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Evidence Based Health Care
Oct. 25th, 2009 09:30 amThere's a really annoying trend in medicine called "Evidence Based". Annoying, because it makes us look at results rather than common sense. Annoying, because it proves that common sense is sometimes wrong.
Take prostate cancer screening. It turns out that men screened for prostate cancer have no decrease in mortality, but a big increase in incidence of impotence or incontinence from more aggressive treatment. It doesn't make sense--shouldn't finding cancer earlier save lives?--but it's true.
I've been thinking lately about this as it applies to the whole HealthCare reform debate. Will HealthCare reform save lives? Common sense says yes; just like with prostate screening, I can say that some people will live because of it who would have died. What I don't know is if, again like prostate screening, some people will die who would have lived. Will infant mortality go down? Hooray! Will standard of care in some disease states slip, as it has in Canada? Boo! But how will it all work out in the long run? We won't know until after it happens.
Certainly, people are now dying who could be saved by available treatments. Some of them have insurance, which just refuses to cover the measure that could save them.
Looking at the mess that Insurance Companies have made of everything, I am, with trepidation, reversing my stand on the Public Option. Let's face it...the government can't do worse than Cigna.
Take prostate cancer screening. It turns out that men screened for prostate cancer have no decrease in mortality, but a big increase in incidence of impotence or incontinence from more aggressive treatment. It doesn't make sense--shouldn't finding cancer earlier save lives?--but it's true.
I've been thinking lately about this as it applies to the whole HealthCare reform debate. Will HealthCare reform save lives? Common sense says yes; just like with prostate screening, I can say that some people will live because of it who would have died. What I don't know is if, again like prostate screening, some people will die who would have lived. Will infant mortality go down? Hooray! Will standard of care in some disease states slip, as it has in Canada? Boo! But how will it all work out in the long run? We won't know until after it happens.
Certainly, people are now dying who could be saved by available treatments. Some of them have insurance, which just refuses to cover the measure that could save them.
Looking at the mess that Insurance Companies have made of everything, I am, with trepidation, reversing my stand on the Public Option. Let's face it...the government can't do worse than Cigna.
