The other Awards Obama will will this year...
#68
Quote:You'd need to show me the study. Intuitively, people die from their maladies, and lack of treatment. Even the example of joint replacements, where the lack of mobility results in deteriorating health, or uncertain mobility leads to a fall. Now, if you think that having a wait list of many months actually saves lives, then I'd need some evidence of that. Generally, I'd say that poor health leads to more poor health. For example, an extended injury can lead to a lack of mobility and exercise, which leads to obesity, depression, and other health problems.
Hm. Scratch the "study" part - the link from the wikipedia article appeared in the footnote to be a journal article, but it is clearly a magazine article, and not a scientific study. While I find its argument to be generally persuasive but outdated, it is clearly opinion supported with numbers, not objective evidence. Nor is it as helpful with its comparisons as it was cited to be - so don't bother looking at that as any kind of authority. However, the basic argument still makes sense, as follows.

The intuition is this - medical treatment is not risk free. Surgeries (and all treatments) lead to complications, infections, medical accidents, and so on, and those things account for nontrivial fatalities. If you treat everyone immediately, some %X is going to die from these things, and more will have less serious problems.

When one waits a couple weeks for surgery, some people will find out they didn't need treatment - their diagnosis was wrong, or their illness is not as severe as it appeared. Doctors (and especially patients) often jump the gun with treatment, because nobody likes to feel that they're not doing what's necessary. And with a "patient-as-customer" approach, patients who want a treatment tend to get it, if they can pay - even if that is not the medically optimal course of action. But those people who don't need treatment who are made to wait a few weeks will be spared the risk of medical complications - and some %X will have their lives "saved" by non-intervention. This is especially true if doctors have skill at sorting out urgent from borderline cases, and can shuffle the list accordingly.

Now, the question then becomes - are there net lives saved from avoiding unnecessary treatment, or are they outnumbered by the lives lost in delayed treatment? There's an optimum there, and at least for many conditions, the optimum is not zero wait time. (Now, it's probably not three months either.) A system that prioritizes medical criteria can, so long as it is funded appropriately, find that optimum. A private system is almost certain to overshoot it on the side of performing too many surgeries too quickly - patients and patience are surprisingly incompatible.

-Jester
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The other Awards Obama will will this year... - by Jester - 10-19-2009, 01:42 PM

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