to Prevent Infection During Chemotherapy
- Echocardiogram Before Surgery
- EKGs and Exercise Stress Tests
- Health Checkups
- You probably don’t need that yearly checkup. In fact, it can do more harm than good.
- Heart Stress Tests Before Chest Surgery
- Home Oxygen After a Hospital Stay
- Imaging Tests for Heart Disease
- Immunoglobulin Replacement Therapy
- Implanted Heart Devices at the End of Life
- An ICD helps the heart beat normally. But if you are near death, those shocks can make things worse.
- Lab Tests Before Surgery
- Lyme Disease Tests
- Mammograms Before Elective Breast Surgery
- Medicines to Relieve Chronic Pain
- Opioids (narcotics) usually are not the best way to treat long-term pain like arthritis, back pain or headaches.
- Medicines to Treat Cancer
- Drugs used to treat cancer can also cause harm, and some are very expensive.
- Oral Antibiotics for Ear Infections
- Sometimes antibiotic eardrops are safer and more effective than oral antibiotics.
- Pap Tests
- PET Scans After Cancer Treatment
- Screening Tests for Brain Aneurysms
- Screening healthy people for weak areas in the brain’s blood vessels can do more harm than good.
- Screening Tests for Ovarian Cancer
- Ultrasound and the CA-125 blood test are not useful for screening low-risk women for ovarian cancer.
- Stress Tests for Chest Pain
- Tests Before Heart Surgery
- Before heart surgery, you probably don’t need a breathing test or carotid ultrasound test, unless you have breathing problems or symptoms.
- Treating Sinusitis
- Millions of people are prescribed antibiotics each year for sinusitis.
- Tests for Urinary Tract Infections in Older People
- Older adults are often tested for UTIs. But if you don’t have symptoms, the tests are not very useful.
- Vitamin D Tests
- Doctors often order a blood test to measure your vitamin D, but the results are unlikely to change their advice.