Health Care thoughts: Comparative Effectiveness Research, Gender and Emotion

by Tom aka Rusty Rustbelt

Health Care: Comparative Effectiveness Research, Gender and Emotion

A key cost bending feature of PPACA (Obamacare) is comparative effectiveness research (see http://www.hhs.gov/recovery/programs/cer/index.html).

This research is designed to apply statistical, economic and clinical analysis to care and treatment to encourage effective care and block ineffective treatments.

It is highly likely, based on current research, the statisticians will recommend less screening and much less treatment for prostate cancer. As my doc says, “almost all old men die with prostate cancer, almost none of them die from prostate cancer.” Screening should likely be focused on younger men and more aggressive forms of the cancer.

With men being somewhat nonchalant about such matters, and prostate cancer being something less than a celebrity telethon issue, it is unlikely there will much of a fuss. Money can be saved and the resulting increased mortality will be slight.

At the same time, current recommendations about breast cancer are suggesting a lot less mammography, and there is an uproar.

(I must plead guilty to being protective and emotional, Mrs. R. will have annual mammography, despite a clean history and no risk factors, if I have to pay out of my own pocket.)

Breast cancer hits many women, hits many younger women, and the results are horrifying. The blowback from advocacy groups has been and will be fierce.

So can we get past gender and emotion to become more efficient and effective? I doubt it, and readily admit I am one of the culprits.