walkitout (walkitout) wrote,
walkitout
walkitout

rationing health care

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html

Peter Singer doing a summary of quality adjusted life years and deciding where to spend health care dollars. He does the usual setup to show that, no, we don't _actually_ have an infinite amount of health care resources and, yes, we are engaging in de facto rationing because not everyone has equal access, and then describes quality adjusted life years as a rationing mechanism. Basically, it's sort of like cap-and-trade for health care: we only have this much money to spend on health care, so let's spend it where it gets us the most.

It turns out that while I'm all over the rationing of health care, and would even happily support this strategy, there are some massive problems with it. It is tremendously easy to get suckered by Pharma's studies showing that if you just put expensive drug X in the water (or whatever), everyone will not die of Y and therefore live forever. Ignoring the fact that they will instead die of A, B, and C, possibly totaling out at more deaths faster than if you never treated anyone at all.

Yes, once again, I've bent something apparently unrelated back to my usual screed against disease definitions which spiral out of control, scare the shit out of people, and result in treatment morbidity and mortality equal to or in excess of whatever it was everyone is so terrified of. Or, don't bother being screened for cancer, but be willing to consider treatment if it becomes symptomatic.

Or, simplest of all, don't go looking for trouble.
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