Death by Bureaucracy
by Newt Gingrich
October 21, 2011
Earlier
this month, a panel appointed
by the Department of Health and Human Services made a recommendation so
detached from the good of individual patients it could only have come
from government
bureaucrats. They recommended eliminating screening for the most common
cancer
among males nationwide
The
United States Preventative
Services Task Force (USPSTF) is composed of 16 government-selected
experts
whose recommendations often influence the reimbursement policies of
Medicare
and private insurers. The range of members’ backgrounds is narrow
considering
the group is charged with advising the federal government and other
healthcare
providers on specific medical procedures: almost all are academics or
administrators rather than practicing physicians. The panel includes
experts in
pediatrics and newborn care, in mental health and geriatrics, but not a
single
urologist who actually takes care of prostate cancer patients.
Despite
lacking any specialist who
deals with the issue, the panel issued a recommendation this month to
stop
using the only available test to screen for prostate cancer. PSA tests,
which
measure levels in the blood of a marker known to be elevated in men
with
prostate cancer, are the sole method of screening other than digital
examination by a doctor, which cannot detect the most common form and
usually
identifies those cancers it can much later, when they are less curable.
Without
the PSA testing, many men will
have no way to know they have the disease until it has developed into a
much
more dangerous problem. In some cases, it will be a too late by the
time they
discover it.
What
is the basis for the panel’s
recommendation to discontinue screening that can save lives?
It
has nothing to do with the merits
of the test. Instead, these government-appointed experts advised
against
screening because they disagree with what some doctors and patients
choose to
do with the information once they have it.
Prostate
cancer is a complicated
issue, and elevated PSA is not always a sign that a man should enter
treatment.
In some cases, men can live with benevolent cancers and remain healthy
for
years. In many other cases, it is simply unclear even from biopsies
whether the
cancers are benevolent or lethal, as both kinds register on test
results.
Exposed:
Lawlessness and Racism Run
Rampant in Obama’s DOJ
So
says DOJ whistleblower J. Christian
Adams in his shocking exposé, Injustice. Revealing never-before
published
details about several important cases, Adams exposes the racism and
corruption
that are running rampant in Obama’s Justice Department. Click here…
Understandably,
many men faced with
this information want to do everything possible to make sure they do
not have a
lethal cancer, and many doctors, as well, recommend curative therapy
even when
they are not certain the cancer is lethal. There are definitely
patients,
especially older men, who undergo treatment for prostate cancer they
could have
lived with if it had gone undetected.
If
prostate cancer is over-treated,
the sensible response for the USPSTF would have been to call on the
National
Institute of Health and the National Cancer Institute to help develop a
better
and more accurate test, and to advise doctors and patients to consider
more
conservative approaches when the test suggests the presence of prostate
cancer.
Instead,
the task force’s answer is
simply to deny doctors and patients the chance to consider early
treatment by
recommending they not screen for prostate cancer in the first place.
That
is not a reasoned response to the
problem. It is a bureaucratic response to the problem, and people will
almost
certainly die because of it.
This
points to the difference between
the bureaucratic approach to healthcare, which leads to rationing, and
an
approach to empower individuals and their doctors to make the best
decisions
for them.
Bureaucrats
cannot comprehend the
complicated details of all the individuals for whom they try to make
decisions
and so they issue one-size-fits-all pronouncements for large classes of
people.
In this case, when the bureaucratic approach identifies a class that is
being
over-treated, it calls for the elimination of screening to warn of the
disease.
That way fewer people will have the information they need in order to
be faced
with choices involving some options the bureaucrats consider
undesirable.
Physicians can’t over-treat a prostate cancer they have not detected.
Of
course, it is ridiculous to have a
handful of government bureaucrats with no expertise in the matter
issuing
recommendations that influence federal, state, and private health
systems in
crafting policies. Doctors and patients are in the best position to
determine
whether individuals should be screened for prostate cancer and to judge
the
best course of action afterward.
No
one should want the government
interfering in these very personal medical decisions. Lethal
bureaucracy is a
disease we can’t afford—and one that is entirely preventable with the
right
policies.
Your
Friend,
Newt
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