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Posts Tagged ‘doctors’

My 44-year old friend Natalie looks great. She is half way through her radiation treatment for a malignant tumor found so far back in her breast no self-exam would have found it. Hopefully she’ll be able to avoid chemotherapy. She had no family history of cancer, no genetic or behavioral markers. It’s true there is no way of knowing whether this particular tumor would have killed her; some cancers are so slow-growing as to be almost non-threatening. Mammograms detect more thoroughly than ever any anomoly but even when something is found to be malignant, it’s not always possible to know whether it’s potentially fatal. Natalie doesn’t care and neither do her friends, frankly. At this level, the anxiety is more than worth it.

I understand the concept of “evidence-based science” as well as the next person. Reason demands evidence, at least when it comes to issuing absolutes. Too many people are inclined to make presumptive declarations — that is, declarations that presume knowledge. So yes, show me the evidence.

I also understand that our bodies are highly complex organisms with any number of uncertainties built right into them. There may be tumors and aneurysms, clogged veins and weakened livers, and even degenerative disks, none of which are necessarily going to harm us or even slow us down. Why find out if you’re caring a potentially threatening gene, some argue, the operative word being potentially? Life is about uncertainty; some things we can’t know; others we don’t need to.

But even though I get all that, even though I believe that we must all learn to live with uncertainty, even though I realize living involves risk and  many kinds of cancer aren’t life-threatening, I cannot wrap my mind around what not being tested might have meant for my friend Natalie.

 

My difficulty with the recommendations has nothing to do with the politicizing of the findings, which are, after all, reissues of earlier recommendations. Trying to tie these recommendations to the “threat” of managed care is another deliberate attempt at fear-mongering. But I find the “small risk” argument to be an unpersuasive one: except for chemo, most women will tell you mammograms, sonograms, biopsies, anxiety, and even radiation are worth undergoing. Yes, evidence shows that only one in more than 1900 women’s lives were saved by early testing. But that one may have been my friend Natalie.

 

 

 

 

 

 

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I am sick to death about the health care arguments. I know you are too. In fact, that’s something about which we can all agree, I hope, as it appears not much else is.  Well, wait, there’s something else: we all feel the health care system needs reforming.

The devil is in the details, as always, and there are far too many details for most of us to process. So we argue about generalities or about specifics that are either irrelevant, less relevant or completely  misunderstood by most of us. Now I read that as Congress recesses, partisans are planning attacks on each other and on selective specifics, such as targeting Congressmen who oppose a public health plan option as being in the pocket of the insurance industry (MoveOn) or preventing a public insurance option because it might cover abortion (private conservative group). The DNC will accuse Republicans of trying to kill health care  reform and the RNC will accuse Democrats of trying to foist a risky experiment on the American people. Doctors will show up at Republican rallies to rail against medical malpractice costs and lawyers will show up at Democratic rallies to rail against inadequate protection for consumers. At this rate, Congress will reconvene in September and do nothing because they can’t agree on what they’ll claim are key pieces of the legislation. leonardo_da_vinci_man_in_circle

Where does that leave us? Bluntly, it leaves me with more than adequate health insurance that, at the present time, I can afford, notwithstanding health-related expenses are becoming one of the single highest yearly expenses I have. But it leaves my single mother friend, my 58-year-old consultant friend, and my married friend with two children and self-employed, disabled husband with a lot less.

The insurance companies are promising to reform themselves, which I’d like to believe but unfortunately, I have only to think of the financial industry – well, you get the point. I detest the idea of more regulation but wouldn’t mind a conditional attempt at requiring the private sector to cover preventive health care and alternative approaches, not to mention pre-existing conditions. I don’t like the idea of more taxes but I don’t like the idea that small businesses can’t afford to insure their employees. I know the between forty to fifty million people are estimated to be without health care but I imagine many more are under-insured, and so the idea of a publicly financed option looks good. I think that trying to track down positive or negative examples of how health care works in Great Britain or Canada is asinine because first of all, the systems don’t resemble each other and second of all, neither will resemble whatever the Senate brings out of committee.

The real question all of us have to ask ourselves is whether we believe health care for all our citizens is a right or a privilege, an obligation or a blessing, a guarantee we must make or one we can’t make.  We should have asked and answered it long ago, but we sure as hell better know when we run into our representatives in August.

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