Two days ago our local newspaper ran an article by Gardiner Harris excerpted from the New York Times. It dealt with a recent study that showed a reduction in risk of death of 20% from lung cancer in current and former smokers with annual low-dose CT scans. In other terms, one of every 300 people screened lived who would otherwise have died during the study. All of the experts are not yet willing to take the leap that this should be the new paradigm, however, and there is still some controversy regarding the statistical methods and financing, with tobacco money in the mix and a clinical researcher who earns royalties from CT machine manufacturers. This researcher is quoted as saying that the study likely underestimated the benefit as the participants were screened only three times, and that 10 years of screening might have averted as many as 80 percent of lung cancer deaths. However, the article goes on to say, it is not known if the cumulative risks of the radiation (equivalent to a mammogram) might offset the benefits.

Regardless of the outcome, one comment in the piece stood out for me: The roughly $300 cost of the CT would likely fall to the patient, as few insurers pay for screening tests of this nature. “The federal Medicare program will soon reconsider paying for such screens, a Medicare official said.”

So, let me get this straight: The financially strapped Medicare program wants to consider taking more of your and my taxpayer dollars to provide free scans to people who voluntarily shell out $5 a day to support a tobacco addiction but don’t want to pay for the scans themselves. Let’s ignore the fact that a quarter of those screened were noted to have anomalies, nearly all benign, that required more CT scans and sometimes biopsies and surgery. Then again, let’s not.

If I sound like I’m seeing red—I am. And my Dad died from smoking-related lung cancer. Those of you who regard people that feel as I do as cynical curmudgeons, don’t make the mistake of thinking we object to paying our “fair share.” It’s just that it’s become increasingly obvious that the people who don’t pay have a grander view of what “fair” is than we do. I have a better plan: Let those who buy the cigarettes pay for the scans. And those nonsmokers who feel others should contribute there “fair share” should voluntarily contribute their own money to a fund set up for that purpose. It’s a revolutionary concept—it’s called charity.


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  1. theseep Says:

    I’m with you, why should we spend preventative money, regardless of effectiveness, on people who are unwilling to quit smoking as the primary preventative act? By choosing to spend that $5-$7/per pack on cigarettes, smokers are relieving anyone else of responsibility for the care of the incurred health problems. I’ve told ER patients with heart or lung disease who continue to smoke that if they’re not willing to quit smoking, the one thing they can do themselves to mitigate their medical problem, then they really shouldn’t be asking us to fix them, it’s irresponsible and a waste of everyone’s time and money! I’m telling you, there is much common ground between liberals and conservatives 😉

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