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Oct 28 / Jonathan

Saved from the death panels, by Medicare

From the NY Times review of Stanley Joel Reiser’s Technological Medicine. (I remember those shoe-sizing machines, so they must have been in use in the 1950s as well.)

The Tools of Doctors, and a Price for Patients

Technology distances doctors from patients. It creates a compelling alternative reality composed of facts that may or may not be accurate (note all the false alarms created by spurious X-ray findings and aberrant blood tests). It incites considerable public backlash (shortly after X-rays were developed, stores in London were selling X-ray-proof underwear to preserve genital privacy). Then wild enthusiasm takes over (as exemplified by those X-ray shoe-sizing machines of the 1940s).

Medical professionals tend to be the opposite: first enthusiastic and then less so, as the limitations and drawbacks of the toys become clear. At a 1960 medical conference unveiling a new Teflon shunt for long-term kidney dialysis, the audience of doctors and scientists actually rose and cheered. But soon enough they were faced with the painful task of allocating what proved to be an extremely limited resource.

In Seattle, the job of deciding who would live on dialysis and who would die of kidney failure fell to a seven-member committee of laypeople dubbed, in a 1962 article in Life magazine, “the life-or-death committee.” Sound familiar? Only after the 1972 decision to extend Medicare to dialysis patients were these decisions no longer necessary.

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