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Hazardous Waste
First, we should squeeze the waste out of our health-care system, reducing the number of unnecessary, ineffective and unproven treatments. We're not just wasting health-care dollars that we need to cover everyone.
Every treatment carries some risk. If a patient undergoes an unnecessary procedure, or takes a pill she doesn't need, she is, by definition, exposed to risk without benefit. Often, even a test can do more harm than good.
For example, five years ago a friend of mine had a PSA test for prostate cancer. The test plus a biopsy showed early-stage cancer. His doctor recommended radiation, saying, "If you were my father, this is what I would advise."
I had read that the treatment could lead to incontinence and that some doctors recommend "watchful waiting" instead. Usually, prostate cancer advances so slowly that men die of something else before it catches up with them. If a man is diagnosed and treated, the odds that the treatment is unnecessary are very high. And we have little evidence that testing and early detection saves lives. Rather than trying to treat early-stage prostate cancer, many physicians advised keeping an eye on it with regular testing. I told my friend.
He returned to his doctor: "What about 'watchful waiting?'"
His doctor smiled broadly. "I think that's an excellent idea."
When I heard his response, I wondered, "Whatever happened to: 'If you were my father . . .?'"
Today, my friend is fine; his PSA levels have fallen.
Cancer experts no longer recommend routine PSA screening for men over 50. Instead, they say that doctors should explain the risk of being diagnosed and treated needlessly, the side effects of treatments and the lack of evidence that these procedures saves lives. They also should acknowledge that if never tested, most men would never know they had the cancer.
By
Maggie Mahar
|
June 5, 2009; 6:54 PM ET
| Category:
Health Care Reform
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Posted by: Maggie Mahar | June 18, 2009 5:17 PM
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do not side with big business and the insurance companies and pers drug companies.....side with the AMERICAN PEOPLE AND BARACK OBAMA .........THAT IS THE REASON HE WAS ELECTED...WHEN IT COMES TO HEALTHCARE IN OUR COUNTRY.
Posted by: STANTONCAROL | June 14, 2009 8:36 AM
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This is a typical response that points us in the wrong direction. Sure we have to control costs, but that's going to be hard. Nobody really has any ideas. There is the low hanging fruit of giving everyone Super Medicare (HR676) which will not cost us any more because of the huge savings we would get by the elimination of private insurance companies with their high overheads and gross demands on physicians and by lowering drug prices to companies that spend 3 times as much on "marketing" as research.
Posted by: lensch | June 8, 2009 11:59 PM
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The comments to this entry are closed.
Stanton-- Thanks you for your comment.
For-profit insurers and drug companies have to put their shareholder's interests first. That means focusing on profits. This is their responsibility.
President Obama has taken an oath to put the people's intersts first. This is his responsibility: the public good.
Lensch--
No one has any ideas? Take a look at
President Obama's speech to the AMA where he lists very specific ideas that would save $313 billion.
Also, take a look at the OMB website and White House budget Director Peter Orszag's blog. Finally, see Dr. Atul Gawande's most recent article in the June 1 New Yorker.