For many years the term “Socialized Medicine” has been a watchword for reactionary and out of date doctors who think we still live in an era of self-reliance. Everybody knows that health care should be a communitarian responsibility because no one can afford their own healthcare. I can’t afford a car crash, either, but I have car insurance for that.
Now, we have evidence that we can’t afford, as individuals, community health care either. The federal government now has a powerful agency named “United States Preventive Services Task Force (USPSTF), which by its name one would think is in charge of making sure we get our preventive medicine testing as advocated by Nancy Pelosi. Except Nancy has changed her mind.
The Obamacare legislation has transformed the USPSTF from its former status as a mere (one might say milquetoasty) advisory board, which made recommendations on preventive health that doctors and patients could take or leave alone, into an extraordinarily powerful GOD panel (Government Operatives Deliberating) that determines, definitively, which preventive services are to be covered and not covered by private insurers, Medicare, and Medicaid.
If USPFTF determines that something will not be paid for, God help you in getting it done. I first noticed this when I was at Dartmouth. It was found that many men with positive PSA tests, which suggested the presence of prostate cancer, did not die of prostate cancer, at least for many years. These tended to be older men and men with lower levels of PSA. The result was a drive to educate men to NOT have PSA tests. Too many men were having the test and undergoing radical prostatectomy.
I was in some sympathy with this view. I had seen examples of overtreatment. Still, it seemed more fair to allow the patient to choose. I see no similar movement to deny mammography to women although the recent dustup about youngest age at which Medicare will pay from mammography does seem similar
just yesterday, the New York Times published a “news analysis” which aggressively begins selling the public on that very notion – that medical screening tests are, by and large, a bad thing to do.
Even DrRich thought the Progressives would be somewhat circumspect about breaking such remarkable and counter-intuitive news to us in the great unwashed – especially considering that they have just spent the last three decades teaching us just the opposite. But then he recalled their smooth, unapologetic and entirely unremarked transition, around twenty years ago, from sounding the alarm about global cooling to catarwauling about global warming.
And he reminded himself that when you are a Progressive, history always began 10 minutes ago. And this turns out to be a great convenience.
In this case it is particularly convenient, when you consider the passionate declarations by Ms. Pelosi and others in 2009 that the watchword of Obamacare – indeed, the very key to the dramatically lower costs we would realize with this new legislation – would be “prevention, prevention, prevention.”
Expect to hear about this. Here’s another way of
The British medical journal Lancet reported last month that 32% of elderly American patients undergo surgery in the year before they die, a statistic culled from Medicare data. In an accompanying editorial, Dr. Amy Kelley of Mount Sinai School of Medicine labeled the 32% figure a “call to action”—to reduce costly surgeries, intensive-care stays and other high-intensity care for the elderly. Her call was parroted in hundreds of media outlets nationwide. But advocates for limiting health-care spending on the elderly are distorting science to make their argument.
Don’t be bamboozled: The Lancet investigators looked only at patients who died, making surgery appear unsuccessful. That’s like saying Babe Ruth struck out 1,333 times so he must have been a poor ball player—even though he had a .342 lifetime batting average and 714 home runs. Investigators should have considered how all surgery patients fared, including those who recovered, returned home from the hospital and resumed active lives.
The day is coming when divided loyalties will be the most serious problem in medicine. Who has YOUR best interest at heart ?
Tags: economics, health care, politics, science
Mike,
I recall reading positive comments from you about the French health care system a few years back. Do you think France would have better health care if they had a free market with private insurance?
Our so-called ‘system’ leans fairly heavily on government already. Why don’t we have some states go further in that direction and others go in the other direction, randomly chosen of course, then in about 20 years we could add up the numbers, all the numbers.
I saw this coming when they were starting to revise the mammo recommendations a couple years ago. How convenient!
So, what if I decide to pay for my own, on my own schedule? What excuse would they come up with to not treat a malignancy, I wonder, in our dark dystopian future.
It is very important to me that the French, last I heard, still have a fee-for-service system. This means that the doctor is your agent. You might want to reread the series to see the differences.