Mammograms & SUVs

The QoL's found one of those haste makes waste stories I adore, in which it is discovered that one should wait a bit and see what the actual long-term effects and costs of one's good ideas are before imposing them globally. In this instance, we find that unprotected Chinese villagers pay the price for all those Priuses we feel so good about driving.

Mr. W. reminded us last night in a dinner conversation that it's the Greens' fault we have SUVs in the first place. All the environmental standards they imposed on cars forced the industry to find a work-around: namely, they exploited a loophole in the CAFE standards exempting corporate and farming vehicles. So first SUVs were corporate cars. And then the EPA, after heavy lobbying, classified the Jeep Cherokee as a "light truck" and granted it a waiver from the Clean Air Act. Voila: the dominance of the SUV.

Heavy lobbying: which points to another problem with government deciding the rules: government can --will-- always be bribed. No standard ever applies except the standard that whoever can pay the most for an exemption wins and the government will be delighted to step in later with an expensive crony-employing program to "solve" the problem it created in the first place. Think, for example, of the recent "death panel" decision not to recommend --or recommend coverage-- for routine mammograms until after age 50. That decision was a cost-cutting measure, pure and simple. No cancer experts were consulted.

The outrage from that decision was so immense, they had to backtrack, as Brett McS pointed out to me.

Think for a moment what that means for our health care system. Aren't you looking forward to the day when the richest, most PC lobbies determine where our R&D dollars go? When your standard of care is controlled by lobbies? Soon we'll all be at each other's throats vying for health dollars: my breast cancer is more important than your HIV; you're only denying my care because I'm black. More fighting, whining and breakdown of the common good. What a beautiful world this will be!

Moreover, getting back to the example of the environmental havoc being wreaked by the creation of Prius batteries, it's inherently problematic to judge standards of treatment on the basis of "studies," even when they aren't ideologically skewed. The redoubtable Nat Hentoff explains, citing two Harvard experts.

President Obama and his supporters in Congress insist that clinical studies prove how many needless and expensive tests and procedures are so often performed. But these are collective statistics. Individual patients are left out.

Harvard Medical School faculty members Jerome Groopman and Pamela Hartzband bring the individual back into this crucial debate in "Sorting Fact From Fiction on Health Care" (Wall Street Journal, Aug. 31): "Data from clinical studies provide averages from populations and may not apply to individual patients.

"Clinical studies routinely exclude patients with more than one medical condition and often the elderly or people on multiple medications. Conclusions about what works and what doesn't work change much too quickly for policy-makers to dictate clinical practice." Everyone, regardless of political party, should keep in mind:

"If doctors and hospitals are rewarded for complying with government-mandated treatment measures or penalized if they do not comply, clearly, federal bureaucrats are directing health decisions," Groopman and Hartzband wrote.

He concludes (RTWT, it's an important piece) and he is not a guy who's ever been given to hysterical jeremiads:

I'm scared, and I do mean to scare you.
We do not elect the president and Congress to decide how short our lives will be. That decision is way above their pay grades.

It certainly is. I don't appreciate our national push for Hobbesian existence.