Thursday, November 19, 2009

Universal health care all about compassion?

I often see the argument that the universal, single-payer plan is all about compassion. So it was almost refreshing to see an editorial from the St. Petersburg Times that stepped far away from that position.

The editorial, titled "Science, not emotion," discussed the new mammogram schedule recommended by the U.S. Preventive Services Task Force. The facts of the matter illustrate how preventive care is not always cost effective care. Women under 50 years of age were getting rather little bang for their mammogram bucks.

The transition to the bitter pill at the end was a bit rough:

The United States spends roughly 16 percent of its gross domestic product on health care — far more than many other developed countries. Britain long ago adopted a less stringent standard: Begin mammograms at 50 and have them every three years. The task force didn't go that far, and its recommendations deserve thorough vetting by the broader medical community. And women in their 40s should always have the option to finance mammograms either out of pocket or through optional insurance coverage.

But a basic tenet of our health care system must include a willingness to base medical standards on science, not emotion. That is the only chance the country has for making health care more available and affordable for all.

Note: "(W)omen in their 40s should always have the option to finance mammograms either out of pocket or through optional insurance coverage."

Um--what about the "right" to health care?


The editors don't quite get it. A government-controlled system is highly likely to decrease availability of mammograms. Take Canada, for example:

In early 2008, women in southeast New Brunswick who wanted a routine mammogram had to wait more than a year to get an appointment. That has changed since the first of two digital mammogram units have been added to the Moncton Hospital.

Rachelle Gaudet, the manager of diagnostic imaging services for Regional Health Authority B, said women now have to wait about 32 weeks to get a routine screening.

Granted, waiting for a year or so provides women more time to save money to pay for the mammogram. But they'll pay more because of scarcity, and they'll have to wait.

The last paragraph from the editorial serves as the paper's admission that single-payer health care is not thoroughly compassionate. If it was, we could base the decisions on emotion instead of science. Or at least science plus economics. We have the science to provide early mammograms. It is economics that ultimately discourages providing them early and often.

Now I'll start hoping that the Times will admit that the single-payer system would discourage medical innovation.

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