Feds to women in their 40s: Skip the mammogram; Update: Meet the task force

posted at 10:55 am on November 17, 2009 by Ed Morrissey

What a difference six months — and a health-care overhaul proposal — can make!  Just six months ago, the U.S Preventive Services Task Force, which works within the Department of Health and Human Services as a “best practice” panel on prevention, sounded a warning signal over a slight decline in annual mammograms among women in their 40s.  In fact, they warned women of this age bracket that they could be risking their lives if they didn’t get the annual preventive exam (via HA reader Devil’s Advocate):

The downward trend, however slight, has breast cancer experts worried. Mammograms can enable physicians to diagnose the disease at early stages, often before a lump can be felt. “When breast cancer is detected early, it often can be treated before it has a chance to spread in the body and increase the risk of dying from the disease,” says Katherine Alley, medical director of the breast health program at Suburban Hospital in Bethesda.

The U.S Preventive Services Task Force, an independent panel of experts working under the Department of Health and Human Services, recommends that women older than 40 get a mammogram every one to two years. The task force finds the test most helpful for women between ages 50 and 69, for whom it says the evidence is strongest that screening lowers death rates from breast cancer. Other groups, including the American Medical Association, suggest a more rigorous schedule, saying the test should be done every year; insurers often pay for annual tests.

But experts say they are seeing gaps beyond two years in many cases. Carol Lee, chair of the American College of Radiology’s Breast Imaging Commission and a radiologist at the Memorial Sloan-Kettering Cancer Center in New York, says many women understand that they need to have a mammogram but don’t go back for repeat tests after the first one. In Bethesda, Alley said she has even heard anecdotal reports of breast cancer survivors forgoing recommended mammograms.

But today, that same panel says … never mind:

“We’re not saying women shouldn’t get screened. Screening does saves lives,” said Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations Monday in a paper being published in Tuesday’s Annals of Internal Medicine. “But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully.”

Several patient advocacy groups and many breast cancer experts welcomed the new guidelines, saying they represent a growing recognition that more testing, exams and treatment are not always beneficial and, in fact, can harm patients. Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.

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 radiology professor at Harvard Medical School. “It’s crazy — unethical, really.”

What changed in six months to change the USPSTF from a sky-is-falling hysteric on a 1% decline in testing to Emily Litella?  If the administration gets its way, the government will be paying for a lot more of these exams when ObamaCare passes.  That will put a serious strain on resources, especially since many of the providers will look to avoid dealing with government-managed care and its poor compensation rates.

The motivation for HHS will be to cut costs, not to save lives.  The sudden reversal in six months of the USPSTF, especially after it made such a stink over a relatively minor decline in screening, certainly makes it appear that they have other priorities than life-saving in mind here.

One final thought.  Barack Obama predicated his ObamaCare vision on the notion that increased prevention would save costs.  Suddenly, his administration is for decreased screening and prevention.  Could that have anything to do with the CBO scoring on screening?  And what does that say about how government will make decisions once they control the compensation and care in the US?

Update: Courtesy of an anonymous reader, here are the members of the US Preventive Services Task Force.  See if you can figure out the one thing they all have in common:

Current members of the Task Force are listed below. They have recognized expertise in prevention, evidence-based medicine, and primary care.

Bruce N. Calonge, M.D., M.P.H. (Chair)
Chief Medical Officer and State Epidemiologist
Colorado Department of Public Health and Environment, Denver, CO

Diana B. Petitti, M.D., M.P.H. (Vice Chair)
Professor of Biomedical Informatics
Fulton School of Engineering
Arizona State University, Tempe, AZ

Susan Curry, Ph.D.
Dean, College of Public Health
Distinguished Professor
University of Iowa, Iowa City, IA

Allen J. Dietrich, M.D.
Professor, Community and Family Medicine
Dartmouth Medical School, Hanover, NH

Thomas G. DeWitt, M.D.
Carl Weihl Professor of Pediatrics
Director of the Division of General and Community Pediatrics
Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH

Kimberly D. Gregory, M.D., M.P.H.
Director, Maternal-Fetal Medicine and Women’s Health Services Research
Cedars-Sinai Medical Center, Los Angeles, CA

David Grossman, M.D., M.P.H.
Medical Director, Preventive Care and Senior Investigator, Center for Health Studies, Group Health Cooperative
Professor of Health Services and Adjunct Professor of Pediatrics
University of Washington, Seattle, WA

George Isham, M.D., M.S.
Medical Director and Chief Health Officer
HealthPartners, Minneapolis, MN

Michael L. LeFevre, M.D., M.S.P.H.
Professor, Department of Family and Community Medicine
University of Missouri School of Medicine, Columbia, MO

Rosanne Leipzig, M.D., Ph.D
Professor, Geriatrics and Adult Development, Medicine, Health Policy
Mount Sinai School of Medicine, New York, NY

Lucy N. Marion, Ph.D., R.N.
Dean and Professor, School of Nursing
Medical College of Georgia, Augusta, GA

Joy Melnikow, M.D., M.P.H.
Professor, Department of Family and Community Medicine
Associate Director, Center for Healthcare Policy and Research
University of California Davis, Sacramento, CA

Bernadette Melnyk, Ph.D., R.N., C.P.N.P./N.P.P.
Dean and Distinguished Foundation Professor in Nursing
College of Nursing & Healthcare Innovation
Arizona State University, Phoenix, AZ

Wanda Nicholson, M.D., M.P.H., M.B.A.
Associate Professor
Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD

J. Sanford (Sandy) Schwartz, M.D.
Leon Hess Professor of Medicine, Health Management, and Economics
University of Pennsylvania School of Medicine and Wharton School, Philadelphia, PA

Timothy Wilt, M.D., M.P.H.
Professor, Department of Medicine, Minneapolis VA Medical Center
University of Minnesota, Minneapolis, MN

What do they have in common?  There isn’t a single oncologist among them, at least not as a listed specialty by the USPSTF published roster.


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The panel’s recommendation will lead to more deaths, and lower costs for Medicare and Medicaid. But it’s not a death panel.

hawksruleva on November 17, 2009 at 11:39 AM

As long as health care remains private, you and your doctor are free to completely ignore it, and do what you did before.

RBMN on November 17, 2009 at 11:43 AM

Yeah, we need the Feds to run healthcare /s

My wife was diagnosed with stage 1 breast cancer at her first mammogram in late 30s and she’s in a low-risk group.

It was treated successfully, but she might not be alive today if she hadn’t had it done early.

DarkCurrent on November 17, 2009 at 11:46 AM

At least libs are consistent. Women are bearers of life and life is one thing a liberal democrat hates.

daesleeper on November 17, 2009 at 11:46 AM

I see a gap cover in Obama’s carrier battlegroup on this one.

Attack sub USS Sarahcuda is gonna put 3 in his side on this one.

Got Facebook?

Sapwolf on November 17, 2009 at 11:17 AM

I think that the Enola Gay is a more apt description than the USS Sarahcuda. She causes the liberals to go nuclear whenever she engages the facebook weapon.

Aside: Too bad that I will already be cold in the ground when Trig breaks a bottle of bubbly over the bow of the Palin as she prepares to set sail in defense of the country.

In case you were wondering, my thought is that the USS Soetoro is likely to be a leaky rowboat without armament on permanent loan to the Indonesian Navy.

turfmann on November 17, 2009 at 11:46 AM

Less screening improve detection?

We also know abortion increases cancer risk. Why keep it secret?

The last thing is if you take one, remove both at the same time. It save money to do a bilateral mastectomy. It prevents future cancer. How about removing them when young and never worry about cancer?

seven on November 17, 2009 at 11:47 AM

Yay…now I can skip the prostate exam. Oh, wait! :-D

SouthernGent on November 17, 2009 at 11:47 AM

As long as health care remains private, you and your doctor are free to completely ignore it, and do what you did before.

RBMN on November 17, 2009 at 11:43 AM

When companies take the penalty of not providing health care, how long before we’re all on the government plan?

Hobbes on November 17, 2009 at 11:48 AM

rockmom on November 17, 2009 at 11:30 AM

Breast cancer is all over my family, these folks can take their suggestions and go forth and multiply.

Cindy Munford on November 17, 2009 at 11:50 AM

Maybe they should charge a surtax for excessive mammograms. Or excessive mammaries. But not for exceptional mammaries.

I digress.

As long as health care remains private, you and your doctor are free to completely ignore it, and do what you did before.

RBMN on November 17, 2009 at 11:43 AM

Meaning, until 2013 under the current proposals. Listen up ladies..you get 1, maybe two more. After that you’ll need a permission slip. Or your own cash.

Has anyone run any models on the effect of black market healthcare after the government takes over?

BobMbx on November 17, 2009 at 11:50 AM

My guess is that all those Dr.’s belong to the AMA.

PappaMac on November 17, 2009 at 11:51 AM

Problem solved – 50% savings: guess how.

Akzed on November 17, 2009 at 11:51 AM

Breast cancer is all over my family, these folks can take their suggestions and go forth and multiply get themselves sterilized.

Cindy Munford on November 17, 2009 at 11:50 AM

FIFY

BobMbx on November 17, 2009 at 11:51 AM

Ed, thank you for keeping us abreast of the situation.

kingsjester on November 17, 2009 at 11:15 AM

Oh, ouch. Ed certainly has a firm grasp of the issue.

Scott P on November 17, 2009 at 11:51 AM

If all fat men got mammograms, lives would be saved too. Statistics enter in somewhere as well in this process.

RBMN on November 17, 2009 at 11:52 AM

A lot of women on that panel though. Safe to assume that some of them must be in their forties or younger. I cannot even begin to guess why they are letting their fellow gals down like that. I think I need to see and hear more detail about this before I pass judgment.

jeanie on November 17, 2009 at 11:54 AM

I wonder what my Mom, who died last March, would think of this. She was diagnosed with breast cancer in her 40′s, and again in her 50′s, and had two mastectomies, and lived to the age of 77, while her mother and grandmother died in their early 50′s of breast cancer.

If she was under ObamaCare instead of private insurance, and had biennial breast exams, the doctors might not have caught her cancer in time, and she might not have lived nearly as long as she did.

Sarah Palin was right. Here come the death panels.

Steve Z on November 17, 2009 at 11:55 AM

Where are the trolls?

I am all for screening in general. There has been a debate in the literature for decades, however, regarding the risk vs benefits of breast cancer screening for women 40 to 49 years old. The real risk, as RBMN mentioned, is radiation-induced breast cancer. Mammographies can detect cancer, and they also cause cancer. You have to balance these two, and the grey area comes in for women in their 40′s. Basically, from what I’ve read, women with a family history of breast cancer or in high risk groups should be screened in their 40′s, and those not in high risk groups, or with no history, should not.

dave742 on November 17, 2009 at 11:55 AM

A lot of women on that panel though. Safe to assume that some of them must be in their forties or younger. I cannot even begin to guess why they are letting their fellow gals down like that. I think I need to see and hear more detail about this before I pass judgment.

jeanie on November 17, 2009 at 11:54 AM

Some are more equal than others, apparently.

BobMbx on November 17, 2009 at 11:56 AM

But what does the IRS have to say about this? Since they’ll help run healthcare their opinion matters too!

gwelf on November 17, 2009 at 11:56 AM

Where are the trolls?

Standing in line to get Sarah’s book.

BobMbx on November 17, 2009 at 11:56 AM

I am a breast cancer survivor. I am now 53. When I was 35, I discovered a lump by self-examination (which they now are saying should not be taught – because it is dangerous). Within days I had seen the Dr., has test and surgery. I went thru 6 courses of chemo and 30 radiation treatments with my lumpectomy. For 18 years being cancer free, I went every year for my mammogram. This past July, at my annual mammogram, they discovered 3 small lumps that could not be felt thru self-exam. I went for biopsys and it was cancer again in the same breast. I had to have a mastectomy. I am now cancer free again. If I had had to wait 2 years, the growth might have too much to save my life.

Is this what we have to look forward too President Obama ?

RUReadingthis on November 17, 2009 at 11:56 AM

But what does the IRS have to say about this? Since they’ll help run enforce healthcare their opinion matters too!

gwelf on November 17, 2009 at 11:56 AM

FIFY

BobMbx on November 17, 2009 at 11:57 AM

Haiku Guy on November 17, 2009 at 11:14 AM

Your contributions
are my favorite to read
when syllables count.

Tom_OC on November 17, 2009 at 11:57 AM

If my mother had done this she would be dead right now. I still have a mother today because she had a mammogram in her 40′s.

Vegi on November 17, 2009 at 11:57 AM

I think I need to see and hear more detail about this before I pass judgment.

jeanie on November 17, 2009 at 11:54 AM

So the little detail that six months ago, yearly exams were important, and now yearly exams are not is not enough?
And the small detail of having no oncologists on the panel isn’t enough?
Just how much “detail” do you need?

right2bright on November 17, 2009 at 11:58 AM

where da trolls at?

angryed on November 17, 2009 at 11:58 AM

A even more effective way to prevent breast cancer during your lifetime may be to change your diet, with less saturated fat and less alcohol. Probably works even better than early detection.

RBMN on November 17, 2009 at 11:59 AM

Problem solved – 50% savings: guess how.

Akzed on November 17, 2009 at 11:51 AM

Obamacare in a nutshell: It’s cheaper to bury them than it is to treat them.

UltimateBob on November 17, 2009 at 11:59 AM

Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.

Bull-effin-sh*t. Doesn’t that mean that 90% of the time the results are completely accurate? Lemme see here…err on the side of caution 10% of the time, vs. erring, period, 100% of the time.
If my physician ever – ever – tells me that she buys into this garbage, she’s gonna get an earful. And I’m gonna get a new doctor. I have a friend who is going through chemo after finding a cancerous lump at 46. Still 4 years shy of what the government has deemed an “appropriate” age to begin screening.
What a bunch of idiots.

uncivilized on November 17, 2009 at 12:00 PM

Out: 30 million uninsured
In: 30 million dead

faraway on November 17, 2009 at 12:01 PM

Jeanie submits her application to be Judgement Czar.

BobMbx on November 17, 2009 at 12:02 PM

Hmmmm… 16 member panel…

8 men, 8 women…

http://www.nationmaster.com/graph/lab_fem_doc-labor-female-doctors

According to the above only 23.1% of American Doctors are women… this stat is MUCH lower in the ranks of Senior Doctors… as Societal changes skew the numbers (over half of premed students today are now Female)…

Thus… I HIGHLY doubt these Doctors were chosen on strict merit… because of the exact EVEN split between men and women on the panel, without a statistical corelation in the General Doctor Workforce…

It would be very interesting to see if the Ethnic makeup is as Policaly Correct as the Male/Female split.

Romeo13 on November 17, 2009 at 12:02 PM

Breast self-examination is a crock. Many women have other problems that mask any result of this method. I recall( with a wry smile)a friend of mine telling me once that she must be doing it wrong because she always found something whether there was anything or not. I’ll bet she’s not alone! If you want to scare the average woman to death this is one sure method. lol Let’s continue the mammograms please–very important for mental health if nothing else.

jeanie on November 17, 2009 at 12:02 PM

I am all for screening in general. There has been a debate in the literature for decades, however, regarding the risk vs benefits of breast cancer screening for women 40 to 49 years old. The real risk, as RBMN mentioned, is radiation-induced breast cancer. Mammographies can detect cancer, and they also cause cancer. You have to balance these two, and the grey area comes in for women in their 40’s. Basically, from what I’ve read, women with a family history of breast cancer or in high risk groups should be screened in their 40’s, and those not in high risk groups, or with no history, should not.

dave742 on November 17, 2009 at 11:55 AM

The whole point of this has escaped you: The panels opinion ‘inexplicably’ changed in the past 6 months from OMG! 1% drop to OMG! you don’t need it – the government shouldn’t be involved in this decision because their recommendation (which will become what is ‘covered’ if they control the system) is driven by accounting rather than sound medical advice.

gwelf on November 17, 2009 at 12:03 PM

If my mother had done this she would be dead right now. I still have a mother today because she had a mammogram in her 40’s.

Vegi on November 17, 2009 at 11:57 AM

RUReadingthis on November 17, 2009 at 11:56 AM

Sarcastically I say…this is the problem, we have to keep treating these people.
If they both would have died, look at the money the system could save.
A crude but accurate statement from the left…my apologies.
I have male friends who have a yearly prostrate exam, and more then a couple whose lives have been saved because of it.
Some people have a propensity, some people have a genetic history, with those, yearly (at least) is absolutely necessary.

right2bright on November 17, 2009 at 12:03 PM

If the GOP doesn’t capitalize on this, they don’t deserve a win in 2010 or 2012.

angryed on November 17, 2009 at 12:03 PM

DEATH PANEL DEATH PANEL DEATH PANEL

unseen on November 17, 2009 at 11:25 AM

Excellent post! I want a tee-shirt just like this!

redwhiteblue on November 17, 2009 at 12:04 PM

I am all for screening in general. There has been a debate in the literature for decades, however, regarding the risk vs benefits of breast cancer screening for women 40 to 49 years old. The real risk, as RBMN mentioned, is radiation-induced breast cancer. Mammographies can detect cancer, and they also cause cancer. You have to balance these two, and the grey area comes in for women in their 40’s. Basically, from what I’ve read, women with a family history of breast cancer or in high risk groups should be screened in their 40’s, and those not in high risk groups, or with no history, should not.

dave742 on November 17, 2009 at 11:55 AM

Also, the panel recommends that women STOP giving themselves self-exams. [Lorien insert joke here] Wow!

gwelf on November 17, 2009 at 12:04 PM

So what is the death rate from breast cancer discovered in, say the 11th month, versus the 23rd month?

Death Panels have begun so that the 20 million leeches not wanting to work and pay their way, millions more illegal border hoppers and 10 million young adults who get free basic care or don’t care about it till later can make us all wards of the state!

Tea Parties are nice and all, but its’ time for a Revolution to put some sanity back in D.C. and the country at large!

dhunter on November 17, 2009 at 12:04 PM

New breast cancer slogan under Obama/Pelosicare:
Don’t Save the Ta-Ta’s

thevastlane on November 17, 2009 at 12:05 PM

I just saw an interview with Jane Skinner and Dr. Manny Alvarez. According to the interview, this recommendation is a great giant step backwards. It took the last 7 years just to get the importance of mammograms across to health insurance companies, individuals, etc., and now they are saying they are not that important. Also, according to Dr. Alvarez, regardless of private or public health insurance, insurance companies will be pressed to drop the coverage if the mandates for mammograms change. Health insurance companies will not be able to recover their costs.

The line in the Washington Post article that really irritates me is from Diana B. Petitti; she says “Then there’s the whole other line of problems that come into play, which is where there are some breast cancers detected that grow very slowly and would never have killed you.” Excuse me???

Makes you wonder if pap smears are next?

InquiringMind on November 17, 2009 at 12:06 PM

As a breast cancer survivor who was diagnosed at 35 I am disgusted by this rationing of care! I had no family history or any reason for concern when my MD found a lump. In the world of Obamacare, I would probably be dead and my post recovery children would never have been born. Of course, they were born 3 months early, so they would be dead either way if Comrade Obama gets his way!

ihasurnominashun on November 17, 2009 at 12:07 PM

I can see a new slogan for breast cancer survivors:

“Death Panel Survivor”.

BobMbx on November 17, 2009 at 12:08 PM

In case we don’t communicate again,stay safe in
harms way Hawkdriver!!:)

canopfor on November 17, 2009 at 11:41 AM

Why, where are you going?

hawkdriver on November 17, 2009 at 12:09 PM

Mammograms produce false-positive results in about 10 percent of cases, causing anxiety…

Whereas anxiety experienced in cases discovered too late will be short-lived, therefore tolerable…

/disgusted

DarkCurrent on November 17, 2009 at 12:09 PM

ihasurnominashun on November 17, 2009 at 12:07 PM

Obama would consider you a “two-fer”…saving medical costs by two…no a “three-fer”, cancer, abortion, population control.
You are not a person he wants around…but we sure do.

right2bright on November 17, 2009 at 12:10 PM

My guess is that all those Dr.’s belong to the AMA.

PappaMac on November 17, 2009 at 11:51 AM

And are Obama bundlers.

Campaign contribution information, please.

The Obama Administration: We Put the Ghoul in Ghoulish.

BuckeyeSam on November 17, 2009 at 12:11 PM

faraway on November 17, 2009 at 12:01 PM

Excellent.

LibTired on November 17, 2009 at 12:13 PM

A even more effective way to prevent breast cancer during your lifetime may be to change your diet, with less saturated fat and less alcohol. Probably works even better than early detection.

RBMN on November 17, 2009 at 11:59 AM

My wife was diagnosed with breast cancer at her first mammogram in her 30s.

She was/is trim and fit, had eaten a low-fat east Asian diet all her life and rarely drank any alcohol. Certainly those help, but why not test?

DarkCurrent on November 17, 2009 at 12:13 PM

I just heard that the way they determined what route to go is from a model. It is the same kind of model that the AGW proponents use to declare we are all doomed. The input into the health care model produced different results depending on what the inputs were….go figure.

I have no idea why scientists, economists, and now doctors just love to use models to support their position rather than what reality shows them.

Patriot Vet on November 17, 2009 at 12:13 PM

Welcome to the scientific dictatorship.

Octavia on November 17, 2009 at 12:13 PM

One more thought.

I suspect that more affluent, better educated women are likely to have regular mammograms. Isn’t this just another form of insidious wealth redistribution?

BuckeyeSam on November 17, 2009 at 12:14 PM

Libs will pay for an abortion, but a breast exam? No way.

WoosterOh on November 17, 2009 at 12:14 PM

I’m sure the doctors on this panel are the kinds of doctors we can trust – certified to be non-foot-rustlers and non-tonsil-diggers. Just don’t ask why their opinion changed so dramatically in 6 months and are now recommending doctors no longer suggest women to self-exams.

gwelf on November 17, 2009 at 12:15 PM

Republicans want you to die quickly. Democrats want you to die slowly.

LibTired on November 17, 2009 at 12:15 PM

I’m facepalming right how harder than the Pickard picture could ever depict. After 10 years of trying to convince my female patients on the importance of regular mammograms and PAP smears I’ll now have to work twice as hard to convince them of its importance.

It’ll be even more difficult when the govt. decides that they’ll pay for a mammogram every 5 years, and people will have to pay for yearly ones out their own pocket.

“Why yes, Mrs. Smith, it is one of the only ways to dectect breast cancer early, and I know you feel fine and I know that you had one 3 years ago and therefore HappyCare won’t pay for another one for 2 more years, but since half of the women in your family had breast cancer, I’m imploring you to get one anyway. No, I don’t think a new HDTV is more important right now…”

DrAllecon on November 17, 2009 at 12:16 PM

DrAllecon on November 17, 2009 at 12:16 PM

You sound like a foot-rustler! /SARC =)

gwelf on November 17, 2009 at 12:19 PM

You sound like a foot-rustler! /SARC =)

gwelf on November 17, 2009 at 12:19 PM

I keep them under my desk next to my tonsil collection.

;)

DrAllecon on November 17, 2009 at 12:20 PM

Ed, with respect, oncologists are not the experts on cancer screening. They generally see patients already diagnosed with the disease by a primary care physician. I’m a doc and have followed the literature on screening exams somewhat. There is, in fact, a lot of harm done in screening inappropriate patients. I will never request a PSA, and if I were a woman with no family history of breast cancer, would probably not want a mammogram.

mikeyboss on November 17, 2009 at 12:20 PM

When I saw this on the news this morning one thing struck me. One of the people mentioned that if this becomes the case then insurance companies may not cover mamagrams for people under 50 (why cover something that isn’t necessary). Is this yet another way to spook people into wanting universal healthcare?

DethMetalCookieMonst on November 17, 2009 at 12:22 PM

mikeyboss on November 17, 2009 at 12:20 PM

With all due respect, I like things the way they are and I’ll run the risk of more harm than good thanks.

jeanie on November 17, 2009 at 12:24 PM

In case you were wondering, my thought is that the USS Soetoro is likely to be a leaky rowboat without armament on permanent loan to the Indonesian Navy.

turfmann on November 17, 2009

If it weren’t bad enough that this fart stain will be a blot on US history, we will have to endure having schools and warships named after him. I wouldn’t be at all surprised to learn that there is a movement already to have him replace Washington on the one dollar bill. They should put him on a new thousand dollar bill. When he’s done with the economy, it won’t be worth more than a dollar anyway.

SKYFOX on November 17, 2009 at 12:24 PM

I was going to say that none of them are Gregory House, MD

I R A Darth Aggie on November 17, 2009 at 12:26 PM

Has anyone run any models on the effect of black market healthcare after the government takes over?

BobMbx on November 17, 2009 at 11:50 AM

Little but second/third-hand stories from survivors of the Castro regime and the Soviet Union…let me tell you right now it’s not a pretty picture.

In a nutshell, anything more complicated than a fairly simple ‘unscheduled’ operation or smuggling fairly small quantities of less-perishable drugs is incredibly chancy. It all stands to reason that you can’t hide a CAT scanner in the trunk of a car, or make more than a relative handful of flu vaccines go missing. Black-market healthcare is one of the most risky and expensive services to try and pull off ‘under the table’, pardon the pun.

Dark-Star on November 17, 2009 at 12:26 PM

So now they’ve thrown women under the bus to make Obamacare affordable. Perhaps this will finally awaken those dim-witted libs from their Obama-induced stupor.

PoodleSkirt on November 17, 2009 at 12:28 PM

I posted this on the headline thread this morning, so forgive me for repeating myself. I live in Ontario, where mammograms are covered for women from age 50, and recommended every 2 years. The kicker is that there is a cut-off — when a woman reaches the age of 74, there are no more mammograms unless a doctor thinks they’re warranted. Yep.

suzeecue on November 17, 2009 at 12:29 PM

BuckeyeSam on November 17, 2009 at 12:14 PM

Not so. Spend some time in the clinics and women’s areas of city hospitals and not only will you see many lower or no income women getting screenings, much, if not all of this, is free. Gyn exams are available too. And you know what? That’s OK with me. I don’t mind my tax dollars spent on this.

jeanie on November 17, 2009 at 12:30 PM

so from a [political point of view Obam just lost the 35 to 49 year old women after losing the 65+ senior citizens. Ithink the dems might want to rethink that thought that if only they could take over healthcare they would have a 40 year majority

unseen on November 17, 2009 at 12:31 PM

This is an issue close to me. After watching my best friends mother complete chemo/lumpectomy and now starting radiation for breast cancer, I can honestly say that I completely believe in early detection.

To me it isn’t just about the survival rate from catching it early. It is also about how much more treatment you might have to endure if not identified. I know I would much rather have chemo/lumpectomy and be able to save my breast than to catch it later, survive, but have a mastectomy and reconstruction. Not that a mastectomy can always be avoided but I would hope that early detection my limit some of them.

maables on November 17, 2009 at 12:33 PM

Ed, with respect, oncologists are not the experts on cancer screening. They generally see patients already diagnosed with the disease by a primary care physician. I’m a doc and have followed the literature on screening exams somewhat. There is, in fact, a lot of harm done in screening inappropriate patients. I will never request a PSA, and if I were a woman with no family history of breast cancer, would probably not want a mammogram.

mikeyboss on November 17, 2009 at 12:20 PM

They also recommended that doctors should stop encouraging self-exams.

Also, while you as a doctor may or may not recommend a mammogram to a given patient it’s not the governments job (nor should it be) to determine these personal decisions (which will happen if they control health care).

Also, there is the issue of why this panel completely reversed their recommendation from 6 months ago.

gwelf on November 17, 2009 at 12:33 PM

I bet AnnAlthouse is sooo glad she voted for Obama over that “dumb” palin who was not even on the top of the ticket…

unseen on November 17, 2009 at 12:35 PM

They are aligning their findings to the UK, Canada and WHO standards.

Anyway I don’t have time to throughly review the study but initially I see they have manipulated a data point.

Anyway, Breast cancer is the #1 diagnosed (non Skin type cancer) in the US and it’s the second leading cause deaths due to cancer for US women. Mammography gives you a chance for detection when the cancer is asymptomatic.

This is a not so thinly disguised cost v. life analysis that’s all. Welcome to what the 53% of those who voted wanted, this is what they wanted isn’t it? Change.

batterup on November 17, 2009 at 12:35 PM

Heh. Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, once wrote a medical piece called,
“Of Babies and Bathwater” (1994).

I wonder what she suggested we do with those babies and the bathwater.

Buy Danish on November 17, 2009 at 12:37 PM

Had my mother followed these guidelines, she would have been dead in a couple of years.

My mother was diagnosed with stage 1 breast cancer at the age of 44 this summer. It took a grand total of seven weeks from diagnosis for her to be cancer free and for the oncologist to determine that she did not need chemo or radiation. Such a terrible health care system we have here in the United States, eh?

My aunt is Dr. Cynara Coomer, an oncologist who regularly appears on Fox News to discuss medical issues. She is whole heartily against these new guidelines and spoke about them this morning with Megyn Kelly. I haven’t check to see if the clip is online yet, but I’m sure it’ll be on FoxNews.com soon enough.

I think this is the government attempting to reset the expectations women have regarding their health check ups. It’s absolutely disgraceful and needs to be called out for what it is.

joshleguern on November 17, 2009 at 12:37 PM

This is all one big ruse so that they can say with plausible deniability that under the new Health Plan that they are not rationing care we are just sticking to federal standards in place prior to the plan ever being even passed. This is pre-rationing plain and simple. Up next “No need for that colonoscopy men! Too many false positives.”

Psycotte on November 17, 2009 at 12:39 PM

In case we don’t communicate again,stay safe in
harms way Hawkdriver!!:)

canopfor on November 17, 2009 at 11:41 AM
Why, where are you going?

hawkdriver on November 17, 2009 at 12:09 PM

hawkdriver: I`m a goin no where,just thought you might be
in-between missions!!:)

canopfor on November 17, 2009 at 12:39 PM

What do they all have in common? They’re all PROFESSORS. Hence, academics and probably not currently practicing doctors.

I win, I win!

Animator Girl on November 17, 2009 at 12:40 PM

Medical College of Georgia

Blech, as a Georgia native I have encountered many a doctor and nurse from this school and have learned to avoid doctors and nurses from this school. Just anecdotal by way of having a series of really, really, really, really bad doctors, nurses and nurse practitioners who were educated there.

Branch Rickey on November 17, 2009 at 12:41 PM

A even more effective way to prevent breast cancer during your lifetime may be to change your diet, with less saturated fat and less alcohol. Probably works even better than early detection.
RBMN on November 17, 2009 at 11:59 AM

I know four women who religiously subscribed to organic health foods and daily physical activity and have always been of below average weight who developed breast cancer before the age of 50. Only one had a history of breast cancer in her family. All of them are still alive due to early detection.

PoodleSkirt on November 17, 2009 at 12:42 PM

Note: if any of them are currently practicing, I tip my hat to them, because it’s rare. And there’s nothing wrong with professors, but boards that are made up entire of them are unlike to consider a wide variety of options.

Animator Girl on November 17, 2009 at 12:43 PM

What do they all have in common? They’re all PROFESSORS. Hence, academics and probably not currently practicing doctors.

Animator Girl, many doctors are apart of hospitals that are attached to Universities and are given the “Assistant Professor” or “Professor” title because of their association with the university. Some of them teach a course here and there, most of them practice medicine though,

joshleguern on November 17, 2009 at 12:45 PM

ObamaCare is just cutting out all those fraudulent mammograms that doctors order to line their greedy pockets with. (sarc) Next to go will be prostate screenings for men. How does that free health care sound now.

la.rt.wngr on November 17, 2009 at 12:45 PM

oshleguern on November 17, 2009 at 12:45 PM

See additional comment above. Most of the adults in my community growing up were doctors, and they worked at a teaching hospital. It seems odd to me that the credentials listed above would be their teaching titles rather than their actively practiced specialty (why list as a Dean rather than a Orthopedic Traumatologist? Why would I trust the former more than the latter). Any ideas?

Animator Girl on November 17, 2009 at 12:48 PM

hawkdriver: I`m a goin no where,just thought you might be
in-between missions!!:)

canopfor on November 17, 2009 at 12:39 PM

We’ve been on standby to execute one for a week. That’s the longest my guys have gone without flying. We come in every night. We wait until someone says, “Nope, not tonight.” This drives my guys crazy when they’re cocked to go.

hawkdriver on November 17, 2009 at 12:49 PM

With the best knowledge when would you pay for a mammogram out of your own pocket? Does the most objective information come from the ACS? Should you do every test ever invented?

tmitsss on November 17, 2009 at 12:50 PM

Death Breast panels

Schadenfreude on November 17, 2009 at 12:51 PM

Be very leary of MD, MPHs. These are the same type of academics writing the healthcare bills. They’re products of our increasingly Marxist higher education system who have been sufficiently indoctrinated to pursue healthcare “for the common good” versus healthcare for the benefits of individuals. This is what we can expect from Obamacare–lots of academic and government funded “research” that serves as propaganda for whatever the government wants.

polmom on November 17, 2009 at 12:51 PM

A even more effective way to prevent breast cancer during your lifetime may be to change your diet, with less saturated fat and less alcohol. Probably works even better than early detection.

RBMN on November 17, 2009 at 11:59 AM

“…..MAY be to change your diet…..”

“PROBABLY works even better………..”

Hear that ladies? These F’n geniuses will have a list of “good” food and “bad” food for ya’.

Stick to that diet and you’ll MAYBE/PROBABLY be just fine.

It just keeps getting better and better.

Talon on November 17, 2009 at 12:52 PM

Gwelf:
Your “OMG” drama is not in the articles. The first article said :

“The U.S Preventive Services Task Force, an independent panel of experts working under the Department of Health and Human Services, recommends that women older than 40 get a mammogram every one to two years.”

That’s all. There was no “OMG” moment in the article. The recommendation of the U.S Preventive Services Task Force changed. It was not the dramatic change you try to make it out to be. They simply changed the recommendation for those in the grey area, i.e., women in their 40′s.

Once again, what you have to discuss here (which the article does not mention) is that radiation causes cancer. You have to acknowledge this in your discussion. You must balance the benefits of screening with the fact that radiation causes breast cancer. If you get a mammography daily, I guarantee you will get breast cancer.

There is another factor, which is some cancers may go away on their own. Treating a tiny cancer may be unnecessary. This controversial finding came from a study in Norway of women aged 50 to 64. They found that women who got regular mammographies got 22% more cancers.

dave742 on November 17, 2009 at 12:56 PM

you are messin with my daughters..my girlfriend..her daughter..my ex wife…and every other woman in my life…DO NOT MESS WITH MY WOMEN..THE 800 POUND MALE GORILLA RISES UP TO DEFEND HIS WOMEN…I WILL BEAT YOU TO WITHIN A INCH OF YOUR LIFE AND MAKE YOU BEG FOR THE REST…MISERABLE F**KING SWINE…FILTH

JJKRN on November 17, 2009 at 12:56 PM

Just proves how stupid Sarah Palin is for babbling about death panels.

misterpeasea on November 17, 2009 at 12:58 PM

dave742 on November 17, 2009 at 12:56 PM

You gonna piss on our heads and call it rain?

misterpeasea on November 17, 2009 at 1:00 PM

dave742 on November 17, 2009 at 12:56 PM

22% more cancers?..based on radiation exposure?…how bout 22% more cancers detected due to FREQUENT SCREENING..the amount of radiation in a standard x-ray/mammogram is near zero..NEARLY ZERO…as a 2 decade medical professional…i know the doses used in x-rays….barely detectable….moronic assumption at best….

JJKRN on November 17, 2009 at 1:03 PM

It’s not just he woen under 50, those over are now suupsoed to ge them eveyr two yers, insted of one.

They will try to “save money” by stretching out all exams. Instead of ten years between colonoscopies, fifteen. Eye exams every five years instead of two.

Wethal on November 17, 2009 at 1:05 PM

misterpeasea:

You gonna piss on our heads and call it rain?

Try and be an adult. My wife is in her 40′s and in excellent health with no history of breast cancer and is in a very low risk group. She is also very intelligent, and has read the literature (not the media) on the issue. She realizes that mammographies cause cancer. There are people out there who got breast cancer because they got a mammography. Considerating her personal factors, she will not get a mammography until she is in her 50′s. Nobody is pissing on her head, she is simply using her mind.

dave742 on November 17, 2009 at 1:07 PM

dave742 on November 17, 2009 at 1:07 PM

I’m glad that you and your wife are informed and have made a decision about the best course to take to be/stay healthy. My larger point is that recommendations like this will likely be used in a government run system to dictate what will and will not be covered and how often – taking the decision out of the hands of patients and doctors and putting it in the hands of bureaucrats.

gwelf on November 17, 2009 at 1:13 PM

mammograms do not cause cancer

JJKRN on November 17, 2009 at 1:13 PM

dave742: That’s fine. That’s you wife’s choice. There are women who don’t agree. Their choices should be honored too.

jeanie on November 17, 2009 at 1:15 PM

With all due respect, I like things the way they are and I’ll run the risk of more harm than good thanks.

jeanie on November 17, 2009 at 12:24 PM

I agree it should be a decision you make with your doctor. I was mentioning what I would choose for myself based on my understanding of the literature.

mikeyboss on November 17, 2009 at 1:19 PM

polmom on November 17, 2009 at 12:51 PM

15 out of 16 are from academia and the other is an administrator. What she said.

DanMan on November 17, 2009 at 1:22 PM

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