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Fixin' Healthcare

Wednesday, December 14, 2005

What If

I was wondering how things would be if Medicaid had preceeded Medicare. What if children had been placed first instead of senior citizens? What if there was a health care system that included medical care but was not dominated by medical care? What if health care was based upon primary prevention services, identification and management of health risk, and early detection of health problems? What if all people (everyone) participated in such a health care system with access to early medical care when it is necessary?

Then, I read about the proposal from the Illinois Governor to provide health care to all children.

"Every single child ought to have health care. If a child needs to go to a doctor, that child ought to be able to go to the doctor," Blagojevich said. He added that health insurance programs for children should target both middle-class and low-income families. "They work, and despite their best efforts, they cannot take their children to the doctors. That's not right in my view," Blagojevich said (Chicago Tribune, 12/13).

Susan Sontag's son recently wrote in the NY Times Sunday Magazine about his mother's struggle with terminal cancer. Several cancer specialists observed that with current knowledge early detection is the most productive course of action.

The focus needs to be on "diagnostics rather than therapeutics," Hartwell said. "If you catch a cancer at Stage 1 or 2, almost everybody lives. If you catch it at Stage 3 or 4, almost everybody dies. We know from cervical cancer that by screening you can reduce cancer up to 70 percent. We're just not spending enough of our resources working to find markers for early detection."

Mark Greene, the John Eckman professor of medical science at the University of Pennsylvania and the scientist whose lab did much of the fundamental work on Herceptin, the first important new type of drug specifically designed to target the proteins in the genes that cause cells to become malignant, agrees with Hartwell. The best way to deal with cancer, he told me, is to "treat early, because basic understanding of advanced cancer is almost nonexistent, and people with advanced cancer do little better now than they did 20 years ago."

Not so crazy, after all.

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