Thoughts From Paul Levy: Good Diagnosis, Zeke. Why No Cure?

The following is reprinted with permission from the blog, "Not Running a Hospital," authored by Paul Levy, former CEO of Beth Israel Deaconess Medical Center in Boston.

I really like it when I agree with Zeke Emanuel and never more so than with his recent column in the New York Times about proton beam machines. You will recall that I addressed this topic several months ago.

He notes:

If you want to know what is wrong with American health care today, exhibit A might be the two new proton beam treatment facilities the Mayo Clinic has begun building, one in Minnesota, the other in Arizona, at a cost of more than $180 million dollars each. They are part of a medical arms race for proton beam machines, which could cost taxpayers billions of dollars for a treatment that, in many cases, appears to be no better than cheaper alternatives.

To generate sufficient revenue, proton beam facilities need to treat patients with other types of cancer. Consequently, they have been promoted for patients with lung, esophageal, breast, head and neck cancers. But the biggest target by far has been prostate cancer, diagnosed in nearly a quarter of a million men each year.

There is no convincing evidence that proton beam therapy is as good as — much less better than — cheaper types of radiation for any one of these cancers.

And here's the upshot:

With Medicare reimbursement so generous, and patients and doctors eager for the latest technology, building new machines is sane, profitable business for hospitals like Mayo.

But it is crazy medicine and unsustainable public policy.

If the United States is ever going to control our health care costs, we have to demand better evidence of effectiveness, and stop handing out taxpayer dollars with no questions asked.

So why doesn't the administration, which runs and controls Medicare, change this?  Didn't you work in the White House, Zeke? Can you tell us why?

More Articles Featuring Paul Levy:

Former Beth Israel Deaconess CEO Paul Levy Calls for Hospital Leadership to Prioritize Patient Safety
Debate Surrounds Ability to "Teach" Bedside Manner

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