We have all heard the mantra: prevention is the best cure.
When it comes to medicine and medical research this is very much true. And it is not perplexing why.
Regular exercise, while admittedly unpleasant for someone as physically indolent as myself, is cheaper and easier to do than develop a new and improved antihypertensive pharmaceutical, and have people take it, and deal with side effects, and so forth. Likewise, eating well is also much more straight forward than developing new treatments for insulin resistance. Any person living in a modern country who has a television can no doubt think of plenty of other examples. Moreover, when it comes to infectious diseases, we can all understand that not catching something in the first place is far superior a choice to catching it and then trying to treat it. Agreed? Okay. I’m not expecting much contest on this. I’m also not expecting much contest on the idea that GPs are an important source of information and advice on how to avoid preventable illnesses by adopting a healthy lifestyle.
So what of those illnesses that we have little if any control over? The cancers, the neurological disorders, and autoimmune disorders for example, that strike when we least expect it and might have relatively little to do with our lifestyle? The best and most cost effective treatment for these is early invervention. By a good old country mile.
The budget launched by smokin’ Joe Hockey tonight included a number of changes to just how much of one’s medical expenses Medicare will cover. Where in the past it was possible to see a bulk-billing doctor for free (admittedly they weren’t always easy to find), all visitors to the doctor will need to make a co-payment of $7. Furthermore, a co-payment of the same amount will also be required for blood tests and the like, which also used to be free. Add to this a hike in pharmaceutical payments, and it is beginning to look less and less likely that old Mrs. Jones, or down-on-his-luck Mr. Smith who was made redundant, will visit the doctor as soon as they feel that something might be amiss. After all, living on a limited income is tough – especially when one has to care for others – and when asked to choose between paying bills that might already be late, and seeing a doctor over what may or may not be a problem, one can understand why they might choose to deal with the more immediately pressing of the issues. Given the circumstances, it is an utterly forgivable choice.
Here’s where things get grim. What if that niggling pain in one’s gut is the beginning of a serious, though treatable if caught early, gastrointestinal condition? What if that dull lower back pain isn’t from lifting up the kids, but is the first sign of a malignancy? What if that odd bout of numbness was a transient ischaemic attack and a more severe stroke is just waiting to happen? What if old Mrs. Jones I mentioned before is taking warfarin and needs regular blood tests to regulate her dosage? Is she likely to keep all of these appointments if she has little spare money? These are all very worrying questions. These are also all situations where early intervention and consistent monitoring is the best option.
With the changes the government has proposed, it is very likely that people with low incomes will wait longer before seeing doctors and those who need regular care will be less likely to comply with treatment plans. People with limited incomes will also be far less likely than those of more ample means to see a doctor for advice on lifestyle changes, like weight loss or quitting smoking. This creates a situation that not only endangers their lives, but can generate more costs. Take the example of the transient ischaemic attack above – some routine tests and an affordable prescription for an anticoagulant may save this person from ever having the stroke. By far this is cheaper than treating a devastating large-scale stroke in hospital. It doesn’t take a team of medical scientists to make this plain.
In something of an attempt to make up for this, or to guilt the Australian public into accepting the changes being made, the government has also offered up billions in medical research funds. Hockey touted these funds as a potential source of cures for illnesses. Any person who has worked in health in Australia (I have worked in community pharmacy for years) knows that those who are most likely to suffer from treatable illnesses in Australia are those with the least monetary means – namely the elderly, the disabled and those trapped by poverty. I think you can see where I am going with this. Again, prevention and early intervention are always better than cures. They have made a crucial error in judgement on this and have given (comparatively little) with the one hand while taking (comparatively much) with the other.
This is why, even though I am a PhD scholar who does all of his research in a medical research facility and likely will build a career in such places, I cannot in good conscience approve of Medicare co-payments being funneled into a medical research fund. If I am serious about the health and well being of human beings, I cannot ignore the clear benefits of a responsible, affordable, accessible and effective preventative healthcare system. Despite the potential benefits to myself, I cannot muster the cognitive dissonance to do this. Now, I am not saying that medical research does not need money – not at all. Medical research and the finding of cures and new treatments is of course a very valuable and worthwhile activity in its correct context. It is also an activity that really does need government funding, as much important research in Australia focuses on illnesses that are unattractive to the bottom-line-oriented mentality of large pharmaceutical companies. Doing it at the cost of sound prevention, early intervention and ongoing treatment practices, however, is just not a sustainable or ethical strategy.