Even the Institute of Medicine suggests that the US healthcare system is now suffering from an epidemic of over-diagnosis and over-treatment (exemplified by things like MRI scans for people with a “black eye”). And yes, this all comes with a $210 billion annual price tag. That’s about $700 too much, each year, for every man, woman and child in America today. If you want to get the picture, read Tara Parker-Pope’s posting on the New York Times “Well” blog today.
We are not trying to imply that all of this is in some way specifically relevant to the management of prostate cancer, but what is certainly true is that as a nation we are not going to be able to go on underwriting the excesses of the US health care system in this way.
Who do you think is paying for all of this? At the end of the day, you do. It comes out of your taxes, your pay checks, your Social Security payments, and what you are paying for everything else (because the people who make and provide you with “everything else” have to pay for the health care of all their employees too).
It’s worth really thinking, each time you doctor says, “We could do this” or “I’d like you to do that” whether this or that is really going to be in your best interests. Will it actually change the way you are being treated? Is there a risk that (like the MRI for a black eye) it will suggest the possibility that there is yet another problem that turns out to be nothing?
Since, we believe in putting out money where our mouth is, I will tell you that I commonly “Just say no, thank you” to tests that get suggested by some physicians I see. I do this after I have done my homework, so that I am comfortable with my decision. I am always polite about it, but I am all too well aware of how excessive testing leads down dangerous pathways to unnecessary procedures and recommended therapies. Less is not always more, but more is commonly not the best way to need less! (Just look at our obesity problem if you don’t believe that one.)
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