Utah tries for health-care reform; doctors say focus should be on wellness

In case you haven't heard, our so-called health-care system is not sustainable.

If you have, and you're like most American consumers of medical services today, you probably couldn't care less.

You're not alone. Even those who have taken on reforming Utah's system had that spoiled "my doctor is my concierge" attitude until they decided to care about medical care. Whether they are health-care professionals on the inside or elected state officials bent on forcing change from the outside, they see a system coming undone and describe it as a contraption that is part gleaming NASA Aries 1 rocket and part hot-air balloon.

In other words, it doesn't fly. It's barely staying afloat under the weight of the hyper-inflated costs of its million-and-one-more procedures, screenings, testing, surgeries and medications. Much of the testing and procedures have, at best, uncertain outcomes. Nearly every new outcome study assesses medical intervention as redundant or even risky.

Results of two studies this past week show that for all the research and screening and treatment of prostate cancer, for every life saved, dozens of men undergo potentially damaging treatment. The common PSA test is now up for debate, with even the American Cancer Society and the National Cancer Institute reporting that while PSA screenings may cut death rates by 20 percent, the screening and follow-up treatments prescribed are 47 times more likely to harm a man's health than save his life.

That kind of knee-jerk screening and treatment by health-care providers is like a wheel spinning off its axle, as one expert describes the U.S. health-care system. And at the hub is the consumer, who is feeling the additional pain of trying to makes sense of statements from insurance companies advising them, "This is not a bill," to HMOs preapproving a procedure and then denying it on the day of a surgery, explaining that preapproval didn't mean the procedure is covered.

"When it comes down to emergency or critical care or rescuing someone from a heart attack, U.S. medical care is second to none," said Dr. Paul Grundy, who has been hired by IBM to try to reduce the computer giant's $2 billion annual expenditure on employee medical care. "When it comes down to preventing that heart attack or promoting well-being, healthy births and longevity, we're about 19th in the world."

Good as we think?