“EmBARRASSOing?”

Dolors & Sense

by Sanford Rose

KISSIMMEE, FL—(Weekly Hubris)—7/12/10—Senator John Barrasso of Wyoming is undoubtedly a man of deep convictions and strong moral fiber. He has led a praiseworthy, even exemplary, life. Unfortunately, he tends to be on the wrong side of most public issues.

Present at the health-care debate with President Obama earlier this year, the senator opined that the principal reason for runaway US health spending is that people eat and smoke too much.

Statistically speaking, that’s wrong. The principal reason for escalating health bills is the aging of the population which, of course, will continue unless we throw open our borders to a lot more immigrants than Sen. Barrasso is prepared to welcome.

In another sense, the good senator is right. Obviously, excess consumption of food and tobacco exacerbates health problems and raises health costs. But it avails little to point this out unless one is prepared to suggest a solution.

One cannot just ignore fat, wheezing people. One needs to look into the causes of behaviors that injure health and the ways to change those behaviors.

Such behaviors, in fact, are generally rooted in class position and/or economic status. Those located in the bottom deciles of the national distribution of income eat and smoke much more than those in the top deciles.

But Sen. Barrasso’s legislative stands do nothing to create a more equal distribution of income. Quite the reverse: the senator, a hardline conservative, votes against anything that would tend to ameliorate inequality. He also votes against anything that would improve people’s health by taxing carbon polluters.

Interestingly, the senator is a health professional, an orthopedist of note and distinction. Do his professional activities contribute more to the health of the population than his legislative positions?

One would like to think so. One should shrink from impugning the skill and achievements of such a celebrated healer (no paraleipsis intended).

But I am a touch biased against orthopods—perhaps because of personal experiences.

Many are accused of performing operations of dubious utility—e.g., those for arthritis of the knee—procedures that unnecessarily raise health expenses.

Others are reproached for failing to stay abreast of techniques that would obviate the need for total hip arthroplasty (e.g., stem-cell core decompression of the femur to alleviate avascular necrosis) or would greatly reduce the recovery time and the chances for postoperative dislocation should that arthroplasty become unavoidable (e.g., superior capsulotomy or percutaneously assisted THA).

Doubtless, the senator was not and is not one of these. But, if he were, his references to national health costs would prove, to say the least, disingenuous, or perhaps even worse.