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William C. Altreuter
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Friday, November 09, 2007

Here's a little snapshot of what's wrong with the American medical system, from an article in yesterday's NYTimes about the death of Ryan Shay at last week's Olympic Trials:

"Since late 2004, the International Olympic Committee and the European Society of Cardiology have recommended that athletes under 35 be tested with an electrocardiogram before they begin participating in sports. This is not standard procedure in the United States.

“In an ideal world, yes,” said Dr. Douglas Zipes, a professor at the Indiana University School of Medicine in Indianapolis who specializes in cardiac arrhythmias. “In reality, the cost effectiveness is insufficient to warrant it. Athletes having sudden death occurs very infrequently. The cost of an echocardiogram or EKG would not be supportable.” An estimated 125 to 300 die each year in the United States.

At the same time, Zipes said, “If this was my own son or grandson, I would want it done.”

So, here is what Doc Zipes remarks break down to: 125-300 healthy people kick it a year? Pffft, what's that? EKGs? Who is going to pay (me) for that?! Europeans? What do they know? Do they even wash their hands? Good thing I'm a doctor so people who are related to me can have this test.

By the way, a quick Google reveals what Doc Zipes and his friends get paid for this service, and it is not an expensive test. A routine EKG is reimbursed by Medicare for under $25 bucks.

My guess is that the actual cost to the doctor is probably lower: if you have the equipment all that is needed is for the physician to read the strip, and I'll bet that most of the time a technician does that. Put another way, apparently there is something about Europe that makes this a test that everybody gets.

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