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Save the boobies under attack

Started by merithyn, November 17, 2009, 07:53:09 AM

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Barrister

Quote from: Berkut on November 17, 2009, 09:53:15 AM
I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

The only acceptable answer is "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!" So much of what is "important" in medicine is based on completely emotive responses, rather than simple and dispassionate evaluations of risks and costs.

Kind of funny Meri that you would champion this, while at the same time you laugh off vaccinations. A bit inconsistent there in your decisions about what preventative measures should be taken. Vaccinations are a lot cheaper, and prevent a illness that is MUCH more likely than breast cancer in women in their 40s.

Funny, I don't recall Merithyn (or anyone else) saying "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!"  Instead all she  (rightly) said was as a woman with no history of breast cancer, but a history of ovarian cancer and a hysterectomy, she wasn't sure what to do.  A perfectly natural response.
Posts here are my own private opinions.  I do not speak for my employer.

Berkut

Quote from: alfred russel on November 17, 2009, 12:02:10 PM
Quote from: DGuller on November 17, 2009, 11:49:12 AM
Quote from: Malthus on November 17, 2009, 10:01:55 AM
The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.
Another way to look at it is that if your budget for saving lives is fixed, then doing away with inefficient expenditures actually saves lives.  Sure, some people who'd previously live will die, but many more people who would've previously died would live.

I buy a lot of crap I don't need, and lord knows the wife does too. If we are going to fix a budget for saving lives, that number should be high. I'm willing to tolerate some "inefficiency" to avoid dying of cancer.

Nobody is saying that it should be illegal for people to get all the mammograms they would like and are willing to pay for.
"If you think this has a happy ending, then you haven't been paying attention."

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DGuller

Quote from: alfred russel on November 17, 2009, 12:02:10 PM
Quote from: DGuller on November 17, 2009, 11:49:12 AM
Quote from: Malthus on November 17, 2009, 10:01:55 AM
The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.
Another way to look at it is that if your budget for saving lives is fixed, then doing away with inefficient expenditures actually saves lives.  Sure, some people who'd previously live will die, but many more people who would've previously died would live.

I buy a lot of crap I don't need, and lord knows the wife does too. If we are going to fix a budget for saving lives, that number should be high. I'm willing to tolerate some "inefficiency" to avoid dying of cancer.
Doesn't matter how high the budget is.  As long as there is a budget, and that budget doesn't allow to screen everyone for everything perfectly, efficiency gains would save lives.

Berkut

Quote from: Barrister on November 17, 2009, 12:03:07 PM
Quote from: Berkut on November 17, 2009, 09:53:15 AM
I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

The only acceptable answer is "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!" So much of what is "important" in medicine is based on completely emotive responses, rather than simple and dispassionate evaluations of risks and costs.

Kind of funny Meri that you would champion this, while at the same time you laugh off vaccinations. A bit inconsistent there in your decisions about what preventative measures should be taken. Vaccinations are a lot cheaper, and prevent a illness that is MUCH more likely than breast cancer in women in their 40s.

Funny, I don't recall Merithyn (or anyone else) saying "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!"  Instead all she  (rightly) said was as a woman with no history of breast cancer, but a history of ovarian cancer and a hysterectomy, she wasn't sure what to do.  A perfectly natural response.

I was not talking about that portion of her response - I was talking about her bemoaning how insurance companies might use this to not fund as many exams. And my post is a little long - it's not like there is any reason to assume that every single sentence I wrote was a direct response to some particular poster, as opposed to the attitudes that drive the industry in general.

Then I was fortunate enough to have Marty come along and make exactly the kind of response I was talking about. He was even kind enough to invoke death panels, which really was rather funny.
"If you think this has a happy ending, then you haven't been paying attention."

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merithyn

Quote from: Berkut on November 17, 2009, 09:53:15 AM
I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

The only acceptable answer is "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!" So much of what is "important" in medicine is based on completely emotive responses, rather than simple and dispassionate evaluations of risks and costs.


The greater concern to me is the fact that the methods used in the last 19 years have dropped breast cancer deaths by 30%. Sure, it bears looking at how that process moves forward that isn't overkill but in a way that still protects women. But I also think that including insurance companies in the discussion is a problem. Insurance companies do not care about people. As an institution, they care about the bottom line, not the EKG line. That's not to say that keeping costs in mind shouldn't happen, but it should be a distant consideration.

For instance, if everyone who freaked out about H1N1 heard that there weren't enough vaccinations because it wasn't cost effective to vaccinate everyone, there would be a huge public outcry.

QuoteKind of funny Meri that you would champion this, while at the same time you laugh off vaccinations. A bit inconsistent there in your decisions about what preventative measures should be taken. Vaccinations are a lot cheaper, and prevent a illness that is MUCH more likely than breast cancer in women in their 40s.

In case you're concerned about how I actually feel about this report (as opposed to what you've assumed), I'm neither for nor against changes of this type, and I certainly champion neither side. Yes, I think that insurance companies should stay the hell out, but that doesn't necessarily mean that I disagree with the new recommendations. The confusion is on who to believe, which studies are useful, etc. I thought it interesting, that's all. 
Yesterday, upon the stair,
I met a man who wasn't there
He wasn't there again today
I wish, I wish he'd go away...

merithyn

Quote from: Berkut on November 17, 2009, 10:15:26 AM
Not at all - my point is simply that we should make these kinds of decisions based on presumably objective and scientific studies (like this one), but for the most part we do not.

I had not gotten that from your posts, either. In fact, I agree with you. Not sure why you took issue with my earlier post, but *shrugs*...
Yesterday, upon the stair,
I met a man who wasn't there
He wasn't there again today
I wish, I wish he'd go away...

Viking

When Boobies Attack!



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