Sunday, May 09, 2010

Cancer Research and Collectivism

By Paul Hsieh

[Note: This post is part of Modern Paleo's weekend schedule of blogging on Objectivism on Saturdays and free market politics on Sundays.]

Scientific American notes the developing tension between modern cancer research, which is making strides in "personalized medicine" based on your specific genomic data, and the current government push towards "cost effectiness" guidelines, which encourage physicians to treat patients according to aggregate population statistics.

The article notes that "the changing policies... present 'a conundrum' for cancer work":

The first challenge is that comparative effectiveness research, by necessity, focuses on broad populations of patients. But as [Duke University researcher Amy] Abernethy pointed out, "in oncology, we take care of individuals." Newly prioritized research might turn out new results about treatments that are best for most breast cancer patients with a defective HER2 protein, for example, but many other individuals with different genetic factors might still need trial-and-error treatment until research finds what works best for them.
Government "guaranteed" health care will accelerate this push where collectivist treatment guidelines and goals are favored over benefitting the individual.

For more on this, see the piece by Dr. Jane Orient, "Forget the Trees; Look at the Forest on Healthcare":
Traditionally, medicine is practiced by physicians, one patient at a time. The outcome is assessed by that patient. The right decision is the one chosen by the patient, in consultation with the physician, based on what is optimum for that patient, considering all aspects of his circumstances. The standard of care is the Oath of Hippocrates: providing treatment for the good of each patient according to the best of the doctor's ability and judgment.

In the "reformed" delivery system, healthcare is practiced from on high by committees of "experts" pulling the strings of marionette physicians (rankings, payment rates, other incentives and disincentives) who are judged on how well they achieve population-based outcomes. Patients are like sheep in the flock, categorized by race, income level, quality-adjusted remaining years (QARYs), compliance, functional ability, diversity score, or whatever metrics the rulers adopt. Any individual can be sacrificed for the good of the whole.
One indicator that ObamaCare will be running into fiscal trouble will be calls by government officials and pundits for further "sacrifices" by patients for the sake of the collective. And for some reason, the sacrificial victim will always be you! Funny how that works...

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