Thursday, June 02, 2005

the american life

There were two articles in the Sunday Boston Globe that caught my attention. One was about a philanthropist who made a promise to some 2nd-graders 15 years ago that he would pay their college expenses. The other was about trying to repair a baby's defective heart.
The article (which is available only through the paid archives, but here is a link to a related story) said that only 4 of the 69 2nd-graders from Cambridge have graduated from 4 year colleges on time. An editorial today paints a slightly rosier picture, as an additional 12 completed technical school and 25 are still in college, and the offer is good through 2008. But still, to me these numbers are shockingly low, and what's worse is that these numbers are considered to be above average. These kids and their parents and their teachers had 11 years to prepare, without the excuse of "how can we afford this", and yet so many of them didn't make it.

I bring up the other story less for what happened to the kid than for what it means for everyone. A baby was diagnosed in utero as having a hole in his heart. The parents decided on an experimental procedure to fix it. It was only a partial success, and the kid had to undergo the standard procedures once he was born.

Nowhere in the 4500 words did the cost get mentioned.

As a parent, I was saddened by the ordeals this family had to go through (I've been told that I have very little empathy, but having a kid changes that). But I just didn't know what to make of it. The procedures must have cost hundreds of thousands of dollars, the family was typical middle- or upper-middle-class, so who is paying for it?

Maybe it's just considered R&D money, as one theme of the article is that doctors need to do dangerous procedures now so that they become viable in a few years (one ethicist even argued that the parents have an obligation to society to consent to the surgeries). Companies certainly have the right and stakeholder obligation to invest in the future, and in this case, the R&D benefits not just this particular company/hospital, but all companies (and thus all of society) since they share knowledge.

On the other hand, maybe the best thing for these kids is to die with dignity (which a majority of the experimental physicians said they would do if it was their own kid).

I think this illustrates the best and worst of American medicine. It's really amazing that doctors can and do go in utero to try to save a baby's life, and that's possible only because they keep on trying. But on the other hand, to spend that much on such a small chance of life while other things go untreated says something too. (And it's not the parents' or the doctors' money that is being spent, or even the hospitals' money as the costs are probably being absorbed by the system. Although others might have, I wouldn't have even brought it up if it was Bill Gates spending a couple million of his own dollars on his kid's life.)

And I don't know what I would do if it was my kid.

1 comment:

Anonymous said...

According to http://www.educationreview.homestead.com/2003GraduationRates.html only 70% of students nationwide graduate from high school, and only 32% do so with the required courses to attend an accredited four-year college. So if the school you're talking about is typical, then only 22 students out of the 69 would even be qualified to go to college, much less would do so. So the fact that 29 of these kids even made it to college --- even if they don't graduate --- suggests that this class is doing better than typical.

That said, I, too, have to admit that I find this shockingly low.

On a related subject, see http://www.cnn.com/2005/EDUCATION/06/06/college.promise.ap/index.html about some women who were promised one of these scholarship deals when they were in sixth grade, but the donor reneged.