More on “Is There Too Much Preventive Medicine?”
The tendency has been to move the goalposts: to screen for lesser and lesser abnormalities, even though the lesser the abnormality the lesser the expected disease cost to the patient and so the less likely the screening and follow-up treatment are to provide net benefits. Moreover, mild abnormalities are far more common than severe ones, so that moving the goalposts greatly increases the number of persons who have to be screened. When the threshold for excessive cholesterol was lowered from 240 to 200, the number of Americans with excessive cholesterol increased by almost 43 million and all of them are recommended to take drugs to reduce their cholesterol, even though the benefits for persons who are not at high risk of heart disease for other reasons are highly uncertain—yet many of these persons are taking the drugs along with persons who can anticipate a significant benefit.
The increased prevalence of screening and preventive treatment has increased the health awareness of Americans and by doing so has increased the innate anxiety that people feel about sickness and mortality.
This is from Richard Posner at the Becker/Posner blog. See Gary Becker’s comments as well. See previous post here.
I thought both the Posner and Becker commentaries were quite good.
Whether or not you think that preventative care is excessive is likely highly to be correlated to whether or not you (or a loved one) have had an ailment that was caught by early screening. It is also highly correlated to your financial interest in patients receiving multiple screenings for diseases.
If you agree with Becker and Posner, then Obama Care is doing exactly the wrong thing. By making these screenings available with no out-of-pocket costs, the act will encourage even more excessive over use.
I’ll start asking a judge for medical advice the same time I start asking my doctor for legal advice. That is never. Posner is a brilliant judge, that doesn’t mean he has a clue about medicine. My doctor is a brilliant doctor, that doesn’t mean he has a clue about law.