Patient Zero – The Root Cause of Costs

If anyone can cause health care costs to go up, it has got to be the patients. After all, if they were not sick or injured there would be no costs in the first place. So the costs start with the patient and they continue to grow from there. So using a term from the medical parlance, it all begins with Patient Zero.

How could the patients be responsible? The patients don’t set the rates, order the test, or perform the work. Patients don’t manage networks or administer insurance plans. Patients are the poor (or they will be when they finish paying their medical bills) bastards who need to services of the health care professionals and institutions. It’s patently absurd that to blame the patient for rising costs; to do so would require that these people are actively engaged in doing something that actually incurs additional work or services beyond what would be required. Why that would mean that Patient Zero would have to things like:

• Go to the doctor for unnecessary and unreasonable matters.
  Like going to the doctor’s office because of a hang-over, minor head-cold, or bruise from playing volleyball.
• Ask or tell the doctor to perform a test or procedure that the doctor would never have done on their own.
  Patient Zero may want a “full set of tests” to makes sure that everything is ok, even though there are no specific symptoms that would warrant more than a blood test.
  Or, Patient Zero may ask for a procedure that they want, because it will get them what they want. A gastric bypass operation so they don’t have to struggle with a diet, or spinal surgery to fuse vertebrate rather than a physical therapy program recommended by the doctor, or monthly treatments with a chiropractor that never end instead of an exercise program that would mediate the problem.
• Request the doctor to prescribe a medication or treatment that is not medically necessary.
  How many patients go to the doctors seeking a new medication that they have heard about or been told of by a friend. Or patients who just want more of the same medication that they got for some temporary pain, insomnia, depression, anxiety, …; it’s not that they are going to be cured by these prescriptions, it’s just that they want them.
• Use medical services inappropriately (e.g., call an ambulance to get to the hospital because you, Patient Zero, does not pay for the service)

While the cost of these services, medications, and procedures may be very nominal and appropriate; the real need to prescribe these items to these Patient Zeros is not appropriate. And if these Patient Zeros are not paying for these then we all know who is paying for them. They become aggregated into the “operational costs” of providing health care and become part of your health insurance premium; your income, Social Security and Medicare taxes; or your own medical bills.

And not only are these Patient Zeros costing you for these services, they also increase the administration costs of the health care systems and consume time and resources for everyone else which translates to more costs.

Like it or not, misuse by a percentage of the patient population directly harms everyone both in the wallet and in the risks that it imposes on anyone else who may need those resources for a legitimate need.

If you don’t recognize all aspects of the problem you may not be able to solve other problem areas that may be produced by the problem source that you don’t see or won’t see.
So any system that is going to fix the Health Care will have to reform not only the medical community itself, it will have to address the public as well.