nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Monday, April 12, 2010

Fewer Tests, Better Medical Care? The Campaign To Cut Costs Begins

Journal editor argues that high-tech, cutting edge tests are "making us worse."

An article appeared in USA Today (Apr 12) that purports to address the centralized planner's need to control cost by eliminating "unnecessary and ineffective" care.

I'm reminded of how the Canadian government denied the use of Herceptin for women with non-metastatic breast cancer, saying the same thing, that it had not been proven effective yet.  How did they do it?  By selectively reviewing the data, as in this article, and by criticizing the available science as "incomplete." 

How many women died as a result, before the government relented?  I don't know, but I bet they'll never do a study to find out.

Now that's not to say they we don't sometimes find out in retrospect that a treatment is ineffective, or not as beneficial as we thought, or additional benefits beyond the primary one were over-hyped.  That's what science is all about: two steps forward, re-orient, one step back maybe, and press on.  That process worksBut "less is better" does not.

In my opinion, we will begin to see a lot of incomplete and selective analyses as we go forward with an unsustainable health care system.  It will be the way we impose (dare I say it) rationing.  Those people who thought death panels would terminate  That's not the way centralized planning works.  There will be no mention of impact on individuals and no implication that decisions are being made on the basis of excessive cost.  Rather, a selective assessment, based on science, and supported by at least one expert, will be produced to show that the needed care wasn't really effective.

Is this too much paranoia?  Big Brother out to get us?  I don't think so.  Regarding these efforts to manage human behavior and choice, John Stuart Mill said they create “a despotism of society over the individual, surpassing anything contemplated in the political ideal of the most rigid disciplinarian among the ancient philosophers.”

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