Thursday, February 9, 2017

Healthcare Quality: Dr. Cruz and Professor Sanders

Ted Cruz told Bernie Sanders and a national audience he knows what good health means for the United States of America.

He told us good health means doing more MRI exams than the English do.
He told us superior health care in the United States has insured more American women deliver their babies by C-Sections.
And he told us mammograms are unalloyed benefits to all the women who get them.

Doesn't he clear this stuff with anybody?

The plain fact is C-sections benefit the obstetrician more than the mother--he can get that baby out and not be late for dinner, not have to wait up all night with a laboring mother and he gets to charge a lot more. 
The mother, of course, has to heal from a significant incision and may have to have all subsequent babies by C-section. Not such a good deal for her.
Of course, there are other "facts" Mr. Cruz did not mention: Infant mortality and maternal mortality in the United States places us behind almost every industrialized nation, more in with third world nations.  These measures of public health don't fit with the tale Senator Cruz has to sell. 

And MRI's. Oh, there's a scandal, if you really want to know.  MRI's cost around $3000 in the USA, but only $75 in Europe. Same machines, different systems.  So we get to pay way more for the same care, and the outcomes for the patients are no better. 

Mammograms are trickier, but the reason we do more mammograms than they do in Europe is the Europeans are more critical about assessing the value of every test they do, and it's still an undecided case about whether or not we do too many mammograms, on women who are too young or too old or whether we do them too often. But when there's money involved, the one thing you can be sure of is the analysis is not going to be objective. Profits are at risk.

It's hard to imagine Ted Cruz, who apparently fancies himself an expert on health care would not have talked to enough people to be aware of these basic public health issues, which, to paraphrase Mr. Trump, a bad first year medical student knows. But, evidently, he has not talked to the right people, which is to say, people who know what the Hell they are talking about. 

Of course, look at the setting:  A town hall meeting, with all its drama, its testimonials from patients in the audience meant to "give a human face" to the dull issues of whether or not we spend health care dollars wisely in this country.

Why should we face the really difficult, statistics dense issues when we can have such a dramatic moment with television producers running the discussion on screen?

And poor Bernie, who knows only that it's the rich screwing the poor with healthcare. It's all about class warfare, don't you know?  If Bernie had taken even fifteen minutes to be briefed by that bad first year medical student before the debate, he might have sunk Cruz's ship easily enough.

But, no. This is America. Where we don't believe in facts or analysis or wonky technical stuff. We're all about feelings, not thought. 
So, now we have the government we deserve. We are about to get the health care we deserve.

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