Public Option?

Posted on October 29th, 2009 in Uncategorized by Karl

The government can’t even effectively distribute this year’s flu shot – not to mention the H1N1 vaccine.  Are you sure you’d like them more involved in our healthcare system?  What are we thinking?

Healthcare Reform: Ditch The Public Option

Posted on October 28th, 2009 in Uncategorized by Karl

Is “the public option” really we really want (or need) to fix our healthcare system?  Think about it.  Do we really want the Federal (or state) government running one of the biggest, most important industries in the US.  (Healthcare is currently 16% of US GDP.)  Show me one example where the government has been able to do that successfully?  Medicare is an absolute disaster on all accounts. The US Postal Service?  Amtrak?  TSA?

OK, let’s say we are stupid enough to allow a public option.  What will happen?  First, the government plan will be focused on achieving economies of scale first and foremost and will not concern itself with innovation.  The government will try to use its size and purchasing power to negotiate special terms.  Second, healthcare providers (hospitals, clinics, & doctors) will consolidate to fight off this newly formed oligopsonist.  So we will quickly have a health care market dominated by oligopsonists and oligopolies. What does this mean?  It means increased prices, limited choices, no innovation, and inferior quality for patients.

What are we thinking?  The public option is a bad idea.

Did I just read that “Cancer Screens are Bad for You”? What?!

Posted on October 28th, 2009 in Uncategorized by Karl

Last week Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society (ACS), said that the benefits of cancer screens, especially breast and prostate, have been overstated.  His message is complex.  However, the gist of Dr. Brawley’s message goes something like this:  According to the ACS, PSA tests and mammograms can be a bad thing for two reasons:  1) PSA tests and mammograms are not very good screens for prostate and breast cancer, respectively.  (Note, however, they are the only screens commercially available today.)   2) Wide spread cancer screening leads to overdiagnosis and overtreatment of patients who would be better off “watchful waiting” and not doing anything with their “benign” cancer.In the case of breast cancer, for every 100 women told they have breast cancer, 30 have cancers that are slow growing and unlikely to be life threatening.  Thus, treating these patients would actually increase their risk rather than lower it. Similarly, 70 out of 100 men diagnosed with prostate cancer would be better off not undergoing treatment.I have two problems with Dr. Brawley’s message.  1) As a quantitative person, I believe that more knowledge/data is better than less.  I do not subscribe to the “I am better off not knowing” philosophy.  If I were the patient, I’d like to have as much information as possible about my illness.  Thus, the idea that “screening is bad” is (in my book) offensive.  I say this even if we safely assume that today’s screens are not ideal and will (hopefully get better) in the future.  2) Dr. Brawley’s timing is suspect.  This smells like the beginning of Obamacare were services and screens will be rationed.  I could scarily see insurance companies reading Dr. Brawley’s remarks and concluding that they will no longer pay for PSA tests and mammograms going forward.    That would be a disaster for the US healthcare system and a huge step backwards.