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Tuesday, May 03, 2005

Medical Stats and improving medicine

Victor at The Dead Parrot Society has a must read post up about medical statistic comparisons between countries and how little they in fact mean. Very interesting stuff. He then goes on to talk about what our priorities should be toward improving health care:

The high aggregate level of cost we see in health care is simply the inevitable by product of having cutting-edge products that people have faith in coupled with a relatively free market system that rewards those who provide those sort high-value products with scarce resources. I do not see this as a problem, per se. Instead, what disturbs me are the large quantity of medical solutions sold without proof of efficacy, the portion of our populace unable to efficiently get basic care or to make quality decisions about where to receive that care, flawed epidemiological practices and interpretations by the lay community, a paternalistic doctor-patient model in which the consumer's particular preferences are frequently ignored or molded for arbitrary reasons, a flawed legal system that encourages iatrogenesis (something that I fear American doctors are not sufficiently trained to avoid in the first place), an insurance system that encourages overutilization, a related unwillingness on the part of the medical community to allow cost to enter into their decision models, a monopolistic and archaic licensing and credentialing process for medical suppliers and practicioners, and a deification of that which is measurable and observed that comes at the expense of the unmeasurable and unobserved.
I agree completely with his list of problems, and though he doesn't provide any answers it seems only one of these (inability to get basic care) would be facilitated by government provided medical care. The other items would be unaffected directry or, quite possibly worsened by such a solution.


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