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CHRISTOPHER TAYLOR'S BOOKS

Friday, February 07, 2014

BAD MEDICINE

"After 'first, do no harm,' medicine’s second great motto should be "above all, humility.'"

Charles Krauthammer recently wrote a piece about different medical procedures and scientific information that shows how often and absurdly these communities reverse themselves or prove themselves wrong.
The big new one right now is a study that suggests anti-oxidants actually cause or at least worsen cancer, but its been a source of concern for a while that they actually have been harmful and shouldn't be pushed so hard by advertisers and nutritionists.  Lay off the massive doses of vitamin A and beta carotene huh?
He mentions that doctors have figured out most tonsillectomies were not necessary, and then he gets to an interesting statistic that Oregon figured out.  Back in 1993, Oregon passed a bill that basically was socialized medicine for the uninsured, taxing people and paying for health insurance for the very poor.  Among other problems this caused are massive debts in the state and insurance companies withdrawing coverage because the state wasn't paying them, but they also discovered this:
Well, in a randomized study, Oregon recently found that when the uninsured were put on Medicaid, they increased their ER usage by 40 percent.

Perhaps they still preferred the immediacy of the ER to waiting for an office appointment with a physician. Whatever the reason, this finding contradicted a widely shared assumption about health-care behavior.
My guess is its because people on the Oregon Health Plan don't have a regular doctor to visit and don't know how to go about getting one, but the emergency room is right there.
Another interesting reversal is that after decades, Medicare has shown no positive effect in health among the people it was designed to cover and help.  Its cost hundreds of billions, but it hasn't made people more healthy.
Part of this is probably because the bulk of people on the program are the elderly who aren't going to get healthier no matter what their coverage is.  Part of it might be that at least some of the rest aren't people who live the best lifestyles, so the money isn't helping them either.
But its counter intuitive, in a culture that thinks throwing money at something and a government program makes things better.
Oh and one more myth?  Most of the people signing up for Obamacare are not only already people who were on government medical assistance, but almost all of them are signing up for medicare, not the absurdly expensive "Affordable Care" plan.  There may be millions signing up (at least, signed on but not actually part of the plan yet, because the website is still a mess and bottlenecked), but they aren't the uninsured.  In the end, so far, the ACA has resulted in millions more becoming uninsured, not less.

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