30 November 2012

Screening is not a valid policy goal

In the absence of broad, clear, coherent policy objectives, we unfortunately default to Mickey Mouse micro-objectives that sound convincing, but whose achievement has little or nothing to do with social goals, and can even conflict with them. Narrow objectives are more likely to be gamed in this way, because resources can more readily be shifted from a similar goal that doesn't happen to be targeted. That is one of the reasons why, unlike with the well-publicised Social Impact Bonds, I have always insisted that Social Policy Bonds be tradable. (See here for an explanation of this logic.)

Mickey Mouse, Image Hosted by ImageShack.us
Here's another example of  a Mickey Mouse micro-objective which, after enough time has elapsed to prove its worthlessness, is at last being questioned:
Can we please stop using screening mammography as measure of how well our health care system is performing? That’s beginning to look like a cruel joke: cruel because it leads doctors to harass women into compliance; a joke because no one can argue this is either a public health imperative or a valid measure of the quality of care. Cancer Survivor or Victim of Overdiagnosis?,

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