JAMA Forum: High-tech Care Can Save Lives—But it Also May Create Incentives That Result in Lives Lost


news@JAMA

Austin B. Frakt, PhD Austin B. Frakt, PhD

In a news story about the care provided to premature infants in neonatal intensive care units (NICUs), reporter Alex Halperin illuminated the miracles and unintended consequences of health care technology. With the use of modern methods, vastly more premature infants now survive early birth—often by many weeks, even months—than was imagined possible a few decades ago. That’s amazing.

It’s also extremely expensive. The cost of medical care for a single premature infant can total hundreds of thousands, even a million dollars, in just the first several months.

Of course, insurance cushions the financial blow for families with coverage. The large insurance payments that hospitals with NICUs receive for saving premature infants’ lives are also good business. Halperin documented how high insurance payments for NICU care help subsidize less profitable hospital services. This serves as an incentive for hospitals to invest in NICUs and to expand the…

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