American medicine is undergoing the greatest financial scrutiny in its history. The hue and cry for reform stems primarily from the soaring costs of health care. However, placing the blame for these costs solely on increased utilization of technology, cutting-edge pharmaceuticals, cost-shifting hospitals, and physicians misses a bigger mark.
A HEAVY PRICE TO PAY FOR TYPE 2 DIABETES
Let's look at a relatively expensive and prevalent disease, type 2 diabetes mellitus. Pelletier and colleagues (1) assessed the costs of this disease and its multiple complications. Myocardial infarction, heart failure, and renal disease occurred in 7.2%, 14.0%, and 11.0%, respectively, of a large but typical cohort of patients with type 2 diabetes. The 12-month mean cost per patient who experienced each complication was $41,695, $30,066, and $34,987.
The population burdened with type 2 diabetes is on the rise, as are these and other expensive complications (including...