It's Rational, Not Rationing

One of the best hours of radio I've ever heard: Drs. Steven Nissen and Craig Bowron talking with Kerri Miller about whether routine medical screenings lead to better medical outcomes.

As it's described on the MPR website: "New research shows that many common medical tests and procedures don't save lives and can even be potentially harmful to patients. But the idea that less care can mean better care goes runs counter to the message that screening for disease is inherently beneficial."

Bowron threw out a term that I particularly loved: the "casino effect." Just as we only hear about the people who clean up on the slots or win the lottery -- and never about all the money millions of people waste on those pursuits -- so do we hear from individuals who had a mammogram at 40 that caught breast cancer, or who had a stress test for no symptomatic reason that found heart blockages. Sure, those unlikely events happen, but you never hear about the vastly larger group of people whose test found nothing, or even worse, who were harmed by the test, follow-up tests, and unnecessary procedures.

Listening to Nissen and Bowron, I had the naive thought that if everyone could just hear these guys explain it, maybe we could solve some of the fiscal and medical mess we're in.