USD Magazine, Spring 1992

accused of performing too much surgery and overusing technology argue that they are only protecting themselves from a population who thinks the answer to every problem is a lawsuit. Experts say caps are needed on malpractice awards, making malpractice suits less appealing, causing the price of malpractice insurance to drop and eventually eliminating some of the excesses in health-care practice.

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afford health insurance or forced to accept low-paying jobs that do not provide health-insurance benefits. Rothman says employ– ers have found benefit packages to be good recruitment tools, but in a time where jobs are at a pre– mium, more employees are finding that employer-paid health-insur– ance premiums are not, contrary to belief, a God-given right. Unnecessary hospitalizations have also contributed to the rising cost of health care. Forty percent of hospitalizations are probably unnecessary, according to a study published recently by The Rand Corp. The research reported that 23 percent of the 1,132 adult hos– pital admissions in the study were for treatments that could have been provided in a doctor's office or clinical lab, or at an outpatient X-ray facility. Another ] 7 percent of the admissions were for surgical procedures that could have been performed as outpatient surgery. In a paper for The Journal of Bu.Jine.Jd and P.Jycholo!J1J, Rothman cited a recent study of almost 400 heart bypass opera– tions performed in California. The researchers concluded that, on average, only 56 percent of the operations were clearly appro– priate, 30 percent were character– ized as "equivocal," and the remaining 14 percent were deemed inappropriate. Another study estimated that half of the 100,000 nonemergency heart bypass oper– ations performed in the United States every year could be avoided-and more than $1 billion saved-if patients sought a second op1n1on. But doctors who have been

USD School of Nursing, says the whole impetus of the movement is to keep costs down. She predicts that the successful plan will likely be some type of e"-'Panded, man– aged care such as that offered by health maintenance or preferred provider organizations. Those who advocate a big-gun

Americans might not complain as loudly about the price tag of health care if the system was working. But experts say finding a cure for

"They value it. They talk about it , but they will not put out the money to pay for it..~'

- Rosemary Goodyear

America's health-care ills is going to be a long process involving lifting various points from the medical bag of proposals already out there and still to come. No one really knows what the final answer '\,ViJ) be. "Everybody has a idea of what will work, but they can't agree on what's the best plan for taking care of the world," hospital administrator Weatherford says. Janet A. Rodgers, dean of the

approach say the solution is a national health plan making gov– ernment the controlling operator of the system. Others favor overhauling the pre– sent system in the hope of making market competition work better. But any form of national health insurance implies higher ta.-xes, more bureaucracy and big tradeoffs for the consumer, such as en forced delays and rationed medical care.