Doctor frustration: “I’m at the office late every night taking care of mindless paperwork, just so the insurance companies can deny payment.”
Do lucky charms improve performance? Sometimes.
Is an adopted child like a used car? Does the adoption agency have a duty to reveal all defects?
Would you pay $93,000 to live four more months? If you have prostate cancer, you may get that chance.
American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it. That’s because the majority of prostate cancers grow slowly. In other words, men lucky enough to reach old age are much more likely to die with prostate cancer than to die of it. Even then, the test is hardly more effective than a coin toss…
The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over.
The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. That’s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long.
Full editorial on the inappropriate use of P.S.A. screening.
Five years after surgery for prostate cancer, for instance, 72 percent of men treated at leading hospitals are alive, compared with 62 percent of those treated elsewhere. Scrutinizing data from specific cancer centers reveals even greater gaps. Five-year survival for stage IV prostate cancer is 71 percent at Fox Chase, for instance, but 38 percent nationally. For stage IV breast cancer, the respective figures are 28 percent and 19 percent—an almost 50 percent edge. For stage IV cervical cancer, five-year survival is 33 percent at the Cleveland Clinic vs. 16 percent nationally.
This is Begley and Interlandi in Newsweek. HT to Alex Tabarrok of Marginal Revolution.
I would be interested to know what treatment he is going to receive. If he is having a robotic radical prostatectomy, I would venture to guess that this modality would not be routinely covered under Obamacare.
It would also be interesting to learn how the diagnosis was made. If it was via transrectal ultrasound directed biopsies, HR3200 has a provision in it which rescinds the Stark exemption for referral of a patient for a radiological procedure to a facility which the physician has a financial interest. This would include ultrasound even though most would consider this a part of a urologist's practice nowadays. Had he needed to be referred to a facility other than the urologist for this procedure, it's very possible that the diagnosis would have gone undetected and he would have had cancer diagnosed at a later stage, when it might be more difficult to treat.
Just some random thoughts about this irony and that we are all going to be patients one day, so be careful what you wish for.
This is Gary Becker, writing at his blog:
A study by Samuel Preston and Jessica Ho of the University of Pennsylvania shows that the fraction of men receiving a PSA test, which is a test developed about 25 years ago to detect the presence of prostate cancer, is far higher in the US than in Sweden, France, and other countries that are usually said to have better health delivery systems. Similarly, the fraction of women receiving a mammogram, a test developed about 30 years ago to detect breast cancer, is also much higher in the US. The US also more aggressively treats both these (and other) cancers with surgery, radiation, and chemotherapy than do other countries. Continue reading Are We Getting Our Money’s Worth in Health Care?
This is from a study by June and David O'Neill for the Employment Policies Institute: