Recession Today Keeps Patients Away?

Doctor visits, hospital admissions, outpatient surgery, laboratory testing and prescriptions have all declined according to recent reports:

Doctor visits fell 7.9 percent in May 2010 compared to the same month in 2009. (Thomson Reuters)

Hospital admissions fell 2.3 percent in April 2010 compared to the same month in 2009. (Thomson Reuters)

Outpatient surgical volume fell 2.6 percent at AmSurg Corp. compared to 2009. (same-facility procedures)

Laboratory test volumes fell 2.3 percent in the first quarter of 2010 at Quest Diagnostics.

New prescriptions for maintenance drugs fell in the first quarter of 2010 at CVS Caremark Corp.

According to the Wall Street Journal, "such cutbacks have happened before in recessions, but the drop seems to be more pronounced this time, industry analysts say."

Insured Americans are moving toward higher-deductible health plans and shouldering a greater amount of the cost of their care. As a result, they may be forgoing health care, especially when money is tight. The recession also may be causing people to delay or opt not to have elective procedures.

Whatever the cause of the unexpected drop in utilization, it will have the effect of lowering America's health care expenditures. Some believe this goes beyond the recession and may be the advent of consumerism in health care and the beginning of more practical utilization of health care services.

I say that this is a time when we must determine whether the decline in utilization is coming at a greater cost. Are people with chronic conditions receiving proper care to manage their health and prevent greater complications? Are people receiving immunizations and preventive care, especially children and older adults? Is it possible that the decline in utilization also is the result of the uninsured and underinsured choosing shelter, food and basic necessities over health care?

Before we celebrate a victory for health care consumerism, let's examine the cost of free-market forces.

— Tom DeSanto

Source: Wall Street Journal, July 29, 2010.

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