Wednesday, March 31, 2010

Preventative Treatment Not Always a Wise Investment

I often hear proponents of increasing health care spending arguing for more preventative care. "More diabetes tests, mammograms, PSA tests, gene testing, blood work ups" they demand. More power to them. Mammograms save lives. PSA tests can find prostate cancers early when survival rates are north of 90%. I like preventative treatments. However, those calling for them often parrot the same refrain: prevention saves the health care system money. This statement seems logical, it seems reasonable. It is also, unfortunately, not true. In many cases, preventative care ends up costing the health care system more than the illnesses they prevent would have cost. I dug up an old Charles Krauthammer article that I read a while back, and he explained it well: "Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care." Since you have to provide preventative care to everyone, even those who may have never gotten the disease in the end anyways, the preventative care will often drain more out of tight health care budgets than it saves. Why am I writing about this now? Last week, the Cancer Advocacy Coalition of Canada released a report calling for many health care innovations, including cutting-edge genetic testing for cancer. These gene tests, or 21-gene assays, can determine whether particular breast cancers will benefit from radiation treatment. Apparently, roughly 25% of breast cancers will not respond positively to radiation treatment, meaning it is essentially useless. Interesting stuff. The group goes on to argue, and the media reports, that Canada should have more access to these $4000 tests. By telling us which 1 out of every 4 breast cancers won't benefit from the $15,000 radiation treatment, these tests will save the health care system money. Got that? If we test all breast cancers at $4000 a pop, we will find out which 1 out of every 4can forgo the expensive $15,000 radiation treatment, thus savings our health care system a bundle. Let's run that math down one more time:
$4000 tests x 4 = $16,000
1 x $15,000 radiation treatment avoided for every 4 tests = $15,000
In the end, doesn't this particular preventative procedure actually cost the health care system $1000 more for every 4 breast cancers?
Now, albeit, this is a rather cold method of determining appropriate care. You could argue, and I would strongly agree, that the $1000 is money well spent for sparing women the agony of radiation treatment that's not going to do any good. Any innovation that can help in the fight against cancer is a welcome one, even if it costs more. However, I'd just rather here our leaders simply say that, instead of masquerading behind disingenuous arguments about "savings."

Monday, March 29, 2010

Earth Hour Dims to New Lows



British Colombians who participated in this year's Earth Hour saved the least amount of energy yet, achieving only a 1.04% drop in energy use. Earth Hour is designed to raise awareness for global warming--er, climate change, an issue I would have thought didn't need any further awareness. I think people are aware enough, I think fewer people this year care. Whether its the leaked Climategate emails showing that scientists fudged data and blocked any dissenting scientific opinions from being published, or its the Nobel-winning UN science team citing anecdotes, off-the-cuff comments and articles from hiking magazines as scientific sources, people have had their faith in the global warming threat shaken, and are accepting less the doomsday scenarios painted by environmentalists. To me, Earth Hour is yet another in a long-list of stunts that do little but grab headlines. After all, dimming the lights for an hour will do nothing to halt whatever climate change we may be experiencing. Perhaps this year's decline in Earth Hour savings is mere coincidence, the result of a few too many people watching a movie instead of genuflecting to this newest eco-tradition. But just maybe, the dim Earth Hour this year is due to people realizing that climate change is too complex an issue to be dealt with by do-gooder yet do-nothing stunts. Perhaps they realize that any reasoned debate on the issue doesn't revolve around the tar sands or the seal hunt or the Chicken Little posturing of the David Suzuki crowd, but rather involves painful trade-offs and implications for our future growth, prosperity and our very way of life and dimming the lights only dims the debate on these real-world obstacles and issues.

Tuesday, March 16, 2010

An Open Letter to Justice Minister Rob Nicholson


Mr. Nicholson,
I am writing to express my strong support FOR the extradition of Marc Emery. I understand that a small group of MPs, unfortunately including one of your own Conservative colleagues, has presented a petition to you and asked for you not to sign the extradition order for Mr. Emery. Mr. Nicholson, I urge you to sign that extradition order. Marc Emery is a cheap provocateur and a tacky rabble-rouser. He clearly was not satisfied with the kid-glove treatment he has been getting from Canadian authorities for years, which I also do not support, and smugly decided to try his hand at selling drugs across an international border into the United States. It is well within the jurisdiction on the United States to punish Mr. Emery for these actions and Canada must not stand in the way. If Canada is to continue to be taken seriously on the international stage, we cannot cheapen our diplomatic efforts by refusing to honour our extradition treaties. Under the Extradition Act, we would have to claim that the United States has conducted "unjust or undue or oppressive actions" in order to justify refusing the extradition request and that is absurd. Marc Emery is petty agitator who rolled the dice and must now face the consequences of his actions. Let us not legitimize his "activism" by refusing the extradition request.
Thank you,
-Cory Redekop

Monday, March 15, 2010

HST Opponents Should Come Up With The $1.6 Billion

The HST opponents are continuing to rally against the proposed harmonized sales tax that will come into effect on July 1st. Former premier Bill Vander Zalm is holding rallies across the province, the NDP is making political hay out of it whenever they can, the BC Restaurant and Foodservices Association is running ads and a website in opposition, and a petition will begin circulating in April hoping to derail the yet-to-be-written legislation. The BC Liberals, who were strangely silent on this issue for so long, have finally begun to fight back, explaining the myriad benefits that the HST will provide for the economy. The BC Liberals need to start demanding one other thing of the HST opponents: where's the $1.6 billion? The federal government gave BC a $1.6 billion payment to harmonize the federal and provincial sales taxes. With the province's budget bleeding red ink, I'd like to know where the strange bedfellows of the NDP and Bill Vander Zalm are planning on coming up with that money? Without the $1.6 billion, we'd be in an even bigger hole than we are now. And what about the tens of millions the government itself will save each year with the HST? Where will that money come from? And what about the billions in savings businesses and employers will get from the HST? What are the opponents' plans to cover all that? The HST makes both short term and long term economic sense for British Columbia and no Vander Zalm-NDP petition drive is going to convince me otherwise.

Thursday, March 4, 2010

The 1990's is no excuse to ignore the deficit


With the federal budget out today, Canada is looking at 5 years of multi-billion dollar deficits still to come, going from a whopping 50 Billion this fiscal year to $27 billion next year to 17.5 billion the year after that and so on. To fight this ballooning debt, the Conservatives have sought to freeze departmental budgets and make some moves to tighten the fiscal belt, with much harder measures to come in following years. The reaction from the Liberals and NDP to this belt-tightening? They want to unbutton their pants and reach for seconds! The NDP is not supporting the budget because they want more spending on personal transfers, more spending on the environment, more spending on public sector wages, and the like. The Liberal leader, Michael Ignatieff, keeps insisting that there really is no deficit problem. After all, he notes, the ratio of debt to GDP is lower now than it was in the 1990's when the deficits were really bad. What Mr. Ignatieff fails to mention is that Canada had no choice but to tackle our deficits in the 1990's because Canada was about to have its bond rating reduced by international rating agencies. A lower bond rating means it would have been harder for us to get money to cover our deficits and we would have to offer higher interest payments to our lenders. We do not want to wait until we are back in that position before we start bringing the federal deficits and debt under control. We already spend over $30 billion a year servicing our public debt. That's money flushed away to our debt-holders that could go to any number of other programs. If we keep piling on billions to the debt just as interest rates rise from record lows, that debt servicing cost will rise. That's the real shame here as it literally forces future generations to pay for our spending. The Liberals and NDP should stop pushing for more spending and support the modest attempts to bring our deficits under control.