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I sincerely hope our presidents' care isn't limited common practice.

by marcusverus 1y ago

dragonwriter 1y ago
I don't think being a current or former president materially changes the rationale for that recommendation.
- fwip 1y ago
  Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The cost of performing the test is inconvenience (admittedly of a man whose time is very valuable), but the cost of missing a major health problem has geopolitical consequences. The health recommendations are definitely going to shift toward "better safe than sorry."
  - dragonwriter 1y ago
    > Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The recommendation is not based around the public impact of the patient's death, but around the expected utility of the test in improving the length and/or quality of the patient's life, which is fairly low in the best of times for PSA screening.
    - fwip 1y ago
      A president and their team is absolutely going to take a "better safe than sorry" approach. The doctor is not the only person who decides what treatment should be, the patient does too.
      - rfdave 1y ago
        PSA is not fool proof test, and is susceptible to false positives. A substantial fraction of men, in the 40+% range have prostate cancer at death. The treatments for it can be painful and have long recoveries, so there's not obvious solutions.
- s1artibartfast 1y ago
  I think it does. For one, there are major 3rd party consequences of illness that are unparalleled. Second, many recommendations are based on resource limitations that simply don't exist for a POTUS. Last, and similarly, standard of care is based on standard doctors, treatment, and hospitals. They go out the window when these aren't true.
  - dragonwriter 1y ago
    > Second, many recommendations are based on resource limitations that simply don't exist for a POTUS. AFAIK, the PSA one isn't based on resource limitations, though. It's based on the specificity being low enough and the risks, especially with advancing age, of the follow up tests being high enough that at a certain point the test is perceived as having zero-to-negative value in terms of QALY for the patient.
- 7402 1y ago
  Indeed: "Mr. Biden’s last-known prostate-specific antigen test, the most common way to screen for prostate cancer, was in 2014. Mr. Biden would have been 71 or 72 years old at the time." https://www.nytimes.com/2025/05/20/us/politics/biden-prostate-cancer-psa-test.html https://www.nytimes.com/2025/05/20/us/politics/biden-prostat...

I sincerely hope our presidents' care isn't limited common practice.

dragonwriter 1y ago

I don't think being a current or former president materially changes the rationale for that recommendation.

fwip 1y ago
Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The cost of performing the test is inconvenience (admittedly of a man whose time is very valuable), but the cost of missing a major health problem has geopolitical consequences. The health recommendations are definitely going to shift toward "better safe than sorry."
- dragonwriter 1y ago
  > Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The recommendation is not based around the public impact of the patient's death, but around the expected utility of the test in improving the length and/or quality of the patient's life, which is fairly low in the best of times for PSA screening.
  - fwip 1y ago
    A president and their team is absolutely going to take a "better safe than sorry" approach. The doctor is not the only person who decides what treatment should be, the patient does too.
    - rfdave 1y ago
      PSA is not fool proof test, and is susceptible to false positives. A substantial fraction of men, in the 40+% range have prostate cancer at death. The treatments for it can be painful and have long recoveries, so there's not obvious solutions.
s1artibartfast 1y ago
I think it does. For one, there are major 3rd party consequences of illness that are unparalleled. Second, many recommendations are based on resource limitations that simply don't exist for a POTUS. Last, and similarly, standard of care is based on standard doctors, treatment, and hospitals. They go out the window when these aren't true.
- dragonwriter 1y ago
  > Second, many recommendations are based on resource limitations that simply don't exist for a POTUS. AFAIK, the PSA one isn't based on resource limitations, though. It's based on the specificity being low enough and the risks, especially with advancing age, of the follow up tests being high enough that at a certain point the test is perceived as having zero-to-negative value in terms of QALY for the patient.
7402 1y ago
Indeed: "Mr. Biden’s last-known prostate-specific antigen test, the most common way to screen for prostate cancer, was in 2014. Mr. Biden would have been 71 or 72 years old at the time." https://www.nytimes.com/2025/05/20/us/politics/biden-prostate-cancer-psa-test.html https://www.nytimes.com/2025/05/20/us/politics/biden-prostat...