Cutting More But Not Saving More

There's an epidemic in American health care, and I don't mean the commonly lamented ones like obesity, diabetes, or even Ebola.  It's surgery.

It would be easy to think I am referring to cosmetic surgery.  After all, according to the American Society of Plastic Surgeons, there were some 15.1 million cosmetic procedures in 2013, more than double the number in 2000.  One can question what all those cosmetic procedures say about our society's values, especially with some of the stranger procedures being done or the reasons for wanting them (selfies!) but at least cosmetic surgery is usually patient-driven and paid for out-of-pocket.  No, I'm concerned about the increase in supposedly medically necessary surgeries.

What started me thinking about this was an article in The Wall Street Journal detailing the increase in women with early stage cancer in one breast who are having both breasts removed.  The proportion rose from 2% in 1988 to 11% in 2011.  For most women -- unless they have a BRCA genetic mutation -- the double mastectomy doesn't appear to improve chances of survival...