Obama Hellcare Begins: Fewer Mammograms

[Gatekeeper]

This is a certain death sentence for *many* American women.

I'm sad, but unsurprised to see this development under the Obama adminstration.

Here's Obama care.

Like they say....careful what you wish for, you might get it.

Like I have mentioned before, and I know it's a "Far Out" conspiracy theory, BUT
What a way to "Thin Out the Population", Rationed Health Care, or call it like it "IS".
we all remember what the definition of IS.....IS....this one IS... Leagalized Genocide.

Unfortunantly many will lose their lives, LONG before they acutally would have, all because of the........... "America of Change"

Let's see, who said something like that?

 

[jillian]

This has nothing to do with Obama, you brain dead loons.

 

[Cecilie1200]

My insurance carrier dropped routine mammograms 2 years ago. I guess they were just ahead of the curve...

So because you can't get decent coverage, the rest of us should by God have the same shitty coverage you do? Is that how it works? MY carrier has routine mammograms starting at 40, or even earlier if you have a family history of cancer.

You realize that the USPSTF makes recommendations, not policy, right?

You realize that that isn't the point, right? I don't care whether they're making recommendations or policy, because the point is that it should be up to me and my doctor to decide how much and what type of cancer screening I need, not anyone in the government. If my doctor reads their report and recommendations - along with all the other current studies and info on the subject - and decides that I don't need mammograms as often, fine. But anytime the discussion goes to "it's a good thing if the government handles this THIS way" from "is it a good thing for the government to handle this at all?" we're off-track.

Which brings us back to my earlier post, which wasn't about the USPSTF at all, but the poster I was responding to, who seems to think that the solution is to bring everyone else's level of care down to what he's getting.

 

[American Horse]

First, let's just drop the "obamacare" bullshit (I know you haven't really been a culprit in that), it's a falsehood.

<SNIP>
As much as I'd love to go into a numbers crunching discussion about sensitivity and specificity, I have a feeling that most people on this thread don't really care. They just want to use this as an excuse to bash Obama care, even when it has nothing to do with it.

Actually I didn't, as you acknowledged, mention "Obama-Care" in any of my posts in this thread. But It would be accurate to give it that title since he campaigned for it, he asked for it, he has driven it, he will sign it (if it reaches his desk), so.... he will get credit or the blame for it. To call it by its rightful name does him no disservice, and serves to notify him and his of that fair attachment; it will, if it passes, along with the processes that play into it, always be known by that name.

Obama has absolutely nothing to do with this recommendation, despite some people's best efforts to claim otherwise.

That was my point.

Got it; but the recommended policy which is the subject of the OP will be adapted, codified and put into actual practice with the force of regulatory law only if Obama-Care is enacted.

If Obama-Care fails to become law this will have been but one recommendation having little other impact. But it will still be a marker in the debate about Obama-Care&#8217;s failure to pass whether or not it is understood for what it is.

 

[PoliticalChic]

And what else does the article state?

washingtonpost.com


A spectrum of women's health advocates, breast cancer experts and public health researchers praised the new guidelines.

"It's about time," said Fran Visco, president of the National Breast Cancer Coalition, a Washington-based patient advocacy group. "Women deserve the truth -- and the truth is the evidence says this is not always helpful and can be harmful."

Susan Love, a well-known breast cancer expert at the University of California at Los Angeles, agreed. "I think that we've oversold early detection. We got carried away with a slogan," Love said. "We're not saying don't do it. Some women should get routine screening. But not all. We think in our society that more is always better. What we're saying is, 'It's not.' "

While the American Cancer Society said it has no plans to changes its guidelines, the National Cancer Institute said it would reevaluate its recommendations in light of the task force's conclusions.

The change is the latest development in a long controversy about mammography. The American Cancer Society and other groups have long recommended that women regularly undergo the tests every one or two years beginning at age 40 to catch tumors

Hey, Apparachik, when are you going to have an opinion that runs counter to the party line?

Death Panels Already?
ObamaCare itself is still just a nightmare, but already questions are being raised--by Reuters, no less--about the possibility of patients' being denied care for political reasons:
Cancer experts fear new U.S. breast imaging guidelines that recommend against routine screening mammograms for women in their 40s may have their roots in the current drive in Washington to reform healthcare.
Critics of the guidelines, issued on Monday by the U.S. Services Task Force, an independent panel sponsored by the U.S. Agency for Healthcare Quality, say the new guidelines are a step backward and will lead to more cancer deaths.
Len Lichtenfeld of the American Cancer society says his group still recommends mammograms for 40-something women:
But he is worried that women will become so confused by the conflicting recommendations they will stop getting mammograms altogether. "Frankly, from our point of view that would be the worst possible outcome," Lichtenfeld said in a telephone interview.
Lichtenfeld and other doctors are worried that insurance companies and government insurers will seize on the recommendations as a way to control rising health costs.
"What is going to happen is insurers are going to say, 'The U.S. Preventive Services Task Force doesn't support screening. We're not going to pay for it,'" said Dr Daniel Kopans, professor of radiology at Harvard Medical School and a senior radiologist at Massachusetts General Hospital in Boston.
"There were no new data to assess. One has to wonder why these new guidelines are being promulgated at a time when healthcare is under discussion and I am afraid their decision is related to saving money rather than saving lives," Kopans said.
If the new advice is medically unsound and motivated by cost-cutting, it's especially insidious, because it's our understanding that mammograms are not pleasant, so that many women presumably will be happy to avoid them. (As a female friend quips, "They couldn't have told me this nine years ago to spare me from all those years of unnatural squeezing?")
One of the advantages of a market-based medical system is that countervailing interests keep one another honest. Sure, the insurance companies want to cut costs, but providers of medical goods and services have incentives that militate in the opposite direction--and, one hopes, disinterested government regulators keep everyone honest. In a socialized health-care system, by contrast, the government is all those special interests, and you can forget about counting on it to keep itself honest.


"There were no new data to assess. One has to wonder why these new guidelines are being promulgated at a time when healthcare is under discussion and I am afraid their decision is related to saving money rather than saving lives," Kopans said.
* "The USPSTF recommendations are a step backward and represent a significant harm to women's health," Dr W. Phil Evans, president of the Society of Breast Imaging, said in a statement.
"At least 40 percent of the lives saved by mammographic screening are of women aged 40-49. These recommendations are inconsistent with current science and apparently have been developed in an attempt to reduce costs. Unfortunately, many women may pay for this unsound approach with their lives."
Experts question motives of mammogram guidelines | Health | Reuters

 

[geauxtohell]

So because you can't get decent coverage, the rest of us should by God have the same shitty coverage you do? Is that how it works? MY carrier has routine mammograms starting at 40, or even earlier if you have a family history of cancer.

You realize that the USPSTF makes recommendations, not policy, right?

You realize that that isn't the point, right?

Um, yes it is. You are blaming Obama for a recommendation that was made by a bipartisan committee that's job is to, and get this, make recommendations. They've been doing it for a couple of decades now.

I don't care whether they're making recommendations or policy, because the point is that it should be up to me and my doctor to decide how much and what type of cancer screening I need, not anyone in the government.

It is up to you and your Dr., read the post where I discussed the different preventative health recommendations from different groups.

Even if the USPSTF was the end all be all, there recommendation was not that women under 50 not get mammograms. It was that Drs. inform women under 50 that routine mammograms are not very effective and might be more harmful than helpful and allow the women to make the decision.

Imagine that. Patient choice.

If my doctor reads their report and recommendations - along with all the other current studies and info on the subject - and decides that I don't need mammograms as often, fine. But anytime the discussion goes to "it's a good thing if the government handles this THIS way" from "is it a good thing for the government to handle this at all?" we're off-track.

Again, the USPSTF has been doing this for decades. Sorry that you are just now figuring this out.

 

[geauxtohell]

Got it; but the recommended policy which is the subject of the OP will be adapted, codified and put into actual practice with the force of regulatory law only if Obama-Care is enacted.

If Obama-Care fails to become law this will have been but one recommendation having little other impact. But it will still be a marker in the debate about Obama-Care’s failure to pass whether or not it is understood for what it is.

I've seen absolutely nothing that indicates that this will be part of "Obama care" and "policy". Feel free to point it out if I am wrong. Otherwise, the bolded part is merely speculation.

Even if it does become policy under "Obama care", have you read the actual recommendation? It's not quite as it is being represented here.

 

[Emma]

"There were no new data to assess..."

That alone tells me he didn't read the report.

 

[American Horse]

Even if it does become policy under "Obama care", have you read the actual recommendation? It's not quite as it is being represented here.

I have, and you are correct, but (as you said) I'm speculating on how it will be perceived in the future in any event.
Remember, perception IS reality ...

 

[geauxtohell]

Even if it does become policy under "Obama care", have you read the actual recommendation? It's not quite as it is being represented here.

I have, and you are correct, but (as you said) I'm speculating on how it will be perceived in the future in any event.
Remember, perception IS reality ...

Then you know the recommendation states that a Dr. should engage in a dialogue about the practicality about routine (meaning no prior indications (i.e. family history, BRCA1 or 2 positive (if that is known), or palpable masses on physical exam) mammograms as a screen. Give the patients the facts and data and allow them to decide. Up to the point where they are 50 and that talking point is simply "we recommend annual or biannual screens for all women over 50."

In the end, the USPSTF's recommendation means more patient/doctor interaction over this matter, but the decision still lies with the patient.

This issue has been "outraged pimped"TM by people who have political agendas and Doctors who should know better. Have you read their objections? With the exception of the radiologist who called them all "idiots" (or some nonsense like that), they wording is always along the lines of: "We fear this might cause misunderstanding among women....". The fears are pretty vague.

Also, as frequently noted, there are often differences of opinion about these matters among groups that make these recommendations. The American Cancer Society is often far more conservative about their screening recommendations.

For prostate cancer, they USPSTF recommends against screening before 75.
Screening: Prostate Cancer

The American Cancer Society recommends screening at 50 (from 1997).
ACS :: American Cancer Society Updates Prostate Cancer Screening Guidelines

As Sloan-Kettering points out, there is no good evidence that routine prostate cancer screening improves mortality in men.
Sloan-Kettering - Prostate Cancer Screening Guidelines

Recently, the ACS acknowledged that their screening recommendations are highly conservative and don't provide any better measurable outcomes, but refused to change them.
American Cancer Society Stands By Cancer Screening Guidelines: MedlinePlus

The larger point being, the ACS is all about cancer, so you'd expect them to always er on the side of more cancer screens. That doesn't necessarily mean that's good medicine.

The main point is, these groups makes recommendations. It's up to Doctors to choose what they are going to follow.

 

[toomuchtime_]

You realize that the USPSTF makes recommendations, not policy, right?

You realize that that isn't the point, right?

Um, yes it is. You are blaming Obama for a recommendation that was made by a bipartisan committee that's job is to, and get this, make recommendations. They've been doing it for a couple of decades now.

I don't care whether they're making recommendations or policy, because the point is that it should be up to me and my doctor to decide how much and what type of cancer screening I need, not anyone in the government.

It is up to you and your Dr., read the post where I discussed the different preventative health recommendations from different groups.

Even if the USPSTF was the end all be all, there recommendation was not that women under 50 not get mammograms. It was that Drs. inform women under 50 that routine mammograms are not very effective and might be more harmful than helpful and allow the women to make the decision.

Imagine that. Patient choice.

If my doctor reads their report and recommendations - along with all the other current studies and info on the subject - and decides that I don't need mammograms as often, fine. But anytime the discussion goes to "it's a good thing if the government handles this THIS way" from "is it a good thing for the government to handle this at all?" we're off-track.

Again, the USPSTF has been doing this for decades. Sorry that you are just now figuring this out.

While Obama may not have had any direct input or influence on this particular report, this is an example of the government presenting recommendations based on what it claims is evidence based medicine - never mind that after the evidence is in, value judgments such as cost effectiveness, how much a life is worth, must be made about it - and since Obama has been enthusiastically promoting such a role for government - never mind that political considerations such as containing costs so that the deficit is not increased or taxes don't have to be raised may filter down to influence such recommendations - it is reasonable to consider this recommendation and its likely consequences in deciding if Obama's vision of the government's role in health care is one we want for ourselves and our families.

While it's certainly true that the USPSTF cannot dictate to a woman or her doctor that mammograms between 40 and 50 are off limits, it is likely some private insurers that now pay for them, about half, will use this recommendation to deny claims for such mammograms and that Medicaid and other government funded health care programs are even more likely to do so, and so for women who cannot afford to pay for them out of pocket, this recommendation effectively sets a policy that will deny mammograms between 40 and 50 to them. Since USPSTF acknowledges there is a net benefit from getting mammograms between 40 and 50 - even after discounting the possible harms from exposure to radiation, false positives, "overdiagnosis", etc. - meaning that these five X-rays will prevent some deaths of women in their 40's from breast cancer, this recommendation will effectively set a policy that causes these needless deaths which will fall disproportionately among poor women, most especially those on Medicaid or other government funded health care.

I agree that Obama may not have had any direct input or influence on this recommendation and that the program, USPSTF, did not begin with him, but since he has made government recommendations based on "evidence based medicine" a key part of his health care program, it is appropriate to think of the preventable deaths of women in their 40's from breast cancer this example of what Obama has been espousing will have effectively caused when deciding if his vision of the government's role in health care is one we want for ourselves and our families.

 

[Skull Pilot]

Mammograms Provide Preview of ObamaCare - WSJ.com

A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.

As recently as 2002, the U.S. Preventative Services Task Force affirmed its recommendation that women 40 and older undergo annual mammograms to check for breast cancer. Since regular mammography became standard practice in the early 1990s, mortality from breast cancer&#8212;the second leading cause of cancer death among American women&#8212;has dropped by about 30%, after remaining constant for the prior half-century. But this week the 16-member task force ruled that patients under 50 or over 75 without special risk factors no longer need screening.

So what changed? Nothing substantial in the clinical evidence. But the panel&#8212;which includes no oncologists and radiologists, who best know the medical literature&#8212;did decide to re-analyze the data with health-care spending as a core concern.

The task force concedes that the benefits of early detection are the same for all women. But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group aren't valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.

The recommendation to cut off all screening in women over 75 is equally as myopic. The committee notes that the benefits of screening "occur only several years after the actual screening test, whereas the percentage of women who survive long enough to benefit decreases with age." It adds that "women of this age are at much greater risk for dying of other conditions that would not be affected by breast cancer screening." In other words, grandma is probably going to die anyway, so why waste the money to reduce the chances that she dies of a leading cause of death among elderly women?

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel's recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to "accounting exercises subject to interpretations and underlying assumptions," and based on costs and large group averages, not individuals.

"I fear that we are entering an era of deliberate decisions where we choose to trade people's lives for money," Dr. Thrall continued. He's not overstating the case, as the 12% of women who will develop breast cancer during their lifetimes may now better appreciate.

More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies&#8212;because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.

 

[PLYMCO_PILGRIM]

We will be seeing all kinds of "recommendations" coming from the NIH "cost effectiveness" programs which will in turn ration care for all of us. Hello death panels.

Chanel they already passed the "death panels", oh i mean coverage advisory boards, in the stimulus bill. They are already law!!!!

http://www.usmessageboard.com/healt...e-stimulus-bill-not-the-health-care-bill.html

 

[Care4all]

Mammograms Provide Preview of ObamaCare - WSJ.com

A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.

As recently as 2002, the U.S. Preventative Services Task Force affirmed its recommendation that women 40 and older undergo annual mammograms to check for breast cancer. Since regular mammography became standard practice in the early 1990s, mortality from breast cancer—the second leading cause of cancer death among American women—has dropped by about 30%, after remaining constant for the prior half-century. But this week the 16-member task force ruled that patients under 50 or over 75 without special risk factors no longer need screening.

So what changed? Nothing substantial in the clinical evidence. But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

The task force concedes that the benefits of early detection are the same for all women. But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group aren't valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.

The recommendation to cut off all screening in women over 75 is equally as myopic. The committee notes that the benefits of screening "occur only several years after the actual screening test, whereas the percentage of women who survive long enough to benefit decreases with age." It adds that "women of this age are at much greater risk for dying of other conditions that would not be affected by breast cancer screening." In other words, grandma is probably going to die anyway, so why waste the money to reduce the chances that she dies of a leading cause of death among elderly women?

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel's recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to "accounting exercises subject to interpretations and underlying assumptions," and based on costs and large group averages, not individuals.

"I fear that we are entering an era of deliberate decisions where we choose to trade people's lives for money," Dr. Thrall continued. He's not overstating the case, as the 12% of women who will develop breast cancer during their lifetimes may now better appreciate.

More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies—because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.

Again, HOW DOES THE GVT SAVE MONEY on this measure?

65 YEARS OLDS, AND OLDER, are not affected by this recommendation....THUS, MEDICARE is NOT affected?

So PLEASE TELL ME, HOW this measure gives government savings?

It most certainly gives the Private Insurance companies savings...that, i can see.... but the government?

 

[Screaming Eagle]

What's really going to be funny is when all these women who voted for Obama have to give birth with no epidural or cough up $2000 of their own money.

 

[rdean]

I watched a doctor explain this on TV.

If there is no genetic disposition towards cancer, meaining no one in your family has ever had cancer, then wait until 50. It was just that simple.

The reason is because mamograms expose breasts to high levels of radiation, which in turn, get this, could cause cancer.

 

[Skull Pilot]

I watched a doctor explain this on TV.

If there is no genetic disposition towards cancer, meaining no one in your family has ever had cancer, then wait until 50. It was just that simple.

The reason is because mamograms expose breasts to high levels of radiation, which in turn, get this, could cause cancer.

Many cases of breast cancer in women under 50 occurred where there was no family history or high risk factors.

So we just tell them, tough shit?

 

[Skull Pilot]

Mammograms Provide Preview of ObamaCare - WSJ.com

A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.

As recently as 2002, the U.S. Preventative Services Task Force affirmed its recommendation that women 40 and older undergo annual mammograms to check for breast cancer. Since regular mammography became standard practice in the early 1990s, mortality from breast cancer—the second leading cause of cancer death among American women—has dropped by about 30%, after remaining constant for the prior half-century. But this week the 16-member task force ruled that patients under 50 or over 75 without special risk factors no longer need screening.

So what changed? Nothing substantial in the clinical evidence. But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

The task force concedes that the benefits of early detection are the same for all women. But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group aren't valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.

The recommendation to cut off all screening in women over 75 is equally as myopic. The committee notes that the benefits of screening "occur only several years after the actual screening test, whereas the percentage of women who survive long enough to benefit decreases with age." It adds that "women of this age are at much greater risk for dying of other conditions that would not be affected by breast cancer screening." In other words, grandma is probably going to die anyway, so why waste the money to reduce the chances that she dies of a leading cause of death among elderly women?

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel's recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to "accounting exercises subject to interpretations and underlying assumptions," and based on costs and large group averages, not individuals.

"I fear that we are entering an era of deliberate decisions where we choose to trade people's lives for money," Dr. Thrall continued. He's not overstating the case, as the 12% of women who will develop breast cancer during their lifetimes may now better appreciate.

More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies—because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.

Again, HOW DOES THE GVT SAVE MONEY on this measure?

65 YEARS OLDS, AND OLDER, are not affected by this recommendation....THUS, MEDICARE is NOT affected?

So PLEASE TELL ME, HOW this measure gives government savings?

It most certainly gives the Private Insurance companies savings...that, i can see.... but the government?

have you missed the so called health care reform bill?

The government will be subsidizing insurance premiums for millions of people. If mammograms are excluded in coverage for all women under 50 the subsidized premiums will be lower.

 

[Tech_Esq]

Mammograms Provide Preview of ObamaCare - WSJ.com

A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.

As recently as 2002, the U.S. Preventative Services Task Force affirmed its recommendation that women 40 and older undergo annual mammograms to check for breast cancer. Since regular mammography became standard practice in the early 1990s, mortality from breast cancer—the second leading cause of cancer death among American women—has dropped by about 30%, after remaining constant for the prior half-century. But this week the 16-member task force ruled that patients under 50 or over 75 without special risk factors no longer need screening.

So what changed? Nothing substantial in the clinical evidence. But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

The task force concedes that the benefits of early detection are the same for all women. But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group aren't valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.

The recommendation to cut off all screening in women over 75 is equally as myopic. The committee notes that the benefits of screening "occur only several years after the actual screening test, whereas the percentage of women who survive long enough to benefit decreases with age." It adds that "women of this age are at much greater risk for dying of other conditions that would not be affected by breast cancer screening." In other words, grandma is probably going to die anyway, so why waste the money to reduce the chances that she dies of a leading cause of death among elderly women?

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel's recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to "accounting exercises subject to interpretations and underlying assumptions," and based on costs and large group averages, not individuals.

"I fear that we are entering an era of deliberate decisions where we choose to trade people's lives for money," Dr. Thrall continued. He's not overstating the case, as the 12% of women who will develop breast cancer during their lifetimes may now better appreciate.

More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies—because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.

Again, HOW DOES THE GVT SAVE MONEY on this measure?

65 YEARS OLDS, AND OLDER, are not affected by this recommendation....THUS, MEDICARE is NOT affected?

So PLEASE TELL ME, HOW this measure gives government savings?

It most certainly gives the Private Insurance companies savings...that, i can see.... but the government?

This recommendation is prospective. It will effect things in the future. For what you say to be relevant, we would have to accept that Obama's Health Care Plan, will not pass.

Is that really what you are suggesting? If so, I would agree with you (although, presumably, Medicaid patients might be impacted by this along with some SCHIP patients as some states do not limit the SCHIP program to children, not to mention veterans and Indians still using reservation health care).

So you see, if the government buys into the analysis proposed under the recommendation, there is actually quite a bit to be saved, even now. If the health care proposal is enacted (which will not take effect until 2013 at the earliest), then the impact is even greater. But recognize that all of this will take years and years to fully implement. It will be well into the 2020s when the private insurance companies are finally killed off and when the more rigorous cost savings can begin. This is just the first shot in a long war that will modify the way we think about health care provision. Instead of thinking about how best to save lives, we first need to think about whether it's worthwhile to try to save the life we might desire to save.

Basically, this study says that once a woman hits 40, you need to just back off a little. They are out of prime child bearing years, so what is the real value of a woman after forty? Is it really worth all this excessive expense of preventative testing or is it ok that about 5% -10% of women get cancer and die instead of all those millions being spent on testing that isn't perfect anyway. In their view, the balance of the equities is that saving a few women isn't worth the cost. (Sure, they say it nicer, but that's the net outcome.)

This will not be the last area that is looked at in this cost benefit manner. In Britain, women get pap smears between 50 and 70 once every 5 years. They get mammograms between 50 and 70 once every 3 years. After 70, they don't test. They would not receive cancer treatment after 70, so why test for it. By the time they notice they have cancer, they'll probably be well on the way to death anyway and then, you only need to prescribe pain meds for a while. Then there dead. This is a much more cost effective way to balance the health care budget.

The one thing they know is that with 51 billion dollars in unfunded liabilities in Medicare, Medicaid and social security, they need to figure out a way to reduce the cost of those programs without taking away any benefits. When you paint yourself into that corner, there is only one solution. Have fewer beneficiaries. If extreme treatment is allowed they will have more, not fewer beneficiaries and that would cause the system to become bankrupt. They cannot allow that to happen, so what choice do they have?

 

[HUGGY]

Federal task force makes radical change in breast cancer screening guidelines

Some questioned whether the new guidelines, coming in the midst of an intense debate about the health-care system and costs, were designed more to control spending than to improve health. In addition to prompting fewer doctors to recommend mammograms to patients, they worried, the move would prompt Medicare and private insurers to deny coverage of many mammograms.

But the American Cancer Society, the American College of Radiology and other experts condemned the change, saying the benefits of routine mammography have been clearly demonstrated and play a key role in reducing the number of mastectomies and the death toll from one of the most common cancers.

"Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it," said Daniel B. Kopans, a professor of radiology at Harvard Medical School. "It's crazy -- unethical, really."

You are a lying sack of steaming shit and an idiot. That was not a federal task force it is a front group for thye HMO's run by the guy that used to try to sell cigarrets for Phillip Morris.

Go Fuck Yourself!! You lying turd.