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Tuesday, March 03, 2009

We want the best and we want it now!

As The New York Times reported today (A Hurdle for Health Reform: Patients and Their Doctors, Mar 3, 2009), what fundamentally drives the costs in America's health care system is the desire on the part of doctors and patients for the best--meaning the costliest to most--new treatments and medicines. It doesn't matter if the upside is slim to none. Stick a high price on something and a few slick ad pages and Bam! you've got a winner on your hands. Ever check out the number of beta-blockers out there? How about ACE inhibitors? Gazillions and none of them work appreciably better than the first ones out of the block twenty-five, thirty years ago.

The Times cited a 2004 study (published in The American Journal of Public Health) that showed that only 1 in 16,000 people benefited from recent technology as regards their health.

Today I finally convinced someone not to bother with Tamiflu for her daughter. Was I being too harsh? You decide. Her daughter had had the flu already for three days. Tamiflu needs to be started quickly, at the onset of symptoms. Even then the average flu symptoms will disappear only a half day before they would have without Tamiflu. Would you spend nearly $100 for half a day's symptoms (which would be alleviated anyway with some ibuprofen or naproxen)? I wouldn't and that's what I told her. She said she wouldn't either.

You got your diet, your exercise, your vaccinations, your indoor plumbing, and good old clean water (to drink AND to wash your hands). Everything else is pretty much luxury.

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