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Rationing Care

Posted Oct 07 2008 7:17pm
One of the consistent themes of this blog has been access to medical therapies for the individual vs. societies need to restrict care to control costs. I have made no secret that I pro-patient and pro-consumer.

Tara Parker-Pope’s recent article on prostate cancer in the New York Times just about sent me over the edge. Parker-Pope reports on the feeling that men are over-screened for prostate cancer. This is nothing new and has been circulating in the medical community for almost a decade. However, Parker-Pope seems to go one-step further and imply that men shouldn’t be screened for prostate cancer at all.

Conventional wisdom is that if cancer is detected through elevated PSA levels, doctors and patients feel compelled to treat the cancer, even if it does not progress. “Watchful waiting” does have its place in prostate cancer treatment. But not screening men at all for prostate cancer is, at best, irresponsible journalism and is, at worse, negligent.

Of course, what Tara Parker-Pope doesn’t tell readers is the motivation behind the article. The rationing of care, particularly for men’s prostate cancer, has been an agenda item for America’s Health Insurance Plans (AHIP). AHIP, in an effort to boost profits for its members corporations, has been selecting disease categories to target for restricting care. If the standard of care becomes to not test or treat for prostate cancer, these corporations could save loads of money. Who cares if an extra 30,000 to 50,000 men die?

The goals of society (i.e., rationing care and saving money) are not consistent with the goals of the individual (i.e., prolonging one’s life).
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