The White House Blog-Reality Check: Beware What “Critics Say” on Reform and Mammograms

[kpete]

Source: White House Blog

The White House Blog
Reality Check: Beware What “Critics Say” on Reform and Mammograms
Posted by Dan Pfeiffer on November 17, 2009 at 11:52 PM EST

One of the hallmark tactics from opponents of health insurance reform has been to grab onto any convenient piece of information and twist it into some misguided attack on reform, no matter how unrelated it may actually be. The hope appears to be that some media outlet will give them unchecked airtime under the banner of covering the “controversy.” Today they’re going back to that playbook again, and Fox News obliges them with the headline “Critics See Health Care Rationing Behind New Mammography Recommendations.” The story refers to new recommendations from the independent U.S. Preventive Services Task Force:
http://www.foxnews.com/politics/2009/11/17/critics-health-care-rationing-new-breast-cancer-screening-recommendations/

***"Some lawmakers on Capitol Hill are blasting new guidelines from a government task force that recommends against routine mammographies for women under 50, questioning whether they are tantamount to health care ‘rationing’ in the fight against the No. 2 cancer killer in U.S. women."

There’s only one problem: the recommendations of this task force would actually be used to provide access to effective preventive services for free or at low-cost. The USPTF would have no power to deny insurance coverage in any way. The line of attack is actually somewhat ironic, because one of the guiding principles of reform from the very beginning in March has been to invest in significantly increased effective preventive care, something these “critics” never seemed to care much about over the past 8 months.
http://dyn.politico.com/printstory.cfm?uuid=ED73A547-18FE-70B2-A8E6190206604521


Read more: http://www.whitehouse.gov/blog/2009/11/17/reality-check-beware-what-2

[Rosa Luxemburg]

1. Republicans have never cared about preventive care before?

[WriteDown]

2. I still fail to see how early mammograms are a bad thing...

If it saves just a few lives, isn't it worth it?

[Demit]

5. False positives; unnecessary/excessive exposure to radiation; no change in death rates since

frequent mammogram usage was initiated. These points were elaborated on in a thread from yesterday, by a healthcare professional. She had good explanations for your question, and also for why self-examinations can be less than useful.

[WriteDown]

6. But for all that....

There are still are lives saved by early detection. I've know 3 family friends who all developed breast cancer below the age of 50. I'm sure if they had passed away, it wouldn't have been enough to change the death rate, but that wouldn't have mattered much to me.

edited for grammar

[kiranon]

7. For false positives, one says "Thank you" and positives saves lives.

To say otherwise is to misinterpret the statistics and to ignore the problems with the studies such as not including enough minority women whose early breast cancers are often more aggressive. My breast cancer found twice by mammography - once in each breast - saved my life. And, most of the women I know with breast cancer are a lot younger than I am. Examining oneself costs nothing and can often find something that needs to be addressed. Otherwise, we are saving money on the backs of dead 40 year old women.

[sandnsea]

3. Who didn't see that coming

Could they really not have held off on this report a few months. Of course this is how it would be interpreted. These will be transformed into "death panels" by Friday.

[madfloridian]

4. Forgive me, but that blog post is a bunch of hooey.

"Isn’t this the first step toward denying coverage for mammograms?

No. The Task force is an independent panel of experts in prevention and primary care that evaluates available evidence and makes recommendations about effective clinical preventive services based on scientific information. Under the health insurance reform legislation, the USPTF would have no power to deny insurance coverage in any way. Their recommendations would be used in health reform to identify effective clinical preventive services."

Of COURSE it is a step toward denying insurance coverage.

And this part:

"Will Medicare now stop paying for breast cancer mammography for women because of this recommendation?

Women who are currently getting mammograms under Medicare will continue to be able to get them. There are no plans to change that. The law states that in order to change Medicare coverage of mammograms a formal rule making process must be undertaken and that is not happening."

CMS last I heard was already planning to do anyway with mammogram coverage in Medicare.

I am getting creeped out for seniors about the possible loss of Medicare benefits in this so-called health reform plan.

The left hand does not know that the other hand is doing...and that is scary as hell.

[JBShakes]

8. With all due respect...

How EXACTLY is it a step towards eliminating mammogram coverage in Medicare? Please provide some actual evidence to support your blanket statement. Has any elected official made any statement suggesting that these new guidelines should encourage Congress to revisit current laws?

The findings of the study used to make these recommendations specifically mention that mammography is FAR more effective (at a factor of about 5-6 times) in women over 60 (you know...the ones who are actually covered by Medicare) than women between 40-60, so these guidelines would actually encourage Medicare coverage of mammography.

Furthermore, one of the key points of the study (conveniently left out of most of the soundbyte driven coverage of this issue) is that these guidelines specifically exclude women at higher risk due to radiation exposure and/or family history, AND that they specifically recommend ultrasound as a diagnostic test for younger women instead of mammography, since women under 60 have denser breast tissue, which makes mammography less effective.

There's legitimate science backing both points of view in this debate. Can we PLEASE let the debate take place without immediately politicizing the information?

[madfloridian]

10. I lost two friends to breast cancer in their early 40s.

The debate has already taken place.

[Demit]

12. They won't listen right now. They are too ready to believe the worst.

Statistics don't matter to someone who has a personal story. Maybe later it will sink in what this information is actually saying.

Even without a personal story, I was ready to leap to the same conclusions yesterday. Then I read a couple of posts here by someone, like you, who actually can place this info into context. She made a lot of sense, once she explained the science & the context.


I know I was prescribed hormone replacement therapy in the 90s, and quit it on my own soon after only b/c I didn't like the side effects. Then some years later I read how doctors stopped prescribing it so freely after the studies were published showing it was more dangerous than previously thought. Correct me if I'm wrong, but this sounds like a similar situation? Mammograms are advised for some younger women if they are at particular risk, but it shouldn't be a blanket recommendation, because the tests themselves are not innocuous and not predictably accurate?

[123m456h789d]

9. madfloridian

("Isn’t this the first step toward denying coverage for mammograms?)
(I am getting creeped out for seniors about the possible loss of Medicare benefits in this so-called health reform plan.)

The Gov. pays for Medicare benefits crazy IF they were going to stop benefits they can do that with or without reform. How low your brain cells can go. Stop listening to FOX news, the DEM. is the one who fought for Medicare, Social S. and all of the other welfare programs, GOP. dont like these programs so why will the DEM. hurt the programs, that is for the GOP to do.

[madfloridian]

11. Look it up. Use search terms like this.

medicare, mammogram, coverage....or make up your own.

I know that right now women, gays, and teachers best be on guard....yes, with a Democratic administration.