Good News For People With Unwanted Wrinkles

Two articles in the New York Times yesterday (August 29, 2007) should give us pause about the sorry state of health care in the U.S.


First, there was an article entitled “Botox Appointments faster than For Moles, Study Finds,” written by Natasha Singer. In summary, the article written by Jack Resneck, Jr, and colleagues reviewed a study published online August 28, 2007 in the Journal of the American Academy of Dermatology in which wait-times for Botox treatment for unwanted wrinkles and evaluations for suspicious (i.e., is it cancer?) moles were compared. The authors found that wait times for appointments for Botox treatments averaged 13 days vs. 68 days for mole evaluations. The authors concluded that dermatologists should better monitor how their patients are scheduled. No duh!

This report is not at all surprising. Who can blame dermatologists and other physicians who treat people for skin “disorders,” including those that are considered cosmetic. Treatment with Botox is lucrative while evaluation of moles is “nickle and dime” stuff. The data are just symptomatic of how bizarre the U.S. health-care system is at present. It would be easy to blame the skin docs for this situation but should we hold them to a higher standard than anyone else in business? Maybe, but I think the blame should go to our higly dysfunction health-care system.

Health Insurance Woes

The second article is actually an editorial entitled “Bleak Findings on Health Insurance.” The editorial discusses the recent Census Bureau’s report on the state of American health insurance. I haven’t read the Census Bureau’s report but according to the editorial the number of uninsured Americans has been “rising inexorably over the past six years.” Last year the number of uninsured Americans increased by more than 2 million to almost 50 million. The leading reason for the steady increase in people without insurance is the steady decline in employment-based coverage (in 2006, 22 million full-time workers have no health insurance). The number of uninsured children increased by more than half a million to almost 9 million. The editorial urges reauthorization of the expiring State Children’s Health Insurance Program (called S-CHIP) but does not give recommendations regarding the overall scary health coverage situation in the U.S.

Of course, the health insurance coverage mess does not have any impact on Botox treatment for unwanted wrinkles since the procedure is not covered by insurance. All it takes is a large supply of cash ($400-500/treatment). What to do about noncosmetic medical care? This is a very complex problem which will require a comprehensive approach if we are to achieve our potential for the best medical care in the world for all people in the U.S. As I discussed in an earlier posting, I have concerns about S-CHIP as it is currently designed given the problems with access to medical care even with S-CHIP coverage in many places in the U.S. (including in my State, Missouri).

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