I’d prefer we go in order. Aka, you address the issues I raised rather than skipping them before I answer your question.
These schedules are set for cancers that the individual is highly at risk for- there is no scheduled sarcoma or leukemia check.
Your are mistaken. Screening is for
all people of a particular demographic (e.g. all women over 21, all people over 50 etc), though frequency or type of test may be determined by level of risk. You are correct in that there is no sarcoma or leukemia screening schedule but what does that have to do with overuse of medical tests?
Politics aside, screening schedules are set up based on scientific data AND taking into account cost-effectiveness. Medial professionals consider how many times a certain test has to be run before a disease is detected or a life is saved. They also look at how accurate the test is, how risky and how expensive. These, and similar factors, determine whether it qualifies as an effective screening test and whether it should be instituted as part of standard medical care. They also determine on who and how often it should be done.
Individual doctors have always been expected to adhere to these and other basic guidelines (even though compliance isn’t always what it should be);
standards of care in medicine are not determined by the individual doctor any more than laws are determined by individual lawyers.
Aside from screening people with no outward indication of disease, medical tests are also used to find the diagnosis when someone is sick as well as to determine how well they are responding to treatment. That’s called diagnostic testing and here the decision to test is based on the individual doctor’s findings or opinions. Still, he/she has to provide a justification for ordering a particular test (to the patient, as well as to the insurance company). It’s easy to overuse diagnostic testing, particularly if malpractice is a major fear, because in medicine, asking ‘what if’ generally makes for a much longer list of possiblities than ‘what’s likely’.
Despite America’s notably less healthy life style, we have the world’s best survival rate for most cancers. I would assume this has to do with the way we treat cancer. Either we are willing to wait longer before declaring someone ‘terminal’ and moving resources elsewhere, or we have someway of assuring that the cancers we fight are weaker. aka, early detection.
If you think the reduction in repeated procedures will be significant, I’d love to see the data that led you to this conclusion.
Not sure what your question is here: “if I think the reduction in repeated procedures will be significant”, but I’ll refer you to my explanation of screening above. Finding cancer early is generally a result of screening unless symptoms arise early. Screening frequency is set as described above.
Yes, increasing the patient population will increase the demand for screening and the need for resources. It will also decrease the proportion of people needing treatment for complications of the diseases that are screened for (e.g less need for amputations, less incidence of blindness, if diabetes is caught and adequate treatment begun earlier).
I provided a case for it- the number of people in the system at any given time can not be increased without expanding the system. However, more people will be trying to get in. Thus, others will have to wait. Their conditions are likely to worsen with time.
Even the obscenely high wages paid to most specialists has failed to create enough of them- if the government wishes to subsidize the education of our doctors, that’s fine. Increasing the patient load will do nothing to solve this problem.
So why not expand the system? Sure there will be growing pains but what’s the alternative? Accepting that the less financially well off go without adequate care?
It is likely that our medical resources for mother/child care would be inundated if every child conceived was brought to term - is this a reason to not aim for that goal?
Dubai is an industrialized nation, why should space there be so much more expensive than space here? America is world’s apart from other industrialized nations in terms of the healthiness of our lifestyles.
Point taken. Real estate isn’t quite the same as brain surgery though. Don’t know about the last part of your statement either. How do you measure ‘worlds apart’?
And for your question- All insurance providers have contracts with their patients that determine when they are obligated to pay.
It’s just that one of your earlier statements seemed to imply that only the actions of private insurance companies were governed by contracts and government was exempt.
