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May 12, 2011


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Goodman's thinking has one major flaw. He (and Kruse?) assume that most people are have to competence to make medical decisions.

I have to disagree. I do not have the competence to make the decisions Goodman insists that I make. I do not have a medical education. I'm not uneducated(I have a BS in Chemistry and Bio. Plus grad degrees in Theology and education). But I know my limits.

In a part of the article you did not quote Goodman said "If not getting a $100 test keeps you awake at night, by all means get the test." That's not what would keep me awake at night. It would be fear of making the wrong decision. If I have the test and didn't need it that is a wrong decision. If I don't have the test and I needed it that a wrong decision. If the decision is made by a Dr then I don't lose any sleep at all.

Michael W. Kruse

You raise an interesting question,ceemac. I was having a discussion recently with a surgeon friend who also teaches. He was talking about the how the pendulum keeps swinging between the doctor basically directing health care and the patient using the doctor as an auto-mechanic. ;-)

I agree that we are not capable of knowing enough to make decisions on our own. But no doctor or bureaucrat can know the different value that each person places on various components that go into making a decision even if the patient had full information an understanding. It seems to me that a physician could be my partner in understanding the costs and risk of various actions. I wouldn't be making decisions alone. For those who just want the doctor to tell them what to do, they can go that route. But those who want to be more judicious could and would.

My main interest in the article is how well he demonstrates that we don't have unlimited resources and that some means of rationing .... by the market or government agents ... must occur. You can't just say health care is a right and act as if there are no cost implications.

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