Saturday, November 28, 2009
The odds of getting a true national consensus on health care are just about as good as achieving lasting peace in the Mideast.
The two primary sides in this debate are never likely to see eye to eye. No, we aren’t talking about Democrats and Republicans. We aren’t talking about rich and poor. We aren’t talking about employers and employees.
We are talking about those who see issues in the macro or the micro. People who view the macro — or the big picture — want data, cost vs. benefit charts, statistics and objective analysis of scientific research. They tend to see health care as a privilege. People who take the micro approach — or focused on the individual — want to know what it means to them and the people they love. It’s fueled by emotion and anecdotes of "I know someone who..." They tend to see health care as a right.
Two recent studies that recommended reduced use of mammograms and pap smears — and to some extent earlier studies that suggested less aggressive methods for prostate and colon cancers and eliminating chest X-rays in routine physical exams — have thrown gasoline on the fire.
The macro group members talk about the cost of tests that prove to be useless or even harmful. They prove their points with numbers and statistics.
The micro group members are angered that anyone would suggest lives are not worth saving as they point to family members and friends who survived cancers. They equate reduced screenings with reduced care — and thus a reduced value on human life.
If you fear for your health or a loved one it is nearly impossible to not take these issues personally. It is emotion at its rawest.
However, a study published in the Annals of Family Medicine found 60 percent of men and 49 percent of women had at least one false positive result during three years of routine screenings for ovarian, prostate, lung and colorectal cancer. As a result, according to a story in the Los Angeles Times, 22 percent of those women and 29 percent of those men had an invasive diagnostic prodecure.
If you are a big-picture person it is hard to support the unnecessary expense, pain and anxiety.
The real problem is that both sides have points in their favor — much like both sides in the Mideast. And both sides are reluctant to compromise because of the fear of starting down a slippery slope — again much like the parties in the Mideast.
What we all must hope and work for — regardless of which side we are on — is a cease fire during which we can find the areas in which we can agree. We will never agree on everything, but we can build on agreements. We must get beyond the political concept of "winning and losing." We must clarify our terminology so we understand each other. We must create an accurate picture of the current situation and share a vision for where we would like to be. Then we can start the journey — maybe not hand in hand, but at least not with clenched fists.