Death Panel? Government Panel Says No Need For Mammograms In Your 40′s, Self-Exams Are Worthless

Proof • November 17, 2009

When I first read the headline to this article I was a little shocked. Typically you’d think doctors and other medical experts would side on the “better safe than sorry” side of cancer screening. America has the best breast cancer survival rates in the world, and you have to think that encouraging early mammogram screenings and at-home self exams are pretty key to that end result even if they only seldom lead to actual cancer detections.
But a new government panel of doctors and experts are telling women to give up self-exams and to wait on mammograms until they’re 50, and only then twice a year. They say that the earlier mammograms and the self-testing at home lead to too many false positives that suck up too many medical resources.
Is that true? I’m not sure I’m medical expert enough to say one way or another, but when I read this part of the article I’ve got to wonder what’s really motivating these people:

The new guidelines were issued by the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies.

With Medicare teetering on the edge of bankruptcy, and the federal government teetering on the edge of all but nationalizing the health care industry, are these government experts being motivated by a desire for healthier Americans or a desire for cost cutting?
And, well, that’s sort of the problem when we’re dependent on the government for something like health care isn’t it? Once we individuals abdicate that responsibility to the government we suddenly have someone else making, or at least manipulating, our health decisions for us. And what motivates those people? Our personal, individual health? Or their bottom line?
Granted, HMO’s and other insurance companies are often motivated by the same thing. But the thing with them is that they’re optional. Unlike the government. If your HMO is screwing you, you can always pick another insurance company. And if you don’t really have any choices, maybe the government solution should be to enhance our choices. By doing stuff like, you know, allowing us to buy health care across state lines and stuff.
The risk of making ourselves dependent on the government for health care is having government panels determine what sort of coverages/treatments we can get and what we cannot get. And that’s a life or death game.

Tags: Asshats, Domestic Issues, Politics

http://Array sayanything-45

Carrick

“Just because it’s a government funded study doesn’t mean I have to believe it Mike. ”

Of course not and just because it’s a government funded study doesn’t mean that you should disbelieve it. I don’t see any downside to self exams either but there’s been a debate over the appropriate use of mammography for years. I’m responding to the use of the Task Force’s recommendations in order to bash government and the healthcare insurance proposals without assessing the evidence behind the recommendations.

GIA

“So to save a portion of the 5 billion dollars spent on mammograms we are willing to let breast cancer death rates go up 15%? Brilliant!”

Actually, what they’re saying is that the number of women who benefit from routine screening before age 50 is less than the number of women who are impacted negatively from routine screening before age 50. At age 50, the number of women who benefit is greater than the number who are impacted negatively. Since the 15% figure refers to all women age 40 and over and not just to those between 40 and 50, your fears are over stated.

Rob

“If this were a report froom some HMO the liberals would be screaming their heads off about greed and callousness. But an Obama task force?”

And if the Task Force had made these recommendations in place of the ones that they made in 2002 would you still blame the government? This isn’t some government department but an independent panel of front line and academic experts who are appointed by the government.

I’m grumpy and no doubt making a mountain out of a molehill but it seems like you don’t want the government bureaucracy conducting research and making policy suggestions and you don’t want the government reaching out for advice to the people who do this stuff for a living either.

This is a perfect example of damned if you do and damned if you don’t. It’s a reflex antigovernment sentiment that doesn’t consider the content or rationale behind the recommendations which, in the past, have been used by the government and insurance companies alike.

The link to the study is here if anybody is interested. I don’t know whether the recommendations are good or not but i know I would seek to understand them before I slough them off as evidence of a death panel mentality.
sayanything-12

Here’s another comment from your article, Mike, and one who’s sentiments I echo:

“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.”

And this is just f-ing retarded:

While the task force recommended against doctors teaching women how to perform regular breast self-exams and concluded that there was insufficient evidence to determine whether doctor exams were beneficial, several experts stressed that women should seek medical attention if they come across any unusual lumps.

Just because it’s a government funded study doesn’t mean I have to believe it Mike.

Anyway, their model doesn’t even include the factors that they list for why women should forgo self-exam or routine screening before 50. That is just the typically liberal-arts bullshit narrative that is devoid of any objective methodology that one expects from soft-brained soft-science types.
sayanything-4625

While annual mammography for all women beginning at age 40 reduced the death rate from breast cancer by at least 15 percent

So to save a portion of the 5 billion dollars spent on mammograms we are willing to let breast cancer death rates go up 15%? Brilliant!
sayanything-45

“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.”

http://www.washingtonpost.com/wp-dyn/content/article/2009/11/16/AR2009111602822.html
sayanything-12

Sparkie, it’s likely that part of the explanation for the increase in cancer since the ’70s is due to another government push: The modern (USDA) food pyramid ignores all nutritional science up to its adoption in the 70s and essentially all research since.

The introduction of high-levels of omega 6 and 12 and high levels of grains into our diet along with high fructose corn syrup have been nation-health wise a disaster, and explains more of the differences in morbidity rate of the US compared to other country than treatment options (or the lack of them).

Interestingly, medical care doesn’t extend life expectancy nearly as much as proper nutrition. There was a study of life expectancy for 4th century Romans living in London, and they were shocked to find these Romans lived nearly as long as modern humans, with the explanation being given that the Roman’s had healthy diets similar to modern man.

It’s true we have better health care, but we also have way higher incidence of certain diseases than they did, and these two effects pretty much offset each other.
sayanything-12

Mike, that is exactly the problem:

But we are recommending against routine screening.

Given the new nearly non-invasive procedures for biopsying masses, what possible health risks do women incur from biopsies?

The only objective harm I can come up with is additional expense to an already strained Medicare system.
sayanything-12

boba:

99% of all breast cancers are found thru the woman examining herself and then getting a mamogram and biopsy

While this was certainly true in my wife’s case, I don’t think it’s anywhere near 99%. Maybe 50%.
sayanything-45

Scepticism applied inconsistently is scepticism denied.
sayanything-4625

Mike,

Define negative reaction. They got scared because of a false positive? They had to have a biopsy to prove that their tumor was pre cancerous and not cancer? I read the stats.

>blockquote>The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not, Brawley wrote.

“It’s an average of five lives saved per thousand women screened,” said Georgetown University researcher Dr. Jeanne Mandelblatt.

Starting at age 40 would prevent one additional death but also lead to 470 false alarms for every 1,000 women screened.

So I guess its not too high a price to pay to kill one women so that 470 won’t be scared for a few months, unless your the unlucky woman that has to die.

So
Padraig’s Ghost

What a Mammogram Denial Form Letter might look like in the future!

Cormrade Citizen Female Person,

Your request for Mammogram has been denied. In the event you develop cancer, the state will no longer requires your services as your utility to the state is deminished. Please report to the Hemlock Society and Dr. Emanuel or Dr. Singer will gently assist you in your exit from this world.

(Your Town) Health Care Allocation Soviet (AKA the “Death Panel”)

P.S. We would also require that you greatly deminish you carbon footprint until you appointment with Dr. Emanuel or Dr. Singer…
sayanything-8606

Key word here…”Government”
sayanything-12

Sparkie:

Just so I’m clear…we should disregard the recommendations because the committee was set up by the government?

To be clear, why should we automatically assume competence on their part?

There are plenty of examples of government mandated policies that have gone horribly wrong to fuel an enormous amount of skepticism in any mentally healthy, independently thinking person.
sayanything-352

Sparkie… If death panel is an exaggeration, what would be more accurate—Not-as-concerned-about-your-health-as-we-used-to-be?
sayanything-12

Or.. the “please don’t do that breast exam because it may cost us money” panel.

Given how many women have found tumors through self-exam, what percentage of false alarms is too high for these asswipes.
sayanything-12

Mike:

Carrick…how unscientific of you.

Well yeah, skepticism is so unscientific. XD
TheTodd (now with child!)

“These are, kinda sorta, the death panels Palin warned about.”

I think women should receive 10 mammograms a week.

If you support fewer than that, then you support rationing health care to cut down on costs. You support death panels.
sayanything-12

Here’s a couple of key parts of the comments:

The new guidelines were issued by the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies.

But Susan Pisano, a spokeswoman for America’s Health Insurance Plans, an industry group, said insurance coverage isn’t likely to change because of the new guidelines. No changes are planned in Medicare coverage either, said Dori Salcido, spokeswoman for the Health and Human Services department.

Some facts: Insurance companies do not appear to be buying into this BS.

It was not an independent study, being funded by the government to cover expenses paid by the government, it very clearly lacks any significant degree of independence needed, and the probably of a substantive conflict of interest was very high.

It was very clearly a calculation of the value of a life versus the cost of treatment, call then death panels, kill a woman-save a cow panels, or whatever you wish, it amounts to the same thing.

Rob is absolutely correct that this is an example of what happens when we let the government run our health care. Just another shameful annal in what amounts to government mis-run health care in this country.
sayanything-12

M… for whatever it’s worth Sparkie, my wife’s life was saved by a breast self-exam…. she had an early stage 2 highly aggressive tumor in her right breast (which though small had already spread to one of her sentinel lobes).

What these guys are basically asking us to do is let people like my wife to die so that hospitals can save a few bucks (prolly making bigger profits) and the cost of some procedures would be less.

My counter offer to these guys is “go f**k off, die and rot in hell.”

Oh and Davie, thanks for chipping in moron.
sayanything-45

Carrick…how unscientific of you.
sayanything-45

From the article:

“For most of the past two decades, the cancer society has been recommending annual mammograms beginning at 40.

But the government panel of doctors and scientists concluded that getting screened for breast cancer so early and so often leads to too many false alarms and unneeded biopsies without substantially improving women’s odds of survival.”

Just so I’m clear…we should disregard the recommendations because the committee was set up by the government?
sayanything-12

Apologize for the missed end bold face
sayanything-45

http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm
HG

Just how is this going to affect “buddy check” ? Inquiring husbands want to know.
http://sayanythingblog.com robport

Corrected.

And my point is: The pronouncements of these panels have a lot more weight when we’re all dependent on the government for health care.

These are, kinda sorta, the death panels Palin warned about.
bikebubba

Correction; best breast cancer survival rates in the world, not the nation.

Good point, though. Gotta make sure we watch exactly who is writing the recommendations….and who benefits.
sayanything-81

Carrick

The position laid out in the article is foolish. My feelings on this are as follows.

1) There has been an increase in cancer, markedly, since the 1970s.
2) Certain genes make some people highly susceptible to cancer and others less.
3) Policy based on large masses of information misses the point that, for the individual, you might be the minority who develops something which meeds to be addressed early and rapidly.
4) I believe that humans have evolved. Ergo, the selective pressures which have slowly formed us have not selected for propensity at rationalizing about large aggregates like these policy-makers who are looking at data about people, ages, money, and so forth. We have evolved to reason about medium-sized objects in our environment which are conducive (or not) utility-wise, for survival. Breats which can potentially have lumps seems to me to be exemplars. A success-oriented policy where application of simple, native skills can be brought off without problems, such as self-exams, seems best. When we get some academic tart, sitting over a pile of data, and applying reasoning skills that are not adept at such feats, you end up with sh*t. I understand how contingency-planning can work, but recommending this article is an aberration. Bio-infometrics theory can be alarming, apparently.

If we have a situation where lots of uninsured people have cancer which they are finding from self-examinations (how else if uninsured?) and their unpaid bills are taxing, so to speak, the government funding for such things, then the fed should be up front about it. This ‘policy recommendation’ is silly. The emotional punch Rob gets out of ‘Death Panels’ is also silly to a degree. ITS ANOTHER ONE OF THOSE MEMES WHICH ARE USED BY THE RIGHT TO CLASSIFY BROAD SWATHS OF PHENOMENA INTO A FEW EMOTIONALLY VALENCED GROUPS. It’s disappointing.
http://sayanythingblog.com robport

And what happens when none of is can opt out of the policy?

Try thinking like a grown up with responsibilities.
sayanything-81

rob
“its an argument against government-run health care”
how do you get that from this? its just a shitty policy recommendation from some academic, is it not?
http://sayanythingblog.com robport

And that’s not really a goid excuse. In fact, its an argument against government-run health care.
sayanything-81

BTW, if you are flinging around bullsh*t memes, the best you could do is figure out where they came from in an effort to understand what you are talking about when you do talk.
sayanything-4253

Rob,

Can’t be. Death Panels don’t exist. They were just created by the Repubonazis who want everyone to not get health care!
sayanything-81

The article that generated the death panel meme is by Alan Wertheimer and Ezekiel Emanuel. It is either the first or the fourth articles listed on this page: http://scholar.google.com/scholar?hl=en&as_sdt=800000000001&q=Alan+Wertheimer+Ezekiel+Emanuel

The context is in cases of pandemics or other ABnormal situations when allocating vaccines and so forth is done with informed rationing. We saw that with the swine flu vaccine. It was available to pregnant women, athesmatics, immune-deficient individuals, old people, young people, and so on… before it was available to the rest of us. The ‘death panel’ meme is derived from those papers and is an exaggeration which is taken out of context.

The right also supports death panels, albeit ‘invisible hand’ death panels. Admit it when symmetries exist in yours and your opponents positions. Everyone cannot be saved all the time. You advocate the rich be saved while others believe that informed rationing such as we have seen with the swine flu vaccine are more appropriate.
sayanything-81

Moreover, these are scholarly papers intended to instigate debate. They will be responded to and the responses will be responded to and we will be underway… then we will be thinking.
sayanything-101

Isn’t this the same bunch that claims health care costs are so high is because most people can’t afford to get preventative health care?
sayanything-81

Ha. I found out that the guy who penned the ‘death panel’ bioethics article with Rahm Emmanuel’s brother is one of my former professors. Small world.

BTW, ‘death panel’ is an exaggeration, from what I have read.
http://sayanythingblog.com robport

Good point.
http://sayanythingblog.com robport

Wow you just never quit with the strawmen do you? Are you really so mentally feeble that you can only argue against your own invented arguments?
http://sayanythingblog.com robport

Its a government panel whose pronouncements impact life and death decisions about what sort of treatments Americans can get.

I don’t like the term “death panels” but Palin wasn’t wrong.

Why don’t you toddle off and teach your pretend class.
http://sayanythingblog.com robport

They are in fact arguing against at home self screening.

To save money.

If this were a report froom some HMO the liberals would be screaming their heads off about greed and callousness. But an Obama task force?

well…that’s different.

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Death Panel? Government Panel Says No Need For Mammograms In Your 40′s, Self-Exams Are Worthless

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