From Kevin Drum today on health care:
But here's the tidbit that caught my eye:
A fascinating series of pilot programs, including for prostate cancer, has shown that when patients have clinical information about treatments, they often choose a less invasive one. Some come to see that the risks and side effects of more invasive care are not worth the small "” or nonexistent "” benefits. "We want the thing that makes us better," says Dr. Peter B. Bach, a pulmonary specialist at Memorial Sloan-Kettering Cancer Center, "not the thing that is niftier."
When I read about healthcare, pretty much the only thing I hear is that everyone wants infinite amounts of it. And they always want the latest and greatest stuff.
Not me. My motto is, "That healthcare is best that cares the least." Or something like that. Basically, I prefer to get the minimum reasonable amount of healthcare possible, and I have a strong preference for the simplest, oldest, best-known treatments. I'm not exactly a fanatic about this, but generally speaking I think that most new treatments turn out not to be nearly as effective as we think, and the more time you spend around hospitals the better your chances of catastrophe.
Wow, that's amazing! Its almost as if we shouldn't have one bureaucracy in Washington making health care decisions for everyone! In fact, there are several things in here that tend to challenge leftish assumptions:
- Contrary to leftish assumptions, individuals do seem to be grown up enough to make health care tradeoffs for themselves
- Individuals seem to want to make different cost-benefit-treatment trade offs from each other, belying the notion there is some universal optimum that bureaucrats in Washington are capable of achieving
- Allowing individuals to actually shop and make price-benefit decisions in health care might actually reduce costs and improve satisfaction (though absolutely no one in DC seems to be proposing a plan along these lines)
Unfortunately, Drum seems to take none of these lessons from his own post. Here is the conclusion he draws:
But maybe the difference is just information: I read an awful lot about this stuff, and it's convinced me that there dangers to overtreatment just as there are dangers to undertreatment. Leonhardt's "fascinating series of pilot programs" suggests that with better information, more people might agree.
Creepily, he seems to conclude from all this that if we can just "educate" the public more, they will be more likely to accept the one-size-fits-all treatment constraints to be implemented by Washington.
PS: I am generally with Drum on doing the absolute minimum for run of the mill health problems I encounter. If I have a cold, for example, I don't start dosing myself with every over the counter drug I can find. And our family tries very hard not to use antibiotics unless the condition is really serious.
But my sense is that my attitude will change a lot if the "C" word ever comes into play. Cancers are much more solveable early than late, and my tendency would be to hit the crap out of it early with as much of the arsenal as I could. I don't know what Drum's personal medical history is, but my sense is that it is unwise to extrapolate linearly one's treatment preferences from colds to cancer.