I have railed in print about our national health care “system” that spends more and
gets less for it than more advanced nations do because it buys not good health
but “health care services.” I
specifically complained about cardiovascular screening tests offered to the general population but screening
for breast cancer also is overdone, as SJ-R reporter Dean Olsen made clear in a
fine background
report about the rollout of St. John’s Hospital’s new 3-D mammography
machines.
Among the many experts who have
raised questions about the research supporting the routine use of mammograms Dr. Aaron Carroll, Professor of Pediatrics and Assistant Dean for
Research Mentoring at Indiana University School of Medicine. He is also
the director of the Center for Health Policy and Professionalism Research.
And author of the widely read (and respcted ( blog, The Incidental Economist, has been making these points for
years. Readers who’d like to catch up
with this on-going debate can begin with these posts.
“We’re
paying more for screening mammograms. They aren’t making a difference”
“Horribly
depressing news about mammograms”
“This
is why we can’t get the public to accept changes to screening mammograms”
The Atlantic Monthly cited Carroll a
few months ago in “How
Mammograms Improve Survival but Not Mortality.” The article provides
useful background helpful in undertanding key terms in the debate, such as
“survival rate,” that are widely misunderstood.
Olsen quoted the hospital’s director of
radiology as saying, “Really, there’s no negative to having it,” he said.
“Everybody who wants it should have it.” No negative? Only in a world in which such complex tests are free, and this is not such a world. Every dollar thus spent
is a dollar is that isn’t available to be spent on medicine that delivers
vastly more for the buck.
This article appears in Jul 24-30, 2014.
