The Real Cost of Unnecessary Breast Biopsies
Articles on the health-care industry are a fertile source of large numbers and, sometimes, large errors. In the article “Study of Breast Biopsies Finds Surgery Used Too Extensively,” (New York Times, Feb. 18), it is estimated that nationally 300,000 women a year may be getting unnecessary surgery at a cost of “hundreds of millions of dollars.” I was happy to believe the figure of 300,000 women a year. However, the cost set off my number-sense alarm.
My first mental step was to convert that cost, which is far beyond human experience (at least, far beyond mine), into one that I could judge. A per-person cost is likely to be human-sized. Thus, let’s divide:
“hundreds of millions of dollars” / 300,000 surgical biopsies
To make the mental arithmetic easy, I translate “hundreds” to 300. Then the extra cost is $1,000 per surgical biopsy.
But that figure seems ridiculously low! Once I had to get an ultrasound at a leading Boston hospital. Cost: $1,000. Doing a surgical procedure must cost a lot more than a simple ultrasound, especially in 2011 (my ultrasound was in 2005).
Later in the article, the surgical cost is given: “Hospitals charge $5,000 to $6,000 for a needle biopsy, and double that for an open?[surgical] biopsy…” The doctor’s fees add roughly another $1,000 to the cost of a needle biopsy, and $2,000 to the cost of a surgical biopsy. So, the extra cost of a surgical biopsy is, say: $5,500 (extra hospital cost) + $1,000 (physician cost) = $6,500.
That’s a factor of 6.5 larger than $1,000 per surgery. So the more likely extra cost is $300 million times 6.5 or $2 billion!