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Prostate Cancer – The real test of health reform

In the NYT today, a nice short article by David Leonhardt makes the case that the key ingredient to look for in health reform proposals is whether or not reform means controlling costs – really controlling costs. Prostate cancer treatment is a great example, where a nearly complete lack of evidence means that we don’t know for any given patient if the better course of action is just monitoring the prostate with periodic check-ups and tests or bombarding the patient with a $100 million proton accelerator. Honest.

One more dubious treatment being performed on at least some NC patients for prostate cancer Leonhardt didn’t mention was noted by Adam Linker almost a year ago in a post making a similar point on costs and reform.

NC Senator Josh Stein has proposed a comparative effectiveness task force to do a better job of assembling this research on what works and what doesn’t using the unique health resources available here in North Carolina. We desperately need to contain exploding health costs. We can’t afford to have what we pay for health care double every ten years as is happening right now. National health reform proposals need to follow Stein’s lead and make only paying for what works in health care a top priority.

One Comment

  1. Herbert Sweet

    July 9, 2009 at 12:46 am

    I saw this too and find it encouraging that thee kind of questions are receiving national attention. I addressed this in my blog recently. http://hrsweet.blogspot.com/
    —————————————————————————————
    The country is now immersed in a great debate over the health care delivery system with the main focus being whether that system should be paid for through private insurance or through public insurance.

    This is the wrong focus and, regardless of the outcome, health care cost will not be contained.

    There are three fundamental health care cost factors that are not receiving the nation’s full attention.

    The most important of these is in the area of terminal illnesses. Terminal illness, put bluntly, means death and very few are willing to come to terms with that. The basic reason is that, while most everyone believes in a life after death, few are really confident of that belief. This is well expressed by the old joke that everyone wants to go to heaven but no one wants to go now. The result is a desperate attempt to hold on to life.

    That desperation turns to medical technology which merely prolongs the agony without curing the disease. This is extremely costly resulting in the consumption of a large percentage of the nations health care dollars.

    The second most important factor is the population’s lack of control over weight. Today, two-thirds of all Americans are either obese or overweight and it is well known that this alone leads to costly chronic disease.

    The final factor is that the age demographic is sliding upwards due to the aging of the baby boomers.

    The end result is a nation of aged, overweight and desperate people focused solely on themselves unwilling to think in terms of the costs that others must incur. Few politicians are willing to buck this sentiment so the problem will likely worsen until rising health care costs produce a fiscal crisis. At this point health care costs will threaten the provision of Social Security and the rest of the entitlements, the functioning of government itself and even the provision of military security.