Do Doctors Drive Health Care Costs?

A public radio report says insurance companies may not be the culprits after all

Insurance companies often play the villain in rising health care costs, but could doctors be the real driving force behind skyrocketing premiums? This American Life, a popular public radio program, explored the question in a special hour-long show this weekend titled "More is Less." A 20-minute segment by Alix Spiegel opened the show and profiled Jack Wennberg, a Dartmouth-based researcher who argues that doctors are responsible. Ira Glass, host of This American Life, introduced:

There are all kinds of reasons that health care costs have risen so quickly over the last few decades. We have higher administrative costs than other countries because our health care system with our insurers and providers is so complicated. We use more expensive, high-tech gear. Our drugs cost more. But there's a whole school of thought that blames a lot of the rising costs on doctors. Prescribing drugs that people don't really need, doing too many procedures. And the reason people think this all goes back to the work of one person, a health researcher named Jack Wennberg.

NPR's Spiegel suggests that as more care becomes available, "supply drives demand," and treatments are pushed whether they're necessary or not. The availability of more care, as well as the fee-for-service model that means doctors get paid in proportion to how much care they prescribe, "forces them to do more" even when "more isn't always better for patients." This drives up premiums, making health care more expensive for everyone. Spiegel cites a study by Wennberg's Dartmouth group that says nearly a third of care could be unnecessary. Does this mean the fault for America's health care crisis could lie with doctors?