Map of life expectancy at birth from Global Education Project.

Friday, November 12, 2010

I had to read a European journal to learn about this

It seems that Kenny Lin, a medical officer for the U.S. Agency for Healthcare Research and Quality, has resigned his position in a controversy over recommendations for prostate cancer screening. The story is quite revealing.

The U.S. Preventive Services Task Force was scheduled to vote at a meeting on November 1-2 on recommendations concerning prostate cancer screening. (Hmm, what else was going on around that time?) It seems the PSTF had voted preliminarily last year to recommend against routine prostate cancer screening for men of all ages, but then they decided to delay the official vote until this year. Then they canceled the meeting.

As Jeanne Lenzer reminds us, writing in BMJ (it's indecent to discuss this sort of thing in the United States, don't you know), reminds us of what happened when the PSTF recommended against routine mammographic screening of women in their 40s. Specifically, the excrement hit the ventilator and and everybody from Sarah Palin to Deborah Wasserman Schultz, to her eternal discredit, started screaming about the Death Panels.

In the 1990s, the Agency for Health Care Policy and Research (now called Agency for Healthcare Research and Quality), which sponsors the USPTF, recommended against spinal fusion surgery. The spinal surgeons, who needed to hold on to their horse farms much more than they needed to provide appropriate medical care, succeeded in getting Congress to eliminate the agency entirely. Funding was eventually restored, but at a much lower level.

Prostate cancer treatment is a river of gravy for surgeons, oncologists, and radiologists. They don't want to see it slow down. AHRQ now says the meeting will happen in March, safely after the election. We'll see. But we will never get health care costs under control if we can't make these decisions based on what's good for people, not what's good for business.

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