There may be good science behind a federal task force recommendation that women in their 40s don’t need annual mammograms, but it was bad timing for the Obama administration. Coming in the midst of the heated debate about health care reform, the recommendation became instant fodder for those claiming that the government is going to ration health care and get between patients and their doctors. Health and Human Services Secretary Kathleen Sebelius responded Wednesday that the task force does “not set federal policy and they don’t determine what services are covered by the federal government.” But that’s unlikely to quell concerns.
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71 Comments
“There is no such thing as an accident. If it happened, you can bet that somebody wanted it to happen”. Franklin D. Roosevelt
Women without health insurance or the means to pay for a mammogram are already rationed out of getting one. There is no science to that at all. It is just Republicans wanting poor people to suffer and die.
“There is no science to that at all. It is just Republicans wanting poor people to suffer and die.”
Democrats wanting to raise the age for which insurance will pay for a mammogram are just wanting poor people to suffer and die.
“Hud” –
You’ve inadvertently admitted it’s not the relationship with your doctor that calls the shots, but “what insurance companies will cover” that dictates health care in America.
So CONs whole “keep your own doctor” canard is utterly meaningless.
Without a profit motive, Medicare is far more…ahem… liberal in allowing procedures recommended by personal physicians than for-profit insurance companies.
Medicare for all would be the most logical cost-effective approach to health care coverage reform.
“Medicare is far more…ahem… liberal in allowing procedures recommended by personal physicians than for-profit insurance companies.”
Let me guess, you are not on Medicare, right?
Need it be pointed out that the same recommendation was made under the last two administration?
It is not a new one nor is it prompted by the Obama administration but then of course there is no need to point that out.
It would take all the fun out of arguing fault and end desire out of the game huh?
Now it can be Clinton’s fault, Bush’s fault and finally Obama’s fault why not FDR fault too!
Maybe Nixon talked about it and the tape was erased?
And no point in pointing out that the task force was make up with three reprehensive from three of the largest insurance companies either. and no I did not misspell it…..
More rationing?
Now they are pushing back cervical exams.
Good luck with ObamaCare, ladies.
Perhaps they were looking at the olders morphology and more elastic qualities to fit in the examining machines?
I mean it’s hard to mash down those perky ones.
“Hud” –
No, I’m not on Medicare. But my Mom got a second knee replacement at age 89 paid for by Medicare.
I remember telling her in the recovery room she’d probably never again play NFL football.
And frankly, I’m not sure a knee replacement for an 89-year-old is good medicine. There’s part of me that thinks “You’re 89! Sit down!”
But Medicare came through and she still toddles around to church and club meetings et cetera.
I’ve written about this many times before. (And WE Blog CONs have steadfastly not responded to the logic and substance.)
Today’s Medicare covers only those people most likely to need high-priced health care.
Medicare is like an assigned-risk auto insurance company that covers only those who’ve been busted for three or four DUIs.
The risk pool of Medicare makes it far more susceptible to high health care expenditures.
Medicare for All would expand the risk pool, cover those young people who think they’re invulnerable to disease or injury, and assure all Americans they won’t go broke simply because they got sick.
OMG, the Death Panels have already started!
Trig has been moved to an undisclosed location.
This is simply the most incompetent administration ever….from top to bottom. They haven’t and apparently can’t do anything without tripping over themselves.
+2,000 pages of buying votes and damaging America.
More evidence of the conspriacy:
Report: 20-somethings can go 2 years between Paps
Medical Writer Lauran Neergaard, Ap Medical Writer – 1 hr 51 mins ago
WASHINGTON – First mammograms. Now — in an apparent coincidence — Pap smears.
New guidelines by the American College of Obstetricians and Gynecologists say most women in their 20s can have a Pap smear every two years instead of annually to catch slow-growing cervical cancer.
The change comes amid a separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology.
The guidelines also say:
_Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.
_Women 30 and older should wait three years between Paps once they’ve had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.
+2,000 pages to install a choke collar on the American people.
Obama “Care”.
It looks like from the record here MH wants his mother to suffer and die.
He must be a closet conservative./Sarcasmoff
How much walking is an 89 yr. old going to do?
My father in law needs a knee replacement, he’s 78, but says he’s too old to worry about it.
Phantom
Posted November 20, 2009 at 8:50 am | Permalink
How much walking is an 89 yr. old going to do?
My father in law needs a knee replacement, he’s 78, but says he’s too old to worry about it.
—————————————————-
Honestly I don’t know and I don’t care.
I do know people much younger that have had knee replacements and the pain they were in before was unbearable and it changes one’s quality of life tremendously.
My problem is with who makes the decision on whether or not you can have one.
BlueJay
Posted November 20, 2009 at 7:10 am | Permalink
Women without health insurance or the means to pay for a mammogram are already rationed out of getting one. There is no science to that at all. It is just Republicans wanting poor people to suffer and die.
YAWWWWWWWWWN! Same ole Same ole
Countdown producer bears witness to America’s health care shortcomings
MSNBC
updated 5:39 p.m. MT, Mon., Nov . 16, 2009
Rich Stockwell
Senior producer, ‘Countdown’
• Profile
New Orleans, La. — – It happened as I watched a 50-something woman walk out, after spending several hours being attended to by volunteer doctors. “She’s decided against treatment. A reasonable decision under the circumstances,” the doctor tells us as she heads for the next patient. The president of the board of the National Association of Free Health Clinics tells me why: “It’s stage four breast cancer, her body is filled with tumors.” I don’t know when that woman last saw a doctor. But I do know that if she had health insurance, the odds she would have seen a doctor long ago are much higher, and her chances for an earlier diagnosis and treatment would have been far great.”
There’s my hand “Freebird”. What do you got?
My mom is on Medicare. They won’t STOP offering her tests. When I was on “free” market insurance, I once laid on a cold exam table for several hours waiting to see if my insurance would approve some test. It was denied. All the doctor could offer was “Well, you could pay out of pocket.”
One instance from “countdown” wow that show is unbiased,not. One instance does not really make your case. If you had been smart you would have known what your insurance covered BEFORE you laid on that exam table.
The US Government wants to take responsibility for your body.
I think that is a very bad idea with horrific consequences down the road.
I don’t wish to become Government Property.
In regards to your lady,I’m sure there were places she could have gone to get care without insurance had she taken some personal responsibility to seek help. But then BJ you marginal lefties dont like personal responsibility do you?
I had an Aunt in the same situation with full coverage. Some people are just denial. Doesn’t prove anything.
And again it was a FREE clinic convention. Why hadn’t she been to a free clinic prior?
They’re going to have the free clinic coming up in K.C., bet there will be a hefty response. Think Brownback and Roberts and Tiahrt will attend, or even acknowledge it?
Wichita would be a good place to have one with all the laid off workers.
Or they could just go visit them today.
http://www.freemedicalcamps.com/vcamp.php?cityid=1429
For the left on this blog to say that poor people can’t get healthcare is incomprehensible. Ask BJ how his son get treatment. Ask someone on medicaid how that get treatment. Go to Hunter clinic and ask someone there how they get treatment and what kind of ‘insurance’ they have.
I’m not saying that healthcare shouldn’t be available for those who can’t get it on their own. I am saying that there is help out there. The woman with lupus that died had help available and didn’t take it. The left like to trot her out as an example of what ‘no insurance’ does.
We are getting ready to let the gov take over 1/6 of our nations economy and they have shown us over and over again how inept they are at managing any program. They have shown us how no program ever comes in anywhere close to the ‘cost’ estimated by congress. Usually 3 to 5 times higher than estimates.
About knee replacements – I will tell you that for over 4 years I did absolutely no shopping. Never set foot in a store. This is why my husband is such a good shopper. I went to work and came home. Went no where because the pain in my knee was insufferable and I thought I was too young for knee replacement. Finally had the surgery and it was the smartest thing I ever did. Yes BJ I had insurance and could choose to do that before you start.
A little disclaimer at the site:
* Some are for low income people, some are for homeless
* Some only serve the local community residents.
* Some Clinics are specific to HIV treatment etc. (We list them as well)
”
The US Government wants to take responsibility for your body.” — anti
How can you sleep at night?
How can you sleep at night?
=================================
It’s a natural process.
I lay down, close my eyes and I sleep.
I am pretty sure most people sleep.
Therein lies the stateist’s logic.
“Some” equals “all” which means the Government must get involved.
“But then BJ you marginal lefties dont like personal responsibility do you?”
And there lies the crux of the problem….they want a nanny government taking care of them and everyone else so no one else has anything better.
“Now they are pushing back cervical exams.”
Do any of you blathering on about Pap smear recommendations know anything, anything about cervical dysplasia? The progression of CIN into squamous cell carcinoma? The time period for this progression? Those who are most likely to die of cervical cancer? (hint: not those who are low risk/are able to receive Paps every two years)
No? Didn’t think so. So typical anti-science. Go read the literature, educate yourself. Heck, even the most dim can handle 150 word abstracts–Google scholar is your friend.
http://www.springerlink.com/content/j73107r177527704/
http://jama.ama-assn.org/cgi/content/full/jama;285/24/3107 (scroll to figure 2)
And my healthcare is already being rationed right this second by my insurance company.
ANTI
Posted November 20, 2009 at 8:10 am | Permalink
More rationing?
Now they are pushing back cervical exams.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Who is pushing back cervical exams?
If this truly is a national emergency I want to do what I can for the good of my county. I’m not a gynecologist, but I may be willing to take a look.
Tara are you still in Hawaii? How is that gov healthcare working out over there? I really want to know. I think there is a middle ground between what we now have and what some would like us to have.
I think we should look at systems that have been tired and see the results. Also see the things that could have been done differently to make them work better.
Sort of like a scientific experiment – where you try several things before you think your have a tried and true predictable result.
If this truly is a national emergency I want to do what I can for the good of my county. I’m not a gynecologist, but I may be willing to take a look.
============================================
Keep sniffing around, I’m sure someone will appreciate it.
Tara,
I understand your frustrations with “Hawaii Care”.
Just don’t force it on the mainland.
OK, I’m not advocating expansion of Quest. I’ve never been eligible for it and the only person I know on it was a pregnant woman who received excellent care. I know they have limited state funds, overworked case workers and a cap on enrollment, but they seem to do very well with mothers and children. This particular program is obviously not the solution, and I never said it was. Not all government programs are equal.
My post was specifically in response to those who are trotting out the Pap smear recommendations as evidence that evil gubbermint rationing is going to kill all the ladies. Without, you know, even bothering to fact check.
And when you run a scientific experiment you don’t mindlessly pick random variables to apply to a system. You do background research (look at other countries) to see what is most likely to bring about your desired income. And if the current variable (profit-driven health management) is not giving the desired outcome after after a reasonable number of replicates, you accept that it never will and move onto the next test.
Problem is, the right and left have different desired outcomes. The right thinks health care is exactly like a Cadillac, and poor people should bootstrap their way to a good insurance plan, while the left think that health is like clean water or police protection, and every American has the right to it.
Deeply ingrained value systems like this rarely budge. That’s why (and I am being cynical here) dividing up the country and letting the red states opt out of a public option sounds like a solution –see where health care costs for each state are in five years.
I forget how this blog reacts when presented with fact-based rebuttals. Ignore and change the subject. Nobody bothered to respond to the Pap smear links.
After all, mudslinging is more fun. Maybe I should preface all my posts with “hey A s z h o l e s!”
After all, mudslinging is more fun. Maybe I should preface all my posts with “hey A s z h o l e s!”
========================
WTF?
I didn’t call you names.
No, I wasn’t referring to you, just the general tone of this place after 8:00 PM or so.
Just a thought experiment, if our current government system of ensuring potable water broke down, would we try to figure out a way to fix it? Or would be immediately decry government control and switch to a free market solution (even though some Americans would no longer be able to afford clean water)?
I am almost afraid to ask because I suspect there are some who would choose the latter.
There are plenty of sustainable government health care programs in the world. Just because Quest doesn’t work so well doesn’t mean that our current model (which is just as bulky and inefficient) is the only alternative.
even though some Americans would no longer be able to afford clean water
========================================
Under the proposed solution of health care reform, many Americans will still be without insurance.
Plus the ones that will be able to use it will have us all paying for it for several years before anyone has access to the program.
“ANTI” gives us –
“…“Hawaii Care”.
Just don’t force it on the mainland.”
They’re coming after us, I tells ya!
Them Hawaiians elected their Kenyan interloper and are taking over the real America!
Better start mastering surfing the Arkansas River. Them evil Hawaiians will ram it down your throats!”
I’m stocking up on tacky floral oversized shirts, just so I can infiltrate the invaders.
It’s the Hawaiians I tells ya.
Let them get the presidency and they’ll soon be indoctrinating our children with “wookie-wookie-wah” hula dances that’ll make Betsy Ross cry in her grave!
(The only REAL flag of America has 49 stars. In honor of Sarah Palin.)
I’m stocking up on tacky floral oversized shirts, just so I can infiltrate the invaders.
======================================
Well then, I suppose I shouldn’t worry.
(The only REAL flag of America has 49 stars. In honor of Sarah Palin.)
===================================
The “Kenyan interloper” thinks there are 57 stars.
Problem is, the right and left have different desired outcomes. The right thinks health care is exactly like a Cadillac, and poor people should bootstrap their way to a good insurance plan, while the left think that health is like clean water or police protection, and every American has the right to it.
——————–
Tara since I don’t fit either of these categories then I’m not sure what to do. I know there are people without insurance thru no fault of their own. I also know there are many of the uninsured who are uninsured because thats how they want it. The gov plan would force many of these to come on board so they can help pay for those who can’t pay or face fine and prison. This isn’t my America no matter how well intentioned the law makers are.
As a small business owner I look at what is proposed and see many businesses holding on by their fingernails that will no longer exist if this bill passes as it is written. This is a segment of the economy that creates 40 to 70% of all new jobs and right now is providing in the 80% range of existing jobs.
To say there is an easy answer would be a head in the sand approach and as a scientist I can’t believe you would be in favor of this.
I have always thought that we needed to look more closely at plans that work, that have been working long enough to see patterns exist – adopt what works and throw out what didn’t. We aren’t doing this we are redesigning the wheel from scratch and plan to take over 1/6th of the nations economy in order to do it.
As for your original issue – I’m really not sure what you were trying to say. This has been recognized as a very real problem and a vacine has been developed that is even now being given to teenage girls isn’t it? I could be on the wrong track. This certainly is one issue that you wouldn’t want non-medical people making procedural calls on as just happened with mammograms and pap smears.
I am fine with non-medical people making procedural calls, if the procedural calls are based on real science done by real scientists. The science behind breast cancer screening changes is not quite as settled as the cervical cancer ones, so to lump them two together as evidence of “rationing” is disingenuous.
What really inflames me are non-scientists trying to make a judgment call on something (like Pap smear screenings) with no desire to actually even take a cursory glance at the research. We all have our pet peeves, this is my big one, enough to drag me out of lurker mode!
Wahine_Tara-
You know as well as I do that scientific studies often come out with at least slightly different results. However, given that, what would consider the acceptable margin of error rate? How many standard deviations? And for cervical cancer, therefore, how many lives lost?
By the way I do understand that their is an economic cost per test, that studies show the economics of screening don;t always pan out. In fact, studies show that in general, they do not. My question to you is not about economics, nor is it snarky in any way. I want to know what level is an acceptable loss of human life in order to reduce the testing schedule.
Here’s a pretty balanced article on the proposed breast cancer screening recommendations: http://www.npr.org/templates/story/story.php?storyId=120613264. You can see the problem when statistical analysis and human compassion are at odds. 15% reduction in breast cancer deaths from age 40-49 seems worth the money imho (i am not a doctor). I definitely wouldn’t want insurance companies (or government panels) to deny mammogram coverage at this age based on the recommendations.
It is good that women are informed of the risks/benefits of screening, though. Why subject yourself to unnecessary tests if you are low-risk?
I didn;t see any scientific data supporting no mammograms until age 50 in the article. Perhaps I missed something.
Apparently, according to the article linked, so did many others, including the American Cancer Society.
Little_john,
It’s a good question, sorry I missed it before my last post!
There is no arbitrary value of what is an acceptable loss of human life. But with the cervical cancer screening, there is no difference in outcome between getting a Pap every year or every 2 years. It’s because of the way the cancer grows–very, very slowly. The follow-up biopsies for cervical dysplasia can cause infection, miscarriage, and premature birth, among other side effects.
Think of it this way–paying for a Pap screen every year rather than every two or three years is like paying money to have someone follow you around to make sure a piano doesn’t fall from a window above onto your head. Except that the monitoring equipment they use to watch for pianos gives you daily migraines.
Once the HPV vaccine becomes routine (it has a nearly 100% efficacy rate), the screenings can become even more infrequent.
Every cancer and disease is different, and the screening guidelines should reflect that.
Gotcha-
Well, I am out of here for the night. Ya all take care now, ya hear
Yes, little john, that’s what I said. The mammogram issue is different from the cervical cancer one. Ladies have different kinds of lady parts.
There are women who are saved from mammograms at 40-49 who would have died while waiting, but the same is not true for cervical cancer screenings.
Not that the federal panels are supposed to dictate insurance coverage, but if they did and tests deemed unnecessary had to be paid for out of pocket, it would be interesting to see 5 or 10 year outcomes.
If there is no difference in deaths between those who could afford to pay out of pocket and those who couldn’t, maybe the entire field of medicine would shift away from ordering every test under the sun to avoid getting sued if something is overlooked.
People are nervous now, that’s understandable. But maybe in several years…
Another good article:
http://www.scpr.org/news/2009/11/20/evidence-based-medicine-focuses-on-what-works/
Once the HPV vaccine becomes routine (it has a nearly 100% efficacy rate), the screenings can become even more infrequent.
====================
Direct result of a promiscuous society.
FTA:
I’m reading this as mammograms have a false-positive rate of 48%. That seems ridiculously high. I can’t imagine that mammography is that imprecise.
#
Regular
Posted November 20, 2009 at 5:08 pm | Permalink
Once the HPV vaccine becomes routine (it has a nearly 100% efficacy rate), the screenings can become even more infrequent.
====================
Direct result of a promiscuous society.
=-=-==-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-==-=
The HPV vaccine strikes me as a cost effective way to save lives as well as reduce future medical expenditures. Seems like a win/win to me.
•Daniel
Posted November 20, 2009 at 5:40 pm | Permalink
#
Regular
Posted November 20, 2009 at 5:08 pm | Permalink
Once the HPV vaccine becomes routine (it has a nearly 100% efficacy rate), the screenings can become even more infrequent.
====================
Direct result of a promiscuous society.
=-=-==-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-==-=
The HPV vaccine strikes me as a cost effective way to save lives as well as reduce future medical expenditures. Seems like a win/win to me.
=======================================
Still doesn’t change the fact that HPV (AKA Venereal Warts) are the results from a promiscious society.
“the results from a promiscious society.”
Don’t knock it til ya’ve tried it.
Oh yeah.
Nevermind.
Regular,
Am I reading that right regarding the false-positive rate for mammography or am I missing something?
•Daniel Posted November 20, 2009 at 6:00 pm | Permalink Regular, Am I reading that right regarding the false-positive rate for mammography or am I missing something?
——————-
Looks about right. The way I understant mammography works is that they are looking at occluded images exhibiting certain morphology and location markers. (Gray Scale images like X-rays)
The false positive may be misleading as I ‘think’ they include when a physician calls a patient back in for further examinations or testing (invasive or lab work.) I know the female members of my family have been panicked when they get called back in for further tests and it turns out to be some sort of ‘fatty cyst’ or something or other.
You have to draw the line somewhere. Women in their 20’s get breast cancer, yet the arbitrary line was drawn to begin screenings at 40. Now someone has done a cost benefit analysis and has come up with 50. If you wanted to try to catch them all, you would have to start about 20. You have to draw the line somewhere.
We complain about Drs ordering “unnecessary” tests to protect themselves from litigation (defensive medicine) but when someone tries to reduce “unnecessary” screening tests we complain about that too.
We have finite resources, so they need to be employed where they will do the most good. Maybe it’s not in early mammograms.
The little secret about breast cancer is that the virulence of the type of cancer is more predictive of outcome than how early it is diagnosed.
“Regular” chimes in –
“Direct result of a promiscuous society.”
Never been laid, eh?
I totally disagree with Brownlee’s assertion that the science was correct.
I’ll tell you right now- if you go to your local city counsel sessions- and they are arguing about whether to fund an additional ambulance, fire, or police service, you can’t stand there before them and say ‘dead babies’ and expect funding. No. You have to show them that the liability would cost them more than saving the life of those people.
AND THAT is where we have gone wrong.
HPV is a virus that comes in many forms and nearly every single person has at least one form of HPV. You even have it Regular.
•politicalmama
Posted November 20, 2009 at 8:30 pm | Permalink
HPV is a virus that comes in many forms and nearly every single person has at least one form of HPV. You even have it Regular.
==============================
Oh, I wouldn’t say that. Besides the discussion was on HPV that was specific type in causing STD’s.
There are many types of Herpes Viruses, so related to STD and some not.
so=some
Regarding the “government task force” saying that mammograms should start at age 50 instead of 40, Secretary Sebelius says that they do not have the job of setting federal policy nor do they determine what services are covered by the federal government. Her department of Health & Human Services has that responsibility. A “task force” is a far cry from an actual federal department such as Health & Human Services.
CNN interviewed the President of the Komen Foundation and also a doctor who is a breast cancer surgeon. Both of these 2 interviewees said they were definitely ignoring what the government task force had said because their experience was that many women died of breast cancer before they were 50.