Wednesday, August 26, 2009

Reforming health care

Another learned person gives reasons for reforming health care:

Financial barriers should not stand between Americans and preventive or acute health care that they sincerely believe will address concerns over a troubling medical condition, in a timely manner, before that condition grows into a critically serious illness.

In short, we will all have regular checkups which will prevent us from getting really serious or late-stage diseases. Illnesses such as cancer will be caught at earlier stages when a better outcome can be expected. Your cancer will be removed when it is the size of a pencil eraser. It won't cost much and everyone will live happily ever after. Piece of cake.

It sounds terrific. Very logical. What's not to like? Well, as a mere lay person who has seen friends and family members die despite regular checkups, eating spinach, and wearing sunscreen, can I suggest that it's not that simple?

I know these things just from living long enough to see what fortunes and misfortunes have overtaken friends and relatives. Preventive care doesn't always prevent anything. Medicine is an art and not a science; it cannot be practiced by the numbers. Furthermore, it's a matter of chance who gets sick. People who engage in aerobic exercise, watch what they eat, and floss daily have heart attacks. Life is unfair! The race is not to the swift, nor the battle to the strong, nor bread to the wise, nor riches to the intelligent, nor favor to the men of skill; but time and chance happen to them all.

Diseases don't always progress in an orderly manner, stages I through IV. Some diseases are not caught early, and it's not for want of trying. A friend of mine developed metastatic breast cancer while she was pregnant and seeing a doctor regularly. She fought it bravely, but still died. Someone else dear to me developed ALS, which eventually killed him. Try preventing that with regular checkups.

There are some diseases for which there is no cure as yet, and early detection won't make a bit of difference. The patients suffering from these diseases, however, will still require expensive interventions: nursing care, hospitalization, perhaps surgery. Unless we just send them home to die because they are not following the script laid out for them by the learned professor of economics.

This fellow is so smart, and he's only a professor of Economics at Princeton! From his superior attitude I would have taken him for a Harvard man, at least.

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