The Texas Senate Has No Heart
Last month House Bill 767, that would have required electrocardiogram (ECG) screenings in Texas students participating in UIL athletic activities, was passed by the Texas House and sent to the Senate for consideration. Today, five Republican Senators from the Senate Education Committee voted to kill the bill.
The Dallas Morning News recently published two pieces that attacked the proposed legislation – the first was a May 11 article by sports writer (but not health expert) Corbett Smith. Then on May 15 the paper posted an editorial imploring lawmakers to “follow science, not emotion,” and to not pass a law designed to mitigate risk and save lives.
To support the bill, I wrote the following rebuttal to the original article by the sportswriter Smith, and submitted it to the Dallas Morning News. Not surprisingly, it was not published, so I present it in this forum.
“In Corbett Smith’s article “Why bill aimed at saving lives of athletes lacks support of medical professionals,” cardiologists Mark Levine of UT Southwestern and Silvana Molossi of Texas Children’s Hospital discuss why looking for heart conditions in otherwise healthy appearing students is a bad idea.
Their reasons run from the extraordinary to the usual. Dr. Levine starts by making the case that since ECG screenings can’t pick up all incidence of disease, doing them in the first place would be a wasted effort. Applying that same logic to driving would mean that since we might have an accident, we shouldn’t wear seat belts. And although I agree that Levine has a point when he says, “ECG’s are an imperfect test,” seat belts aren’t perfect, either.
And yet, every time I get into a car, I automatically buckle up. Not because some law tells me that I have to, but because I know how much safer being strapped into the vehicle is. Even though seat belts aren’t 100% effective, even though they won’t always protect me against serious injury, and even though in some cases they can actually lead to harm – or even death – I still take the time to make sure mine is put on properly.
Next, the cardiologists point out that even a “modest false positive rate” would unnecessarily sideline thousands of athletes a year, and Dr. Molossi expresses her concerns about the testing that would be needed to follow up any abnormal ECG’s. Never mind that even if – among those thousands of youngsters – only one hidden heart condition were to be found and that life saved; it seems that the good doctors would have the legislature believe that in that type of scenario, the juice just isn’t worth the squeeze.
But this proposed law is really about minimizing risk, which is something our government already has – many times in the past – taken great pains and expense to do. For example, after terrorists brought down the World Trade Center, a national system was created which employs a massive workforce, costs billions of dollars to administer, and disrupts the lives of thousands of people every year, often due to false positives that turn out to be nothing.
And even though their screening methods can never be 100% effective, the Transportation Security Administration was put into place to save a relative few out of the millions of people who travel to and within our country. A colossal effort to be sure, but one which is – I think most Americans would agree – well worth it.
Just like the ECG bill before the Texas Senate. Even though all disease won’t be caught, even though some players will miss games while chasing down false positives, and even though every death won’t be prevented, the relatively few lives that could be saved will be, well, worth it.
Especially since the bill allows parents to opt out by simply signing a form, since Texas taxpayers will not pay anything for its implementation, and since – most importantly – making such testing readily available to so many will drive down the artificially inflated charges that are a product of our current “managed care” system.
Behold, where Levine and Molossi both conclude their reasoning, is with that ultimate of excuses why health care services can’t be performed outside the “normal” delivery mechanisms – the cost. And this is, I suspect, the real reason why they, their employers, and the medical profession in general will not support the idea of making health care services like ECG’s available to the masses.
Because doing so would pull back the curtain, and reveal that it isn’t the costs of health care that are outrageous; it’s the charges. To perform an ECG only costs around 50 cents for the ten pieces of plastic and single sheet of paper required, and mass screenings are already being carried out for prices as low as $15 each. But our health care system rewards itself by allowing a charge of hundreds of dollars for an ECG, in exchange for restricting the tests availability to the population at large.
So by remaining opposed to mass screenings UT Southwestern, Texas Children’s Hospital, and countless other health care entities are – literally – making a killing.
We need proactive, consumer-oriented health care in this nation, and we can start by safeguarding the most precious commodity we have: our children. As a practicing physician I support this bill because it represents a tremendous step forward in that direction. I hope the Committee, the Senate, and ultimately the Governor will agree.”
A few days ago, twelve witnesses (including a cardiologist) testified to the Senate Committee in favor of the bill, and only two (including the good Dr. Levine, who had a testy exchange with Senator Sylvia Garcia) spoke against it. And yet, the establishment won. There will be no mandatory ECG screenings required by law. At least not for now.
A setback, to be sure. But the tide is turning. The house of cards of Big Health Care is wobbling. And as more and more efforts such as this take hold, the sheer anti-sense of what the health care “experts” preach in their hopes to ban access to affordable health care services, will become more and more apparent, and the right changes will happen.
To quote my friend Scott Stephens, who lost his son Cody to undiagnosed heart disease and has been the driving force behind this legislative effort, “Screen ’em. Screen ’em all.”