Medical Education and Training
Current medical training programs in internal medicine are taught by sub-specialists, who provide less desirable role models for students. The results of this may include unnecessary tests and consequent findings of "incidentalomas," which further add to costs of tests and treatments. Efforts to significantly enlarge the cadre of broad-based internists and family physicians teaching in medical schools and residency training programs may help to reduce the costs of medical care.
It has been reported that Medicare utilization is 50% higher than private health insurance, with no better outcomes and with a 37% increase in hospital costs for Medicare patients. Price controls have clearly promoted ways to maximize reduced reimbursement and also have shifted payments to private insurance companies. Fraud and abuse are enormous, as noted by a 2010 report by the Government Accountability Office, which found that "improper payments" account for $70 billion of Medicare spending.
Finally, the increasing use of hospitalists has been noted to decrease the amount of time patients spend in hospital, thereby decreasing costs, but is offset by higher medical costs after discharge.
J Community Health. 2012;37(4):888-896. © 2012 Springer
Springer Science+Business Media