Monday, September 03, 2007

Edwards Supports Mandatory Preventive Care

As part of his bid to control a huge part of the economy, John Edwards is proposing that everyone be required to get check-ups whether they want to or not.

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat "the first trace of problem."

I understand Edwards' personal interest in women getting early mammograms. But several problems spring to mind for me.

First, shouldn't adults be allowed to make decisions, even bad ones or ones you and I would disagree with? My mother died of lung cancer and that was probably the most devastating event of my life and the lives of my father and siblings. But as much as I hate to admit it, it was her choice both to smoke (which caused the cancer) and to refuse to seek help once symptoms began cropping up. In short, forcing mandatory preventive care takes away our basic right as adults to make our own choices.

Secondly, as I noted in this post, preventive care doesn't bring down the costs of health care. Why? Because preventive care requires not just treating the person who has a disease or condition--say, diabetes or obesity--but also all the people around that person who will affect that person's choices. That's very expensive, and doctors aren't even sure if such measures work in curbing bad behavior. It's a nice theory that if we emphasize preventive care that the costs of treating diseases will go down, but even if we do reduce the number of people who are obese or have diabetes, these same people will eventually get something else and need treatment for that. In other words, preventive care just adds another layer of cost to the health care system.

Finally, how would we enforce a mandatory preventive health care system anyway? Will there be health care police coming to beat on your door if you haven't gotten your annual mammogram? Will the system disallow treatment for certain diseases if a person didn't get the preventive care when they were supposed to? I can't see that being a winning proposition for any political candidate.

Emphasizing preventive care through education efforts is a good thing, but Edwards and all proponents of universal care must realize that preventive care is not the cure-all they want. There's simply no easy solution to human nature and the choices we make.