3 March, 2008. Prevention being the mother of...invention?

I'm going to be speaking with one of Rob's doctors this week, as I still have questions.

I'm fairly certain that these questions don't actually have definitive answers, but at least if I ask, I'll know that I've asked. You know?

It makes me think about health care, too, in this country. I realise that over here, it's considered uneconomical to provide what we generally term "preventative health care" in any meaningful capacity, but at which point does expense start to override the obviously economically smarter decision to prevent a disease?

Rob had type 1 diabetes, hypertension, renal disease and a very strong family history of heart disease. And, he smoked. He was, perhaps, the poster child for heart disease. Only one of these factors was directly preventable - we both knew that his smoking wasn't doing him any good. Having said that, would an angiogram two years ago have prevented the tragic outcome? At his age - 31 - would it have even been considered?

An angiogram here costs $2100. Cost is obviously a factor in deciding whether or not to proceed with any kind of diagnostic testing, but where do we draw the line?

Rob's eventual medical care (CABG x 3, pacemaker & defib. insertion, associated hospital stays etc) came to over $120k. If he had had an angiogram perhaps two years ago, it would have certainly showed blockages in his left and right coronary arteries (both were 100% blocked at the time of his diagnosis). Could we then have taken steps to prevent last January's massive anterior MI?

Doesn't a $2100 test trump $120,000? Isn't it more cost-effective to prevent a condition, than to treat it once it is manifest?

I'm still thinking about all of this, given the situation, the current health care mess in this country, and the upcoming election.