Let the rationing commence...

[Parkbandit]

Health and Human Services Secretary Kathleen Sebelius tried to dispel concerns Wednesday that new guidelines on breast-cancer screening threaten insurance coverage for the procedure amid a growing debate about the guidelines among patients, medical professionals and legislators.

A federal task force on Monday reversed the recommendation that women in their 40s get annual mammograms. The panel also said that women aged 50 to 74 should get routine mammograms every other year, rather than once a year. "They do not set federal policy and they don't determine what services are covered by the federal government," Ms. Sebelius said of the task force. "I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."

The task force said the new guidelines strike a better balance between the benefits of early cancer detection and the unnecessary anxiety and extra costs associated with false positives, which sometimes result from the tests.

Karla Kerlikowske, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco, said the task force made the right call. The data on the benefits and harms of mammography in younger women are "a toss-up," she said. The age at which to begin routine screening "depends on where do you draw the line."

Many others disagree with the new guidelines, including the Mayo Clinic in Rochester, Minn. "Every day we discover invasive breast cancer in a woman age 40-50," said Sandhya Pruthin, director of Mayo's Breast Clinic.

The American Cancer Society said it stood by its recommendation that women initiate mammograms at age 40. The Johns Hopkins Hospital's breast center in Baltimore, the University of Pittsburgh Medical Center and other institutions also said women should have regular access to mammography starting at age 40.

Because of the new guidelines, "fewer women are going to get mammograms and more women are going to die of cancer," said Carol Lee, chair of the breast-imaging commission for the American College of Radiology, whose members include doctors who perform mammograms.

About one-third of U.S. women in their 40s and older aren't getting mammograms even every other year, according to data from the Centers for Disease Control and Prevention. After a steady uptick in the rate of such women getting regular mammograms between 1994 and 2003, the numbers dipped slightly in 2005 -- the most recent year for which CDC data is available -- prompting renewed concern in the breast-cancer field about why women aren't getting screened.

The U.S. Preventive Services Task Force, the formal name of the 16-doctor panel that issued the guidelines, is funded by federal money, but the group is designed to act independently.

http://online.wsj.com/article/SB125859364756654837.html

I always assumed that early detection of breast cancer was a key to the success in fighting this disease. Why would a government sponsored panel suddenly say that we can push the mammograms to age 50 instead of age 40.

[Paradii]

And in other news, chocolate rations have been increased to twenty grams per week!

[BriarFox]

And in other news, chocolate rations have been increased to twenty grams per week!

Soma! Soma! Soma!

Really, though, my understanding of the mammogram thing was that it was just cost v. benefit for the patients.

[Cephalopod]

I always assumed that early detection of breast cancer was a key to the success in fighting this disease. Why would a government sponsored panel suddenly say that we can push the mammograms to age 50 instead of age 40.

I heard about this the other day, and was pretty disappointed in the study. I can't imagine why anyone in the medical community thinks this is a good idea. The reasons given are valid (many women subjected to biopsies and other diagnostics who ultimately don't need them, removing a cancer that never would have turned malignant, etc), but don't seem strong enough to warrant this sort of sweeping recommendation.

What sucks is that insurance companies will use these guidelines to get out of paying for mammograms under age 50, while the National Breast Cancer Foundation (rightly so) will still be recommending them. Ugh.

[Jarvan]

Things like this are funny. Notice how the HHS Secretary said that Private plans will most likely not change their guidelines.

Now.. as for the Public option the Dems are going to jam down our throats and tell us we like it. How much you want to bet THAT one follows the new government guidelines? Which of course will reduce it's overall costs.. at first. Though once it starts resulting in more breast cancer cases, costs will sky rocket. of course, at the same time, Women will generally just get the test done anyway, and then have to pay out of pocket for it.

Anyone else notice that the Heathcare reform bills in congress do nothing to "Lower" the cost of healthcare? Only two ways to Lower how much an MRI costs. Do not allow it (ration) or pay less for it. And since they won't cut DR fees, and they shouldn't, good luck getting that MRI.

Little known fact.. Pittsburg PA has more MRI machines then Canada.

[Cephalopod]

Anyone else notice that the Heathcare reform bills in congress do nothing to "Lower" the cost of healthcare?

Someone made an interesting point the other day that Obama stopped referring to the bill as 'health care reform' and now refers to it as 'health insurance reform'.

Oh, here it is (http://www.npr.org/templates/story/story.php?storyId=120464701).



There's been a significant rhetorical shift in the way President Obama and his congressional allies refer to their health care overhaul. This summer, when President Obama was still talking about what he then called "health care reform," he promised to bend the rising cost curve of health care downward.

"Our proposals would change incentives so that providers will give patients the best care, not just the most expensive care," Obama said in July. "Which will mean big savings over time. This is what we mean when we say that we need delivery system reform."

Fast-forward to the day after the House passed its health care bill earlier this month. Notice how President Obama, in praising that action, no longer called it either delivery system reform or health care reform:

"It brought us closer than we have ever been to comprehensive health insurance reform in America," the president said of the bill in a Rose Garden address.


Disappointing.

[Whimsi]

Medical misogyny at it's finest.

[Parkbandit]

Soma! Soma! Soma!

Really, though, my understanding of the mammogram thing was that it was just cost v. benefit for the patients.

Isn't that always the case for rationing?

[TheEschaton]

Isn't it obvious, PB? Obama is trying to kill your white women.

[Whimsi]

Isn't it obvious, PB? Obama is trying to kill your white women.

This will affect economically disadvantaged women more than those who can afford the $200+ out of pocket cost when insurance companies decide this means they don't need to cover mammograms for women pre-50. Guess who that will be mostly?

[Parkbandit]

Isn't it obvious, PB? Obama is trying to kill your white women.

I hope this isn't the best reasoning you could come up with.

[Suppa Hobbit Mage]

I will check any breasts that need checking for free!

4srs though, I've grown to really dislike insurance companies and government :(

[Jarvan]

Know what the funny thing is about insurance companies is?

More then half their profits is from administering a large companies insurance program, NOT from offering their own insurance.

Most large companies pay for the insurance them self, they just hire companies to run it for them. At these companies, there is NO direct benefit for the Insurance company to deny coverage, as they are not the ones paying for it. Do they still deny coverage for some things that should be covered, of course. Do some of these things get covered anyway, yes. Do others not get covered, Yes. These last ones, are actually denied BY the Employee's Company. Not the insurance company.

Now that's not saying insurance companies are not evil. Cause, to a degree they are. As are almost all Companies.

Know whats really evil though? Two hospitals in the same city. Hospital A takes insurance, Hospital B does not anymore. Hospital B 2 years ago, did a tonsillectomy for child a for total $1,500 under your current insurance. Hospital A does one this year on a child for $11,000. When asked why it was so much, the answer is.. cause we can, and you have no other option.

Good thing this bill fixes THAT problem.

[Latrinsorm]

Karla Kerlikowske, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco, said the task force made the right call. The data on the benefits and harms of mammography in younger women are "a toss-up," she said. The age at which to begin routine screening "depends on where do you draw the line."Implication: data exists, and to at least some degree indicates that mammograms can be harmful.
Conclusion: it is possible to actually research this issue rather than go on supposition or gut feelings.
Observation: no one has.

[AestheticDeath]

This will affect economically disadvantaged women more than those who can afford the $200+ out of pocket cost when insurance companies decide this means they don't need to cover mammograms for women pre-50. Guess who that will be mostly?

Wait mammograms only cost $200ish bucks? And it is once a year or less?

is it seriously a big deal for insurance to cover it?

[Cephalopod]

Wait mammograms only cost $200ish bucks? And it is once a year or less?

is it seriously a big deal for insurance to cover it?

It's a bit less than that in most areas, but to put this in cost perspective:

Assume ~21m women in the concerned age range (40-49) [source (http://www.censusscope.org/us/chart_age.html)], at a cost of $120 per mammogram per year. That's $2,520,000,000 ($2.52bn) in costs that the insurance companies are suddenly getting the opportunity to avoid. That doesn't even account for follow-up biopsies and other diagnostics, as well as treatment they'll avoid having to pay for.

So, yeah... it could be a big deal, cost-wise.

[Jarvan]

It's a bit less than that in most areas, but to put this in cost perspective:

Assume ~21m women in the concerned age range (40-49) [source (http://www.censusscope.org/us/chart_age.html)], at a cost of $120 per mammogram per year. That's $2,520,000,000 ($2.52bn) in costs that the insurance companies are suddenly getting the opportunity to avoid. That doesn't even account for follow-up biopsies and other diagnostics, as well as treatment they'll avoid having to pay for.

So, yeah... it could be a big deal, cost-wise.

See my previous post about insurance companies.

As for insurance companies not offering it anymore.. that normally would be up to the companies as well. Also, it's the Government that decided this, not an insurance company.

As for the cost vs benefit for a false positive.. Well.. yeah. I am sure that getting a false positive can be stressful. Then again.. having breast cancer for 9+ years before you find out could be stressful as well..

At least for your family members planning your funeral.

Seriously, what's next? Flu shots are under rated since not that many people really die from it (except the old, but hey, they are old saves money anyway) -hint, sarcasm- or maybe prostate exams, pap smears, and other preventative checkups.

Isn't this the same government, and sorry these people are following what Obama says not deciding on their own, who said that MORE preventative services need to be done.

[Jorddyn]

My mom had breast cancer at 37. I had the joy of starting mammograms at the age of 27. I can guarantee you that I will continue them regardless of coverage.

That said - why say you don't need them until 50, then you need one every year? Why not every 2 years starting at 40? Or every 3?

C'mon, men love boobs, women want to keep their boobs, everyone wins.

[Back]

I dont know that this is so much rationing as rational...

If the procedure does not really need to be done as often as earlier recommended does that not drive down the cost for everyone?

[Jarvan]

Frankly, Rationing is a little more accurate.

Unless/Until all the nation's Medical groups say the same thing on this, it's just one political group trying to change what is considered standard for some obscure reason.

Ask your Dr how long it takes breast cancer to be a problem if gone unchecked, or how quickly it should be caught for the best possible chances. If the DR says oh, you can have it for 3 years and still be fine. the good, every three years is ok.

I guess a better Rational would be this..

Breast exam every year - 100-200$ per year
Breast exam every other year - 100-200 every two years.
10 years worth of exams A-1000-2000 B- 500-1000.

Save 50% on breast exams.

Course.. get cancer in an off year.. and your screwed. Cancer spreads, or gets worse. Now you have to get a mastectomy, or double mastectomy.

Cost of a mastectomy, 10k +. Not including Drugs, just the surgery.

So basically, these Dr's become accountants, and look at statistically how many women will get cancer, and have to get the cancer drugs, or a mastectomy and how much the total costs will be. Then look at how much current prevention costs across the board. Compare the two, long as new ideas are cheaper over all then old ideas. New Ideas are better.

And if a few people die due to it, well.. it saves in Medicare as well not to mention future mammograms, so it saves even more money. Yay for Rationalizing Healthcare.

[Mabus]

If the procedure does not really need to be done as often as earlier recommended does that not drive down the cost for everyone?
You believe costs will go down instead of profits for insurance companies going up?

[Parkbandit]

Women should start cervical cancer screening at 21 -- and most don't need an annual Pap smear, according to new guidelines aiming to reduce the risk of unnecessary treatment.

The guidelines from the American College of Obstetricians and Gynecologists, comes just days after a similar recommendation by a federally appointed advisory panel advising women to get mammograms at age 50 rather than 40.

The ACOG guidelines released today say women younger than 30 should undergo cervical cancer screening once every two years instead of annually. And those 30 and older can be screened once every three years.

Prior recommendations called for annual cervical cancer screening to start three years after a women becomes sexually active, or by age 21.

The recommendations are based on evidence suggesting more frequent testing can harm a woman's chances of carrying a child to full term.

Read more: http://www.nypost.com/p/news/national/pap_smear_revision_fdN87pojfqA5zfi32DegRM#ixzz0XPK QlsMn

The reasoning behind this change is because it can harm a woman's chances of carrying a child full term? Really? What are those stats compared to the success rates of cervical cancer?

And it's just one big coincidence both of these stories are coming out days before the big Senate vote on healthcare "reform".. oh wait, that's changed, now it's Health INSURANCE reform.

[Gan]

This will affect economically disadvantaged women more than those who can afford the $200+ out of pocket cost when insurance companies decide this means they don't need to cover mammograms for women pre-50. Guess who that will be mostly?
The most profound post in this thread.



C'mon, men love boobs, women want to keep their boobs, everyone wins.
Second most profound post in this thread.

:)

[Atlanteax]

http://cagle.com/working/091118/siers.jpg
http://cagle.com/working/091117/markstein.jpg

[Latrinsorm]

What are those stats compared to the success rates of cervical cancer?Why don't you ask them? (http://www.acog.org/from_home/proxy/)

[Warriorbird]

He's concern trolling. He doesn't want an actual answer.