Wednesday, November 18, 2009

So Talk of Government Healthcare Rationing is Just Right-Wing Misinformation, Huh?

One of the biggest buzzes out there today is about the new "guidelines" for mammograms. Something called the "U.S. Preventive Services Task Force" has put out very controversial new guidelines for mammograms and breast self exams. It's left women asking, "At what price?"

The guidelines penned by the U.S. Preventive Services Task Force say:

--Most women in their 40's should not routinely get mammograms.

--Women 50 to 74 should get a mammogram every other year until they turn 75.

--Women 75 and older need not undergo mammograms.

--Breast self exams are of no value.

In a staggering coincidence, these guidelines are right in line with the World Health Organization's guidelines for mammography, and well as the guidelines in Great Britain. Hmmmm.

The U.S. Department of Health and Human Services defines the U.S. Preventive Services Task Force (USPSTF) as, "An independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services."

Additionally, the U.S. Dept. of Health and Human Services says this about the USPSTF: "The mission of the USPSTF is to evaluate the benefits of individual services based on age, gender, and risk factors for disease; make recommendations about which preventive services should be incorporated routinely into primary medical care and for which populations; and identify a research agenda for clinical preventive care."

Furthermore, according to the Health & Human Services website, in 1997 the Agency for Health Care Policy and Research (AHCPR), now known as the Agency for Healthcare Research and Quality (AHRQ), launched its initiative to promote evidence-based practice in everyday care through establishment of 12 Evidence-based Practice Centers (EPCs). The EPCs "develop evidence reports and technology assessments on topics relevant to clinical, social science/behavioral, economic, and other health care organization and delivery issues—specifically those that are common, expensive, and/or significant for the Medicare and Medicaid populations."

The EPC reports are used by the the USPSTF, which reviews the evidence, estimates the magnitude of benefits and harms for each preventive service, reaches consensus about the net benefit for each preventive service, and issues a recommendation.

Apparently the USPSTF has determined that mammograms for the above-referenced populations are unnecessary. According to their own information, the recommendations are based at least somewhat upon cost and Medicare/Medicaid populations.

By the Task Force's own admission, mammograms reduce breast cancer deaths in women in their 40's and 50's by 15 percent. I know they are including the death rates for women in their 50's in this statistic, but they seem to have deemed it acceptable that without mammography, there will be a possibility of up to a 15 percent increase in breast cancer deaths for women in their 40's. Most women, I think, would find this unacceptable.

Many experts find these guidelines unacceptable as well. The American Cancer Society and the American College of Obstetricians and Gynecologists said they will not be changing their guidelines.

"The American Cancer Society will continue to recommend that women of average risk of breast cancer start screening at age 40 and get screened every year," said Dr. Len Lichtenfeld, the group's deputy chief medical officer.

This decision also comes on the heels of news that younger women--as young as in their 20's--are being diagnosed with breast cancer at previously unseen rates. No one knows why.

This is a preview of government rationing of healthcare, folks. No, they didn't outlaw mammography for younger and older women, but their recommendation is sure to influence insurance coverage for mammography. Health insurance is a for-profit industry. I predict they will use these guidelines as a reason to cut benefits for mammography. I also predict these cuts will be implemented in Medicare and Medicaid, and soon-to-come Obamacare as well.

One more note. People don't seem to be paying attention to the Task Force's guideline that recommends women over the age of 75 shouldn't get mammograms at all. Someone I love dearly, who is in her late 80's, got her regular mammogram just days after she lost her husband, and breast cancer was discovered. They caught it so early that she won't have to undergo radiation or chemotherapy, which could be deadly for someone her age. I am grateful Medicare covered this procedure for her and that we won't be losing her now.

You can't put a price on that.

1 comment:

Anonymous said...

It's funny that this "cost saving" measure came out just as the promise of ObamaCare moves forward.

If you want to save money in treating cancer, catch it later rather than sooner. Dead people require no medical treatment.

One of the points that Obama has made is that preventive medicine will save money. I guess early detection doesn't fit into that model. Death panels do.

Just how well is socialized medicine working in other countries? ...