Use of the Release: Hypochondriac Nation

When insurers talk about actual money they spend on helping pay for medical care, they describe that portion of their expenses as the utilization rate. According to themselves, less than half of every premium dollar paid goes to paying for medical services.

A portion of this utilization rate is ascribed to physicians practicing defensive medicine, testing for everything, because why not?

There are some logical reasons why not. First: Running patients through endless testing has created a new kind of hypochondria but an old kind of psychology. Like the old joke with the guy waving his arms to keep away pink elephants, when informed that there are no pink elephants, he responds "See, it's working." This flawed logic has both doctors and patients awaiting "results" from any number of tests that takes the responsibility of paying attention to our bodies off the physician and off the patient. But the psychology goes further.

After being tested and passing the medical test, some people, then think that they should continue being tested...but I didn't test my...and I didn't test my.... and I didn't test my.......... People live from test to test.

Second: Insurance companies love covering preventive services such as testing. Why? Because there is no risk...the cost of a test is a confined number of dollars and insurers will cover a certain percentage of those dollars. As we all come to realize that insurers really don't insure when they cover preventive costs because insurance is designed to cover RISK not certainty, we remain a step behind the insurance companies. Now that they've made real cuts into covering the RISK of medical services for illness (the purpose of insurance), we have begun to hear the murmurings that over-testing is costing them money. Of course, when you want to save your way to prosperity there are only certain areas that can be cut, then a new area must be cut. The momentum of this approach will likely be evident in mandatory screenings for certain illnesses in order to preserve coverage and the impossibility of getting coverage for less-common and more expensive testing.

Third: Physicians figure why not use all available testing? The physicians really don't want to come clean and acknowledge that like patients who don't want to feel that they didn't get tested for something that strikes them, physicians don't want to risk malpractice claims predicated on the fact that they didn't use all the technology available to screen their patients. A common twist on this fear-based referral for testing is from physicians claiming they don't make money from testing. Really? Covering your butt has always been a PREVENTIVE way of avoiding consequences...in other words the same psychology that motivates patients to submit to testing.

It's time for a little grown up behavior. If you get tested and you still get sick, bad luck. If you don't submit to a test and you get sick, also bad luck. If your insurer is willing to pay 50% of the cost of a non-indicated test, you are out that money. You have not prevented anything, you have just paid money for no reason. And as for the physician services...we know you're greedy, we know you're scared, we know you're human. We know this each time any of us have our children inoculated and sign a paper that acknowledges that we know that this inoculation has rarely caused death. If we are willing to sign such documents for our children, we can sign them for ourselves. If I want an antibiotic, I will gladly sign a release that I opted out of all the testing required ...you're off the hook, and that's really what you wanted anyway.