Bureaucratic centralized control is the bane of good medicine. And yet, our fearless leaders keep wrapping the system in increasing bureaucratic chains, giving faceless planners ever more power, sapping the system of competency and efficiency.
One bureaucratic agenda item is fighting childhood obesity. That’s a good cause, but once medicine takes on a centralized check list approach, stupidity naturally ensues. Case in point, from the UK: Bureaucrats have accused a boy with cancer of becoming obese after his chemotherapy treatment led to weight gain. From the story:
A schoolboy battling cancer has been branded overweight by NHS bosses – after putting on 2lb following gruelling chemotherapy treatment. Medics even suggested that five-year-old Lewis Mighty should take up swimming, even though an intravenous line put in his chest to deliver cancer-busting drugs made it impossible. The youngster, who was given only 20 per cent chance of survival, was diagnosed with neuroblastoma in October 2008. He has since endured months of intensive chemotherapy, surgery and radiotherapy which saw his weight plummet to two stone.
His achievement to put on a few pounds was seen as a milestone for proud mother Jaime, 33. So she was left stunned when a letter from NHS Derby City came through the letterbox of the family home in Mackworth, Derbyshire, saying for his age and sex Lewis was 2lb over what was classed as a healthy weight – between 2st 7lb and 3st 3lb. Incredibly, it even warned he could be at risk from cancer.
Obamacare emulates the NHS’s centralized control–an approach our new selected office temp, Medicare/Medicaid income redistributor/rationing advocate Donald Berwick, has called a “global treasure.” If we keep on this path, we too will soon see such utter stupidity–and worse–such as Oregon Medicaid refusing rationed chemotherapy but offering two cancer patients assisted suicide.
July 21st, 2010 | 12:13 pm
[...] This post was mentioned on Twitter by Stand In The Gap and prasad gurjar, Wesley J. Smith. Wesley J. Smith said: The Stupidity of Centralized Health Care Control Has Bureaucrats Accusing Child Cancer Patient of Obesity SHS |http://shar.es/mV9JC [...]
July 21st, 2010 | 1:02 pm
I suffered debilitating depression for years, alone, mostly bed-ridden and in agony, tempted by suicide constantly; but what did my state low-income health plan never fail to contact me about every month?
My exercise-induced Asthma, which I had not suffered in years, and had always succesfully pre-empted with two puffs of the inhaler. It was a non issue.
It would have been nice to get a call about my life-threatening condition, but nothing I said to these people ever seemed to matter. I wasted my breath, their actions never changed. Talk about making a person feel even more hopeless.
(BTW, I’m cured now. God heals.)
July 21st, 2010 | 2:05 pm
This is what the system should be doing. Irrespective of his cancer, a screening program found him to be over ideal weight and made suggestions how to improve. Big deal. Health care bureaucrats sending letters. How scary is that!
July 21st, 2010 | 2:55 pm
Jeffery,
Think of all the trees cut down and the irreversible climate damage caused by letters from these silly bureaucrats, to which this kid is nothing but a faceless, anonymous cog whose paperwork must be dealt with before lunch-break at McDonalds…
July 21st, 2010 | 8:30 pm
JustChris,
Why does it matter if the workers mailing the letter know much about the young man? They know he is overweight and respond accordingly. Reducing childhood obesity can reduce pain and suffering later in life and also reduce healthcare costs. In addition, the system is probably quite efficient. Your interest in trees and global warming is commendable although your concern might be better served by supporting a carbon tax, solar power or electric cars.
Wesley posted this bit of silly trivial to take a shot at the British NHS, for reasons only he understands. Although the US will never have a NHS-type system, our private insurance companies will continue to mail us bills and EOBs.
Here’s a question for you guys. In the states, why doesn’t everyone who goes to the doctor with a headache receive an MRI? This would save lives by picking up the rare early brain tumor or aneurysm. In fact, why don’t we each have a yearly whole body MRI? This would save thousands of lives a year at a cost of about $300 billion.
July 22nd, 2010 | 8:06 am
So, was the kid obese (in addition to having cancer), or wasn’t he?
Since Wesley neglects to tell us what the British “stone” means with respect to weight, let me. It’s 14 pounds avoirdupois. In other words, the British medical standard for a 5 year-old’s healthy weight is between 2 st. 7 (35 lbs.) and 3 st. 3 (45 lbs.). This kid weighs 47 lbs., which by anybody’s standard (except, perhaps, my Italian grandma’s) is kind of zaftig for someone his age.
Yet Wesley is offended by the idea that the “Nanny State” would bring this to his parents’ attention because, God forbid, the boy’s folks might then have to focus on more than one medical problem at a time. I have to agree with Jeffery: this silly bit of rant is just another of Wesley’s cheap shots at the British NHS.
Wesley J. Smith Reply:
July 22nd, 2010 at 11:20 am
Do you read the story, HW? Or should I just top putting in links? No, he wasn’t obese.
July 22nd, 2010 | 8:20 am
I can’t tell if Jeffery is being crazy or sarcastic–someone help!
Wesley J. Smith Reply:
July 22nd, 2010 at 11:19 am
What makes you think it is an either/or proposition? : )
July 22nd, 2010 | 8:52 am
I think the point Mr. Smith is trying to make (please excuse me if I am wrong) is that a doctor who is involved in the day-to-day care of this patient is better informed and equipped to make health care judgements that is a remote, detached bureacrat.
Wesley J. Smith Reply:
July 22nd, 2010 at 11:17 am
GW: Bingo! And that point is vividly illustrated by the utter stupidity of a bureaucrat looking at check points and not individual circumstances, telling a cancer patient he has become obese because he gained weight.
July 22nd, 2010 | 9:49 am
What do you want to save all those lives for? Don’t we suffer from overpopulation already?
July 22nd, 2010 | 3:11 pm
Yes, I read the story AND the links. Do you have a better word for “overweight” than the medical term “obese”? Or is two pounds over the limit like being “only a little bit pregnant”? Kind of like having a variable constant in math.
July 22nd, 2010 | 3:29 pm
“overweight” than the medical term “obese”?
“obese” is NOT a medical term for “overweight.” A person who is 5′ 5″ and 150 pounds is a bit “overweight.” A person who is the same height and weighs 250 pounds is “obese.” There’s a difference.
July 23rd, 2010 | 7:29 am
In his post Mr. Smith publicizes a trivial event to propagandize against universal healthcare. His intent is to mislead his readers. His association of the words “stupidity” and “accusing”, the right-wing dog-whistle words, “bureaucrats” and “control”, with universal healthcare reveals his intent. The term “obesity” was not used in the story; Mr. Smith added that. In fact, no “bureaucrat” was “accusing” anyone of “obesity”; Mr. Smith made that up. He falsely labels US healthcare reform efforts “Obamacare”, and falsely equates Britain’s NHS to US law.
If the worst outcome of universal healthcare is a form letter suggesting you eat right and exercise, I suspect most Americans will be on board with it. That opponents feel compelled to lie about and exaggerate even the most trivial of events in a vain attempt to defeat universal healthcare efforts reeks of desperation.
His post was dishonest from top to bottom. His post was disrepectful to his readers, who deserve an apology. Mr. Smith?
Wesley J. Smith Reply:
July 23rd, 2010 at 9:13 am
Jeffrey: Almost everybody calls “health care reform” by the title (epithet?) Obamacare. Second, if you would pay attention, I bring up the NHS because of its top/bottom control and rationing boards, exactly what Obamacare brings us. When a recovering cancer patient is sent a letter about his weight, it illustrates the utter stupidity that ensues from this approach–like the Oregon no chemo, but we’ll pay for assisted suicide horror I also mentioned.
Hardly disrespectful nor dishonest. But perhaps over your head.
July 23rd, 2010 | 7:36 am
Safepres: we’re talking about a five year-old whose weight is excessive by medical standards, not somebody who’s 5’5″. Call it what you will. There was no real issue, and Wesley simply used the story as a pretext for taking another of his shots at NHS.
July 23rd, 2010 | 7:53 am
And by the way safepres, it was Wesley who first used the term “obesity” — in the title of the article.
He also erroneously stated that the overweight condition was brought about by chemotherapy (“[b]ureaucrats have accused a boy with cancer of becoming obese after his chemotherapy treatment led to weight gain.”), when the article says very plainly that the child “endured months of intensive chemotherapy, surgery and radiotherapy which saw his weight PLUMMET to two stone.” (emphasis added) That is, to 28 lbs.
Any comments about that?
July 23rd, 2010 | 10:34 am
No, Wesley. BOTH disrespectful and dishonest.
July 23rd, 2010 | 1:05 pm
Wesley,
Neither a single anecdote (nor a string of anecdotes) is sufficient to discredit a healthcare system which caters to millions of patients. Errors are made all the time, even in the smallest practices with the closest doctor-patient relationships.
Every system has its drawbacks. What one ought to ask (if one really cares) is, all things considered, do the advantages of this system outweigh its disadvantages?. One would have thought that a question of this sort would require more detailed analysis, lots of public health facts and figures – rather than a few articles about individual bureaucratic snafus cherry-picked from the popular press.
I know, for instance, that in the US total healthcare expenditure per capita is more than twice that in the UK – without a corresponding difference in healthcare outcomes. This is admittedly a rather boring fact – but it’s far more relevant to this discussion than the tale of the unfortunate young man who got sent an inappropriate letter because of a computer error.
Wesley J. Smith Reply:
July 23rd, 2010 at 1:19 pm
In some cases you would be right, Rave Chukwu. But the NHS is close to implosion and treats the most ill and the elderly most unjustly. There is much to learn from its travails.
July 23rd, 2010 | 10:44 pm
Wesley,
I agree. The NHS isn’t perfect – but this story tells us very little about the sorts of problems the system actually faces and is completely irrelevant when making judgements about the effectiveness (or otherwise) of “centralised medicine” as a whole.
July 24th, 2010 | 4:41 pm
Suppose, instead of the mother’s being proud because her son had gained back his weight, which might actually be a good thing if he needs another round of chemo, she had thought that the writers actually knew what they were talking about and put her son on a diet. A personal, non-form, letter recommending health care measures, done in ignorance of the circumstances, could be much more harmful than helpful. Thank goodness she was able to analyze the situation.
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