Monday, November 2, 2009

Under HCR iotragenic disease will increase

If you don't know the definition of iotragenic don't feel bad, most people don't. Here's the Merriam Websters definition:
induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures

The word incorporates the nasty side effects of medications, contracting resistant infections in a hospital, and of course incompetent practice of medicine. The term is neutral, as it's existence doesn't mean that a cost benefit analysis of a procedure, or a system, would find that such iatrogenic effect negates a net health gain.

Under HCR, with more people going to doctors, of course, iotragenic disease will increase, but other diseases will decrease.  My point is that the down side of increased doctoring has recieved little attention in the Heath Care Reform debate.

One of the major planks of this HCR is promoting preventive care, with the administration depicting this as an unmitigated good, such as more education, safer food and safer highways. Actually, it is more complex than that, much more so. Preventive care means more tests, such as Mammograms, PSA tests for Prostate Cancer and an array of others.

The argument that such testing saves money has been challenged by many studies, including the this one being a single example that makes the argument that in the very long run it will save money....but no where near what it's advocates claim.   

Actually, the annual doctor visit, if the current system is kept in place, which it fundamentally will, would vastly expand the cost of medical care due to false positives that would require extensive follow ups. And example of this trend is here:

The American Cancer Society (ACS) does not recommend routine prostate cancer screening for all men at this time.

And here's the worst part, from a N.Y. Times article that explains opposition to regular screenings such for PSA, Pap tests, and Mammograms. 

But Dr. Silvia C. Formenti, the chairwoman of radiation oncology at New York University Langone Medical Center, said: “I don’t think there is enough debate. Screening does not pay off the way we expected.”

Dr. Formenti said she was concerned about finding tumors in older people that would probably not kill them. But the diagnosis turns them into cancer patients and erodes their peace of mind forever.

“We take away the innocence of being healthy and not having to worry about cancer,” she said. “The psychological cost of becoming a cancer patient is underrated.”

Dr. Formenti said the emphasis on screening by groups like the cancer society might have misled the public into thinking that screening could prevent cancer. “It’s a giant misconception,” she said.

This HCR will be a victory for the worst strand of the Medical-Hospital-Pharmaceutical complex.  The real cost can not be measured in dollars, although if taken to its logical extreme, it will have dire fiscal consequences.   It is a victory of those who want to make medical care into a religion, a panacea to all that humans are heir to.

It is a false religion, which like every such faith based plan, will exact its toll on a society that it captures. And to make it worse, it will be imposed on every citizen of our country whatever his or her view of mortality.  We will not be forced to dutifully march to our doctors every year, but we will be forced to pay for those who chose to.

This has little to do with providing basic health care to every citizen, something that could be done for a small fraction of this HCR, that requires everyone become full members of the believers in salvation by doctor. 

Learn that word, "iatrogenic." We me have more use for it in the near future.


Comprehensive diary on defects of HCR.

Diary on the roots of the "faith based" Medical religion

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