How you can claim that the rationale was cost cutting when cutting costs was not considered as a factor is beyond me. Similarly, how can you consider the Task Force’s recommendations to be the government’s recommendations when the paper clearly states that the recommendations should not be construed as government policy or policy proposal? As an analogy, think of the work that consultants perform…do we consider a consultant’s report as the report commissioner’s final word?

You’re normally more reasonable than this.

Mike: The only way the govt can “cut costs” is to withhold services and medications. Since they are not responsible for making a profit, they don’t have any incentive to be cost-efficient, and since govt bureaucrats aren’t doctors with a personal connection to the patient, all of us are merely “budget items” to them.
Do you really want to get your medical care from a bunch of bean counters who don’t even see you as a person?

Mike: Cutting costs is rightfully the job of the one spending his own money on his own medical care, not some panel or “Task Force”.
It is the entry of govt into the relationship between patient and doctor that is the problem.

Mike Adamson:

They are policy proposals made to the government, not by or on behalf of the government

Oddly enough, when one looks it up, the USPSTF appears under the arm of the Agency for Healthcare Research and Quality, which is run by the US Department of Health and Human Services.

Funny that, considering Mike thinks they aren’t acting as an agent of the US Government.

As to the other, of course private industry pays attention to what they say… they are essentially setting industry standards, which is so upsetting about this particular position paper being so wrong.

Mike, this is from the White House website:

If it was on the Task Force’s website then you might have been on to something. I’m sure the WH sees the cost savings implications as easily as we do but that doesn’t negate the fact that cost savings were not part of the recommendation criteria. I’d stick to attacking the science of the recs rather than the political fallout…wingnuttery doesn’t become you.

Mike, you are being extremely naive. I thought you were smarter than that.

I doubt you or any other conservative here has read the report.

Conservatives would rather just attack friom ignorance.

When experts give recommendations it is not government intervention, it’s information.

I don’t know if this board is right, but I don’t assume that they are a death panel whose sole purpose is to cut down on medical costs.

From there report these seemed like serious people who have legitimate concerns about the over use of mammograms. This is not the first time they have recommended that mammograms be used less often.

95% of women think gov’t should offer
mammograms to women on demand?
Just my guess.
P.S., men get breast cancer too.
Check yourself.

Obviously fewer screenings will result in more cancer going unreported longer. And obviously the motivation here was saving money.

Simple question Rob, did you read the report?

More mammograms lead to more problems with radiation and more unnecesary surgery. They are making the argument that in a low risk population the benefits of the mammogram do not outweigh these risks.

It is not obvious that the motivation behind this is saving money. That is just your accusation.

They are very different, because in a private insurance program, the decisions are made on a much more regionalized basis than with the centralized control of the Canadian health care system.

Health care is an area of Provincial responsibility in Canada so I don’t think your point holds water.

I found this in a CNN report:

While the task force does not have any oncologist members, the panel chose a team of cancer experts who reviewed an array of evidence. This team consisted of four oncologists, a cancer surgeon and a cancer researcher. They then put together a report and presented the evidence to the 16-person panel.

“The task force has presented some new evidence for consideration, but our policies remain unchanged,” she said. “Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

http://www.cnn.com/2009/HEALTH/11/19/breast.cancer.task.force.uspstf/index.html

If you read some of the documentation put out with the recommendations then you’ll see that’s not the case.

MikeA, you are beating that dead horse to ribbons, give it a rest. You lost.

It’s a legitimate question. I wonder whether the Task Force included oncologists when it issued its previous set of recommendations in 2002…I don’t know. You would think that the TF membership selectors would have known that an update on mammography was due and that the presence of an oncologist or radiologist would be helpful but obviously I don’t have any specific insight on that angle. Finally, I’d be surprised if oncologists weren’t involved in the data collection and analysis stages but why they weren’t represented at the Task Force level is a question I can’t answer.

Amongst other problems, it fails to compute the lost revenue from people who die due to a lack of early detection. And as far as I can see, the difference in treatment costs for early intervention versus waiting until the disease becomes symptomatic.

The problem from MikeAdamson, Lioncourt, etc’s perspective is it is exactly an illustration of the problem with centralized government control and what happens to mere human beings, when callous cost/benefit analyses get performed. That’s the only reason I can see why they are spinning this so hard.

Nobody I’ve seen in the press or anywhere else wants to even touch defending this piece of wretched dreck. Interesting that they are willing to get themselves smeared in BS to do so.

Mike,

We’ve all seen this before. With Medicare reimbursement schedules, with Social Security “fixes”, with any sort of problem for which cowardly or stymied politicians (usually the former, as here) are searching for an authoritative, outside scapegoat to provide a solution that is inescapable and around which they can hope to build some sort of consensus. Outside panels of distinguished experts are nothing new.

After all, if the panel’s purpose to determine the best course of detection and cure, irrespective of costs, why were there no oncologists?

MikeAdamson:

Interesting poll result although I’d be remiss if I didn’t correct your statements that this was a government recommendation and that the rationale was cost cutting.

Which likely would have cost more money.

Even at that, it was a FAIL.

My question dealt with the obvious similarity between your enthusiasm for government paternalism and that of Cass Sunstein… not on whether I intended to have a mammogram.

Nor do I recall using the term “death panel” as you’ve intimated.

As for your “experts” and their “information” if they were hired by the federal government then obviously your parsing is pointless. I believe the recently revealed emails about man-made global warming were also authored by “experts”, weren’t they?!

The problem from MikeAdamson, Lioncourt, etc’s perspective is it is exactly an illustration of the problem with centralized government control and what happens to mere human beings, when callous cost/benefit analyses get performed. That’s the only reason I can see why they are spinning this so hard.

When I read this report I don’t get the feeling that they are just taking into consideration the monetary cost of treating women in their forties.

You can say they are doing a cost benefit analysis, but the cost is whether the results of a the radiation of a mammogram and the false positives are beneficial to the population of women in their 40s as a whole. I think they honestly believe that women in their 40s would be healthier in the whole if they didn’t get mammograms.

And I believe this is an honest study and women should be able to take it into consideration without conservative blowhards calling this group a death panel.

Why do you think women are too stupid to read this?

Yes I do, because unlike you I have read the report.

They were all doctors or nurses. You can see the list here: http://www.ahrq.gov/clinic/uspstfab.htm

How is a private health insurance plan bean counter in America any different from a government bean counter in Canada? They perform the same role from what i can see. Doctors are reimbursed by public health plans in Canada whereas in America they are paid in cash or, more often, reimbursed by a private insurance company. Are you saying that American doctors who accept health insurance are functionaries of insurance companies?

There are legitimate arguments to be made against public health care but the role of bean counters isn’t one of them.

Count me as another one of those women. I haven’t been very good about scheduling mammograms, I’ve only had one, but I’ve been doing self-exams since our family doctor taught me how when I was 18.

My cousin, at age 50, had to have a radical mastectomy about 11 months ago. Her tumor was the size of a tennis ball, masked by the fact that she had double D breasts and yes they were natural. The first thing the doctor said after seeing her mammogram was, “Why oh why did you wait so long, if we had caught this 5 years ago, we could have saved your breast? Instead she was mutilated and spent months sick with chemo, lost all her hair, and lost her job and health insurance. She is the single mother of a 14 year old and her life matters. Five years earlier would have made her 45 and with today’s new guidelines, the breast cancer would not have been caught anyway because there is a good likelihood that she wouldn’t have had a mammogram or found the lump thru the self-exam that is no longer thought necessary either. Anyway, last month, she went in for her 9 month bloodwork and 2 days later she was back in the hospital having her thyroid removed because of the pre-cancerous cells that were showing up. Not an unusual thing in a beast cancer patient. Again, early detection would have prevented things from going so far downhill so fast.

My cousin was an upbeat, excited about life kind of person. Now, she is just trying to survive long enough to see her 14 year old graduate from h.s. and maybe college. The five year countdown is on. She told me the other night she doesn’t experct to live to see her daughter get married or to see her first grandchild.

She thought it was safe to wait until 50 for her first mammogram since breast cancer did not run in our family. We thought heart trouble and stroke was our big enemy, based on family history. I’m a genealogist and I went back thru all the family death certificates I’ve collected over the years and I had to go back to our mutual great grandfather to find any hint of cancer. His death certificate lists prostrate cancer as a secondary condition but not what killed him.

If you don’t want to spend the time to read the report and make a substantive critique than just say so.

If the panel’s recommendations aren’t policy proposals then why are our tax dollars going to this government-appointed panel?

Because they will be policy proposal’s if the health care bill passes…

http://transcripts.cnn.com/TRANSCRIPTS/0911/23/acd.01.html

Take a look right there in section 2712. It’s titled “Coverage of Preventive Health Services.”

It reads — quote — “A group health plan and a health insurance issuer shall provide coverage for and shall not impose any cost- sharing requirements for services that have in effect a priority rating of A or B in the current recommendations of the U.S. Preventive Services Task Force.”

Well, that task force says mammograms between ages 40 and 50 is a level C, not a priority level, not covered.

So this panel is going to assign priorities for coverage. Only A and B levels will be covered. Mammograms for those under 40 are C so no coverage.

For reference, a mammogram costs $200-400, and the study found that 1904 mammograms were needed to save a live from ages 40-50, but 1335 for a life from ages 50 and up. So the cost of saving a life is somewhere between half a million and a million bucks in detection, and a certain amount for actual treatment–I’d guess in the hundreds of thousands of dollars.

So for a woman in her forties, a million bucks could theoretically give her 30-60 more years, ten years less for a woman in her fifties. Economically, this study does not make sense.

Rather, what it does is to equate the fear of a false positive and other difficulties with tests with the likelihood of death by breast cancer, and the study didn’t have any oncologists. It’s a horrifying picture of what healthcare can be if we give it to the government.

Thankfully, women are cluing in to what government can do to them if we allow it.

Simple response to simpleton.

If it’s not about saving money, how about if Zero pays women not to have Mammograms?

If you’re looking at it, its through rose colored glasses.

This is a government appointed panel that studies health care efficiency and influences medicare coverage.

All facts.

I think that if an individual woman wants to refrain from self-exams, and wants to postpone getting regular screenings until she’s in her 50′s, that’s her choice.

But the scary thing with this is that the government doesn’t just suggest things. And this especially won’t be a suggestion if they get control over our health care.