Health Care Link Dump

It's too multifaceted for me to get into today, but there are a number of good posts out there on health care. Don't worry, though -- it's a very small link dump.

To lead off, here's Digby the medical/insurance industry as an arm of Wall Street. From a Bill Moyers interview with Wendell Potter:

Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year. Under these conditions, Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations."

Here's Barbara O'Brien at Mahablog on treatments that work versus treatments that cost a lot. She's focusing on a new treatment for prostate cancer costing billions to develop that is probably no more effective than what we already have.

There are a number of treatments for early-stage, slow-growth prostate cancer. These treatments range from “watchful waiting” — not treating the cancer at all, but just keeping an eye on it — to surgical removal of the prostate gland, to high-tech proton radiation therapy using a proton accelerator. The costs for the various treatments range from a few thousand dollars to hundreds of thousands of dollars.

However, there is little evidence that the more expensive treatments are any more effective than the cheap ones, including watchful waiting. Indeed, for an older patient, watchful waiting makes sense, as there is a high probability he will die of other natural causes before the prostate cancer becomes a problem for him. On the other hand, younger patients, meaning men under the age of 65, might benefit from more aggressive treatment. But which more aggressive treatment?

Having just been through three months of having my whizzer nuked five days a week, I feel qualified to comment on this one. The results were positive, but not definitive. I would have preferred another treatment that is cheaper and just as effective, but the hospital I was at doesn't do that one. One thing that O'Brien doesn't mention is side effects, which are a consideration when making a decision on therapy. I was intent on avoiding surgery at all costs, because the side effects are unacceptable and largely permanent, and it's only slightly less expensive than the radiation therapy I was undergoing. So now I'm back to the baseline -- watchful waiting. And, me being me, you'd better believe my doctors got grilled on effectiveness of the various treatments proposed. I live by one rule when dealing with professionals: they are professionals, they know the field, and their advice should be listened to. But how to proceed is my decision.

OK -- those two are required reading.