Thursday, July 23, 2009

Health Care Reform

I have spent the last few days (procrastinating by) reading articles and commentaries on the health care reform. Most of the debate seems to be based on polemics with little understanding of the bill. To be honest, I haven't read the bill(s) floated around, so I cannot comment on its(their) substance. But what I find troubling is some of the attitudes:
"Why is maternity care required to be covered? More than half of the population has no need for maternity care, either because they're male, not hit puberty, or in menopause."
By that logic I wonder why anything should be covered: after all at any given point in time a certain malady afflicts only a few people at a time.

More importantly, pregnancy is not a disease, and should not be treated as such. Since cloning of humans doesn't seem to be anywhere close to hapening, each and every one of us came as a result of a pregnancy. If there were any complications,-- even trivial things like improper diet leading to insufficient nutrients, let alone the more complicated effects such as a wrongly turned fetus(baby), could have resulted in severe health and metal problems to death. So why doesn't self interest tell us that we should provide maternity care?

It seems to me, albeit anecdotally, that the people who make the above claims are also pro-life. If the fetus is alive and worth fighting for while in the mother's belly, why is it not worth fighting for its health care?

Maybe it is the cynic in me, but if men were all of a sudden to become the ones who can get pregnant, I expect that they will be on maternity(paternity) leave the moment a test says they are pregnant, they will have extended stay in the hospital after giving birth, as well as a physical therapy program to get them back into shape and a few more years of paid work to recuperate. In addition, the baby gap in their CV will be yet another "gold star," which we women will lack.

But lets get back to actual diseases that afflict a small portion of the population. Prostate cancer afflicts only men, and predominantly in their late age -- diagnosis before 45 is rare and the average age of diagnosis is 70. Breast cancer strikes women, but unlike prostate cancer it can strike very young women, although of course the risk increases with age. Most men live with prostate cancer and die of other causes, while about 1 in 35 women die from breast cancer. Now the NIH does spend more on breast cancer ($744M) compared to prostate cancer ($299M) or a factor of almost 2.5 according to http://report.nih.gov/rcdc/categories/ the risk of death is nowhere near this 2.5 factor.

I also find it amusing that, at least as far as the wiki page is concerned, there are several new tools for early detection of prostate cancer vs 0 for breast cancer. In general, the wiki page is more/better developed, including 3 times more references and quite a few more meaningful links. This of course maybe just a reflection of who bothers to update the wiki and how, but at best reflects disparity in attitude of the writers and at worst reflects disparity in the available information, which may or may not reflect on the amount of serious effort put into the problem. Or maybe we women just fail to communicate what is important?

UPDATE: Ok so the Mankiw blog is odd. I find his writing seductive, but I often don't quite agree with the message. Anyways, he was also discussing the health care reform and something stuck out in the post for his long term plan to fix the balance sheets (see here linked from here):
The government budget is on an unsustainable path. Americans are living longer and having fewer children.
Well Mr. Mankiw, last I checked women are supposedly interested in having children. Last I checked (and while I myself have no children, my officemate is very pregnant and this here Large University has better than average healthcare and other benefits) maternity care is hell...