Monday, October 08, 2007

The ICD gap

We should be proud of ourselves as Americans. This past week, the Journal of the American Medical Association published two papers showing that white males receive significantly higher numbers of ICD’s (implantable cardioverter-defibrillators) than black males or women. These are little machines that shock your heart if it goes into a deadly rhythm, often restoring a normal rhythm and in the process saving your life. Having one is like having a whole resuscitation team, electric paddles and all, tucked neatly inside your chest. That white men are receiving them disproportionately should bolster our faith that our free market health care system is working: it proves that if you have money, you can buy better healthcare. Granted, patient preferences may explain part of the ICD gap, and bona fide racial and sexual discrimination may also be occurring. When the devices cost $30,000 each, though, and the disease against which they protect (heart failure) affects many pre-Medicare age people, we can rest assured that financial restraints are playing a central role. That’s where we’ve done well; that’s precisely what makes this country so great. Here, the wealthy don’t have to stand in line with everybody else. If they did, you might as well be living in France or Sweden; we might as well just have adapted the socialist model. No, in the U.S., money still makes a difference, and the American Dream is still alive. We didn’t want to share our health care resources with the poor, and the JAMA studies show that under our current system, we don’t.