Flunking the test
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.
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.