Quotes of the day
posted at 10:30 pm on November 20, 2009 by Allahpundit
“New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past…
“Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, ‘long before the Obama health plan came into existence.’
She called the timing crazy, uncanny and ‘an unfortunate perfect storm,’ adding, ‘There’s no political agenda with regard to these recommendations.’”
***
“Dr. Elizabeth Eden, an obstetrician/gynecologist and professor of obstetrics and gynecology at New York University School of Medicine in New York City, disagrees and says it’s another attempt by the government to cut costs on preventative medicine.
“‘I think it’s a bad idea,’ she told Fox News Friday. ‘I think a large number of adolescents are sexually active and by the age of 21 we’re talking about what could be five or six years removed from their first sexual experience.’…
“‘There is no money being saved by not testing,’ Eden said. ‘The test isn’t as expensive as the study suggests. There is severe risk in not testing these women and the article is scaring them away from routine tests that could potentially save their lives.’”
***
“Come on, be honest. Don’t you want the federal government to have a complete overview of health care? The potential rationality is stunning. And one thing in this emerging rationality is clear: Although women tend to love the notion of government control more than men do, it is women who will be told they’ll have to cut back. On treatments. And years. You know we’ve been taking more than our share.”
***
“We need answers: Is early screening not saving lives? Why do doctors’ groups disagree? Did costs play any role in these decisions to change the recommendations on breast and cervical cancer screenings? We need assurances that everything we’ve heard this week about fewer tests for women’s cancers is a result of patient-focused research and providing the best care for the right reasons, and not because of bureaucratic pressure to control costs.
“Obviously the first thought that comes to mind when hearing of these new recommendations from bureaucratic panels is ‘rationed care.’ It’s fair – and healthy – to ask if that’s what Washington has in mind with a government-controlled takeover of a health care system.”
Blowback
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I also want medical studies done to recommend best practices.
And when it comes to health and illness, life and death, all recommendations require an examination of individual factors, not just statistical norms and ranges.
I would prefer to rely on a medical doctor to add the healthy dose of commonsense, as I don’t believe a lifelong government bureaucrat or a panel of politically appointed “experts” is likely to be guided by “common sense.”
Loxodonta on November 21, 2009 at 1:29 AM
If BigBrotherCare passes, oh yes you will, unless you’re filthy rich or a Congressman. Do your homework.
You do realize that there was not even one oncologist on that (death) panel, don’t you?
hillbillyjim on November 21, 2009 at 1:30 AM
The government should stay the hell out of it, the patients and doctors should make the call, period.
echosyst on November 21, 2009 at 1:31 AM
OBAMA: LEAVE THE BOOBIES AND THE OTHER THING ALONE!!!
Ahh. Thanks, I feel better now.
n0doz on November 21, 2009 at 1:32 AM
Simple solution, really. 84th trimester abortions.
Loxodonta on November 21, 2009 at 1:34 AM
The concept of “Best Practices” makes a fine thesis paper but when implemented without taking into consideration the human factor it generally fails. To the academe, who are generally marxists, we’re all clumps of cells.
Annie on November 21, 2009 at 1:37 AM
I did Sarah but they won’t listen. They say they know what’s best for us. We don’t know what we’re talking about. Not much we can do about it.
Brat4life on November 21, 2009 at 1:40 AM
How do these technical panels get selected? Are help wanted ads posted on professional journals, and nationwide searches undertaken? Are employment application completed and interviews held? Is there some kind of scale that can be used to measure the relative qualifications of the candidates?
Or, is a phone made from one politician to another? Perhaps the call might go something like, “Dr. Schmooze was a great help in raising funds for my last campaign. If you appoint him, he’ll help us raise a lot more nationally.” And then, after a brief run through the criminal records, scandal sheets, and Wikipedia, we get an announcement like this: “Today, after a nationwide search, I am proud to announce the appointment of Dr. Schmooze.”
Loxodonta on November 21, 2009 at 1:45 AM
When this bill passes and takes effect your opinion won’t matter. There is no way adding 30-40 million people to the system without adding doctors will get you the care you want or maybe need. Unless you live in an area where everyone already has insurance. They will come out with guidelines and with the government involved billing, online medical records, and setting the standards of what your insurance will cover and when you can have procedures done there isn’t much you can do. Washington doesn’t care cause if they did, they wouldn’t put you in jail for not going along with this unconstitutional bill.
Brat4life on November 21, 2009 at 1:47 AM
The government should stay the hell out of it, the patients and doctors should make the call, period.
echosyst on November 21, 2009 at 1:31 AM
The general concept of the new bill, when put into practice, will be somewhat similar to the VA structure which is similar to the Medicaid concept. We’ll all be seen and treated by Nurse Practitioners and see the doctor, only if the NP needs another opinion, the opinion will come from a Resident not an experienced MD. The waits will be long and the Residents will change frequently leaving the NP’s in full charge. The only time we’ll get to see a real MD is when a speciality consult is ordered. The consult currently takes about two-three weeks depending on which state, in the future that wait will be months.
Annie on November 21, 2009 at 1:48 AM
Yeah, that was way wierd.
AnninCA on November 21, 2009 at 1:48 AM
I think I’ve shared this. I’m a Kaiser baby for over 35 years.
I love it. I’m an expert at knowing how to work that type of system. *haha
I’ll have an advantage over some of you. :)
AnninCA on November 21, 2009 at 1:49 AM
You need an MRI on your knee? Come back in six months, meanwhile try not to walk on it.
Yes, I look forward to guv’ment healthcare.
Bishop on November 21, 2009 at 1:51 AM
Good point. But I think we’re getting better at it. I think the initial trials in this were a bit statistic-heavy. But I honestly do see progress.
I should add that I have a distinct prejudice here. I think there are a lot of very mediocre doctors who would give you bad advice in a heartbeat. I wouldn’t mind some of them having to pay attention to commonsense findings from other doctors, who are frankly better.
AnninCA on November 21, 2009 at 1:52 AM
The government should stay the hell out of it, the patients and doctors should make the call, period.
echosyst on November 21, 2009 at 1:31 AM
AnninCA on November 21, 2009 at 1:53 AM
I have government run health care and I have learned how to work the system. It’s sad that you have to learn how to get what you need. But now we are in a place where we don’t have a military base by us. We are very limited to what doctors we can see. There are very few doctors in the area that take our insurance. We are supposed to have the best care. Doctors won’t take our insurance because the payout’s not that great.If I want my son to see a derm, the only derm that he can see comes to this area once a month. I know all about government health care.
Brat4life on November 21, 2009 at 1:57 AM
I had dental insurance like that once. Omigosh, you should have seen the place I was sent to once. It was scary.
Kaiser is terrific where I live, so it’s not quite the same as some of the HMO’s that are weaker.
AnninCA on November 21, 2009 at 2:01 AM
Negotiate. Purchase it privately.
AnninCA on November 21, 2009 at 2:02 AM
Anne, It depends on the motivation for Best Practices. If it’s motivated with the patient foremost in mind then it’s a good thing but if it’s money/outliers then it’s the cuttie cutter angle and we’re just clumps of cells.
If people currently on Medicaid think they have it bad now (and they don’t by a long shot in comparison to EU) – just wait until they’re completing with 300 million of us and that includes Kaiser and you Anne. I know the socialist system well. My family in Europe have been buying their own private insurance for years. They can afford it but the poor unfortunately can’t…that includes myself.
Annie on November 21, 2009 at 2:03 AM
Well, this is certainly no crystal ball, but I can tell you having been with the granddaddy of HMOs the progression over the past 30 years. Remember, Kaiser was born out of WWII as a mass product for people. I still think it’s brilliant.
The “best practices” part used to be terribly clumsy and very over-managed. People complained. Kaiser defended and resisted.
Then, in the 80′s, they really revamped. Now, best practices is with a light touch. Yes, there are protocols. However, the doctor doesn’t have to jump through many hoops if it’s smart to suggest a different route.
The one thing Kaiser or any mass plan never will match with cadillac plans are the “latest” treatments which haven’t really proven themselves. They’ll always lag behind on that.
I’m not overly obsessed with dying and wouldn’t ever be one that went to wierd lengths, anyway. So it’s OK for me.
Those who are? I think they need to earn the money and just buy those cadillac plans for themselves.
AnninCA on November 21, 2009 at 2:10 AM
Representative of the vote tonight don’t worry our concerns will be heard and addressed.
heshtesh on November 21, 2009 at 2:13 AM
This is amazing…I am a certified Cytotechnologist…in layman terms, I actually read pap smears and Breast fine needle aspirations for a living. In essence, I can look at cells in the human body at tell if you have cancer or not. These guidlines are ridiculous. I urge any woman/teenager who is sexually active-do NOT wait more than 2 years to have a pap smear done. And, if you re 40 years old, do NOT wait until you are 50 to have a mammogram done-especially if you have a family history of breast cancer. This health crap is getting out of hand! The rationing of health care is starting already, and it sounds like woman are in the cross hairs, first-unfortunate and unecessary..
Static21 on November 21, 2009 at 2:55 AM
Sarah Palin: In the Midnight Hour
Geochelone on November 21, 2009 at 3:21 AM
If you don’t already know it, just about everything AnninCA says is wrong.
Blake on November 21, 2009 at 7:08 AM
Um, have they yet said anything about prostrate exams?
We don’t want to be sexist about this. I mean, we demand equal rationing.
And what about sickle cell anemia. We MUST have Affirmtive Action rationing.
Universal Health Care Rationing!
davidk on November 21, 2009 at 7:20 AM
Maybe you should inform your radical liberal friends to cease and desist and that won’t be an issue.
jimmy2shoes on November 21, 2009 at 7:33 AM
Universal Health Care Rationing!
davidk on November 21, 2009 at 7:20 AM
davidk: This procedure,is called BarrakisBendOveris,and
hopefully this Lefty Orwellian HealthCare,
won’t be contracted out to gawd forebid,ACORN,
El Code Pinko’s,or NOW,
but,heres the people who will be running this,:)
(Sarc).
http://iowntheworld.com/blog/?p=9234
canopfor on November 21, 2009 at 7:38 AM
Waiting for the N.A.G.’s (National Organization of Gals) heated press release condemning this……………………………………………….
…………………………….. Still waiting……….
…………………………………………………..
…….Hello, anybody there?………………
conservnut on November 21, 2009 at 7:49 AM
Anyone who thinks rationed government health care will be in any way comparable to what Kaiser Permanente delivers is dreaming.
When you wake up, and see the grim reality of Obamacare, you will be miserable. There will be no way to “work the system,” because it will be overloaded and underfunded.
BTW, Kaiser medical plans are not a cheap option. At many companies it is one of the more expensive plans available.
marybel on November 21, 2009 at 8:02 AM
Crickets.
unclesmrgol on November 21, 2009 at 8:12 AM
Cool. Let’s shoot our way out.
Grow Fins on November 20, 2009 at 11:22 PM
You will actually be the first one I come looking for!
Vince on November 21, 2009 at 8:28 AM
As an NP who has worked in the Ob/Gyn field for 20 years, I can tell you that these guidelines have been a long time coming and they are based on outcomes research, not any political maneuvering (so no need to thank the Dems, LaurainMaryland). They are not mandatory but they are binding in the sense that a lawyer will most certainly hold you to those standards in any court of law. We can always do more (or whatever the patient’s insurance will pay for) but we can never do less. The big difference with government health care will be that we will not have the choice to do more.
Bingo. While I don’t agree with the implication here that NPs provide substandard care, the use of mid-levels is entirely consistent with a health care delivery system that has to keep down costs. I told a PA student following me last week that he is in a great position, because if we are saddled with a single-payer system, he will be in great demand. Our training is as physician “extenders”, to off-load the less complicated care to allow the MDs to concentrate on areas that require their more extensive education and training. You don’t need an MD for a routine Pap smear or to treat your child’s Strep throat but, in our current system, you can request to see the MD if you would prefer. With single-payer, that choice will be gone.
inmypajamas on November 21, 2009 at 8:41 AM
-
You can’t mean this…
Kaiser baby
-
-
Or at least… not what she means…
-
RalphyBoy on November 21, 2009 at 8:44 AM
Don’t confuse “best” practices with “exclusive” practices. The beauty of our health care system is the diversity of opinion and approaches among the medical services corp. If you don’t like how your current doctor is running your case, it is simple to seek out another doctor that may treat your condition differently (i.e. the brilliance of second opinions). If the Feds control your healthcare, then their “best” practices will be the “only” practices. IOW’s, doctors treat their patients using the “flow chart” method, which means that they’re really not practicing medicine at all, but rather following a checklist.
This is dangerous stuff but b/c of the consequences of the the proposed plan but rather because of the insidious nature and lack of conscience from those proposing it. Most won’t agree but it’s akin to the Feds legislating away other fundamental rights all in the name of the “greater good”. What’s most frightening though is that they are proceeding w/o regard to the current political climate or opinion of the electorate, which can only mean that they’ll do whatever they have to to enact their agenda, which is not the way that our democracy has (or should work). Dangerous times, folks.
volnation on November 21, 2009 at 8:51 AM
Obama will just buy the nay sayers off in one way or another. Apparently they all have a price, it’s just a matter of finding it.
jeanie on November 21, 2009 at 9:02 AM
What part of I don\’t want to have Government run Healthcare, you just don\’t get Ann?? I don\’t WANT to work the system. It isn\’t going to be okay. You are never going to have live as good as we have it now if you get your way. You will have life as good as Cubans.. which isn\’t as pretty as the lamestream media wants you to believe. I want the system I have right now. I don\’t want an over hall like this for a very TINY TINY minority that don\’t have healthcare. IF you like government run healthcare, move to CA and work the system, but all real choice for us. Take the nanny stater\’s in this country with you..
Noelie on November 21, 2009 at 9:12 AM
I think people are over reacting to some of this. Individuals and their doctors can decide what tests patients need and when they need them. The idea that insurance won’t cover them or whatever, just underlines the problem we have with demanding that insurance cover everything. I am an older woman, and I can remember a time when people actually paid for tests like this when they got them. This idea that insurance has to cover everything or people will not get the tests is one of the reasons health care costs have gone up in the first place.
Terrye on November 21, 2009 at 9:25 AM
The thing is the government getting involved in the first place was where a lot of the other recommendations came from.
Terrye on November 21, 2009 at 9:29 AM
But here’s the kicker: Once that system is in place – and it will suck – any suggestion by the Republicans that we move back towards a free market solution will be attacked by the Democrats as trying to “take away our health care”.
It will be like the current Social Security ponzi scheme in which taxpayers are being ripped off but are unable to move off the plantation because of fear.
PackerBronco on November 21, 2009 at 9:31 AM
Totally. Kaiser is a “Cadillac Plan” according to the Dems’. That’s why Rockefeller’s against the bill as it stands; it taxes all the union Kaiser plans as if coal miners are a bunch of AIG execs.
I hope you’re ready to pay those luxury taxes Ann? They’ll kick in next year while the plan doesn’t even start until 2014. No problema, si? Just add that to the extra 10% withholding “loan” to the Union mafia in Sacramento.
rcl on November 21, 2009 at 9:52 AM
The govt take over of all our health care decisions will usher in more of these new recommendations for men as well as women. The current board comprised of doctors will be changed to bureaucrats all in the name of controlling costs. If the govt gets this much control over our lives, we are going to lose many loved ones to rationing of care that we have come to expect. The govt can’t run squat very well, we might as well plan ahead for our demise.
Kissmygrits on November 21, 2009 at 10:00 AM
Your equating Kaiser Permanente to the VA?!?!?!?!!?!?
BWAHAHAHAHAHAAHAHAHAHAHAAHAHAHAHAHAH!11!!!!11111!
Your a joke, goodbye!
Phil-351 on November 21, 2009 at 10:07 AM
Under a single payer system, Doctors are limited by what their employer (the Feds) allow them to do. That’s why single payer is so insidious b/c it takes the decision out of the doctor’s hands and puts it squarely under the purview of some beaurocrat. That also doesn’t take into acct what kind of “doctors” we’ll have when the Feds determine what they make. That’s not an overreaction, it’s reality for what’s to come under this plan. Make no mistake, Obama and his ilk want to control as much of our lives as possible and they make no bones about it, it’s there for all to see.
volnation on November 21, 2009 at 10:09 AM
volnation:
I am not a supporter of a single payer system or anything like that. The people who came up with the idea that women needed all these tests every year were also panels just like this. That is my point. If you have a history of breast cancer in your family, then your doctor is going to want you to get these tests and if you are willing to pay for a mammogram, then it your business.
The same is true with the pap smears. The truth is they have been making money by terrorizing women into getting all these tests for years.
Your need to get a lot these tests has more to do with your history, your general health than any government panel.
Terrye on November 21, 2009 at 10:25 AM
Dr. Utopia says he might not run again in 2012.
Meanwhile Darleen at PW has the agenda for “health care” and it is a wee bit broader than signing up the uninsured:
•An income surtax on taxpayers earning more than $500,000 a year,[1]
•An excise tax on high-cost “Cadillac” health insurance plans that cost more than $8,500 a year for individuals or $21,000 for families,[2]
•An excise tax on medical devices such as wheelchairs, breast pumps, and syringes used by diabetics for insulin injections,[3]
•A cap on the exclusion of employer-provided health insurance without offsetting tax cuts,[4]
•A limit on itemized deductions for taxpayers with a top income tax rate greater than 28 percent,[5]
•A windfall profits tax on health insurance companies,[6]
•A value-added tax, which would tax the value added to a product at each stage of production,[7]
•An increase in the Medicare portion of the payroll tax to 3.4 percent for incomes great than $200,000 a year ($250,000 for married filers),[8]
•An excise tax on sugar-sweetened beverages including non-diet soda and sports drinks,[9]
•Higher taxes on alcoholic beverages including beer, wine, and spirits,[10]
•A tax on individuals without acceptable health care coverage of up to 2.5 percent of their adjusted gross income,[11]
•A limit on contributions to health savings accounts,[12]
•An 8 percent tax on all wages paid by employers that do not provide their employees health insurance that satisfies the requirements defined by the Secretary of Health and Human Services,[13]
•A limit on contributions to flexible spending arrangements,[14]
•Elimination of the deduction for expenses associated with Medicare Part D subsidies,[15]
•An increase in taxes on international businesses,[16]
•Elimination of the tax credits paper companies take for biofuels they create in their production process–the so-called “Black Liquor credit,”[17]
•Fees on insured and self-insured health plans,[18]
•A limit or repeal of the itemized deduction for medical expenses,[19]
•A limit on the Qualified Medical Expense definition,[20]
•An increase in the payroll taxes on students,[21]
•An extension of the Medicare payroll tax to all state and local government employees,[22]
•An increase in taxes on hospitals,[23]
•An increase in the estate tax,[24]
•Increased efforts to close the mythical “tax gap,”[25]
•A 5 percent tax on cosmetic surgery and similar procedures such as Botox treatments, tummy tucks, and face lifts,[26]
•A tax on drug companies,[27]
•An increase in the corporate tax on providers of health insurance,[28] and
•A $500,000 deduction limitation for the compensation paid by health insurance companies to their officers, employees, and directors.[29]
Mr. Joe on November 21, 2009 at 10:26 AM
Yeah. Sure.
GarandFan on November 21, 2009 at 10:42 AM
GarandFan:
I have never had a mammogram. And I don’t have plans to get one any time soon. And that has nothing to do with politics.
Terrye on November 21, 2009 at 10:47 AM
Soon, the government will figure that they can get away with confiscating all income and profits, and simply sending individuals a check for “their fair share”.
justltl on November 21, 2009 at 10:58 AM
When government is “paying” the bill, doctors will have to follow guidelines or not get paid.
Damn the patient, let’s be penny wise and pound foolish.
I’d prefer to see women wait until marriage for sex, but reality is that they’re not and if you want them to remain reasonably healthy, they should be screened.
Mommynator on November 21, 2009 at 11:06 AM
When do we start hearing about men’s health issues? No prostate cancer screening for men aged 40 & up? No little blue pill for men in their 70′s and up?
Just last month I went for my yearly pap and the nurse and I were talking about women’s healthcare would suffer the most. Didn’t know we would be hearing about it less than a month later.
moonsbreath on November 21, 2009 at 11:18 AM
My understanding is that women consume more health care in general, so any rationing would impact them most. Ultimately, it’s a lose-lose for anyone who isn’t currently uninsured and has no way of becoming insured without government assistance and anyone on the government’s own plan (although one suspects that once they screw everyone who isn’t on the government plan to the maximum extent, they’ll start gunning for the low-level government workers’ plan and so on and so on).
venividivici on November 21, 2009 at 12:02 PM
I am not a supporter of Obamacare or anything like that, but panels have been making recommendations for years and sometimes insurance companies and doctors follow them and sometimes they don’t. The idea that someone with a history of breast cancer in their family is not going to be allowed to get a mammogram because of this is silly. The truth is there is real doubt as to how much good a lot of these tests are anyway.
The truth is if people want these tests, they can always get them if they want to pay for them.
I had an ovarian cyst rupture 3 months after a pap and pelvic. I almost died. The test did not show anything amiss.
Terrye on November 21, 2009 at 12:06 PM
veni:
Well now, I am not so sure about that. If a woman wants a pap smear or pelvic, call doctor, set up an appointment for a pelvic, go in, get the exam and pay for it.
People do it everyday.
Terrye on November 21, 2009 at 12:09 PM
Well of course women go to doctors more than men. The main reason is because of our reproductive system. I would be more than happy to give my menstrual cycle, child birthing and hysterectomy to a man so then he can go to the doctor more.
However, this isn’t in regards to that. It’s about the recommendations to not allow cancer screening for women between certain ages.
moonsbreath on November 21, 2009 at 1:01 PM
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