In a recent statement published by the journal Pediatrics, an advisory panel sponsored by the National Heart, Lung, and Blood Institute of the NIH recommended universal cholesterol screening for all children ages 9 to 11. I’m sure they meant well, but this statement means important people in leadership positions have officially lost their minds.
This decision is wrong on so many levels. In no particular order:
1) There are no randomized controlled trials showing screening and treating children for high cholesterol improves their lives.
2) There is evidence that the heart attack-sparing effect of statins is achieved with just a few years of use. Therefore to start treatment 50 years in advance wastes 45 years of medication.
3) There are lots of studies showing that scaring a patient with a lab value is mostly ineffective in changing behavior.
4) We can just imagine the anal retentive middle- and upper-income parents who will insist on annual cholesterol testing beyond the guidelines “just to be sure.”
5) We can imagine the psychological harm of a child being forced to take a cholesterol medication every day.
6) We can imagine the financial harm to the families, especially those on high deductible insurance plans.
7) We can imagine the harm caused when an obese child actually has a good cholesterol value, and a lot of them will. Now the job of convincing the child and parents to make significant behavior changes just got more difficult.
8) There was clearly no concern to this panel about cost. This will be a hugely expensive undertaking – doctor’s visits, labs, and medications — for essentially no benefit.
On another level, this statement displays the arrogance of the healthcare system at its worst. These people just assume that every issue they think is important must also become important to everyone else in society with no discussion of the risks, benefits, and costs. These people just assume that the most important use of scarce resources is to generate more business for doctors, labs, and ancillary support people such as dieticians.
And all this at a time when our Congress doesn’t have the courage to raise taxes and cut spending so that our children aren’t saddled with an unmanageable debt. With so many children on Medicaid, if this decision is followed it will add to our national debt at about the worst time imaginable.
The ologists, and sadly this time the pediatricians, are once again driving our nation further into bankruptcy and threatening the future of our children. I expected this from the cardiologists. The pediatricians ought to know better.