A Swift kick
That’s what our ignorant, pandering politicians need
Notes on the news:
It’s too bad Jonathan Swift isn’t around to witness the antics of the U.S. Congress. The author of Gulliver’s
Travels would recognize the increasingly boorish, yahoo behavior of our lawmakers.
An example occurred recently when House Ways and Means Committee members tried to tie down CMS chief Dr. Donald Berwick with threads of hostility like Lilliputians. Republicans have painted Berwick, the noted patient-safety and quality advocate, as a lover of government-run healthcare and rationing. They detest the reform law and anyone connected to it or President Barack Obama. The tense tenor of the hearing—the first Berwick has undergone since his appointment—was established early when Chairman Dave Camp (R-Mich.) asked, referring to the U.K’s system: “Are you still in love with the National Health Service?”
Camp was referring to Berwick’s statements about singlepayer health systems and preventive medicine. It’s doubtful that Camp and colleagues have a handle on healthcare in the U.K. American politicians’ fuzzy understanding of healthcare is exceeded only by their ignorance of other countries. Combine the two, and you create a giant intellectual sinkhole.
For more than two hours, Berwick was pelted with objections from representatives railing against the reform law and warning that it will conjure up all manner of evil, including the placing of healthcare in the hands of demonic government officials and the demise of capitalism. Throughout this, Berwick remained calm and declined the bait. Whatever Berwick’s faults, it is hard to view this Harvard pediatrician-turned-quality advocate as a mad bureaucrat bent on thinning the American population by devouring its babies, as Swift satirically suggested about the Irish in A Modest Proposal. This magazine has raised
questions about how effective his 100,000 Lives Campaign really was, but the fact remains that he has tried to save lives. That’s better than most members of Congress, whose record likely will be measured not in lives saved but in lives ruined.
After the hearing, two developments showed the importance of comparative effectiveness research, a concept regularly denounced by unenlightened or cynical politicians as a gateway to rationing and the demise of our own citizens. One was a new book by Dartmouth
researchers titled Overdiagnosed: Making People Sick in the
Pursuit of Health. It contends that medicine’s push for early diagnosis of disease can harm patient health. Authors say the tests often lead to unnecessary and expensive treatments for ailments they may never develop, let alone die of. The second item was a new study in the Journal of the Amer
ican Medical Association showing that many women with early breast cancer do not require painful removal of cancerous lymph nodes from the armpit. That’s about 20% of patients in the U.S., or 40,000 women each year. This finding runs contrary to a century of conventional wisdom among American surgeons, who thought it would prolong women’s lives by preventing the cancer from recurring and spreading. That practice, however, sometimes results in infection and disabling swelling.
The goal of these studies is not to deny care. A key objective is to be compassionate and spare the patient unnecessary distress. Blasting such research may be good politics, but it is not good for people.
At a time when America’s problems are becoming more complex, our political leaders, particularly in Congress, are peddling cliches as solutions. Healthcare professionals unhappy with efforts to mindlessly slash health programs and retard progress have options. One is to vote to dump the cynics and the willfully ignorant of both parties in favor of candidates dedicated to serious governance.