I briefly touched on this topic in an earlier post, but I'm very irritated at both sides of the political spectrum shamelessly demagoguing the issue. (Being "against" breast health is like coming out against Mom, pie, and Chevrolet.) The Democrats are claiming their very rationale to "control costs" is based on preventive medicine, exactly the kind of thing yearly exams are designed to detect--moreover, they argue findings like these just play right into the hands of "evil" health care insurers, whom allegedly will now use the relaxed standards as an excuse to short-shrift women's health. The Republicans and media conservatives are using this as basically a harbinger of what's to come under the rationing of government-run health care.
Enough! I've had it with this anti-intellectual/scientific populism which doesn't even begin to address what the task group was discussing. Let me quote Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force (I'm sure the Democrats didn't see the word "preventive"):
We're not saying women shouldn't get screened. Screening does saves lives. But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully.What's that you say? "Serious negatives or harms"? [How many demagogues over the past 10 days have addressed what the task group actually said, never mind the results were based over politically-neutral FACTS and sophisticated mathematical modeling, based on medical breast health histories of hundreds of thousands of women?]
Very simple: In up to 10% of cases, mammograms result in false positives: that is, women are falsely diagnosed with breast cancer and under aggressive treatment undergo disfiguring biopsies, surgery, radiation and/or chemotherapy. Ask cancer patients how they would feel if they found out these treatments were done over false positives or innocuous tiny or slow-growing, never life-threatening tumors... [Who's more unethical, Dr. Kopans? Might I suggest someone whom is knowingly willing to push an imperfect technology at the expense of the physical and mental health of women whom have been wrongly diagnosed? Is the Hallmark "sorry" card you send going to make up for putting them and their loved ones through a needless living hell?]
The study points out blanket testing at 40 would correctly diagnose less than 1 woman out of a 1000, but 470 would receive a false positive and some 33 would undergo an unnecessary biopsy. Why did the study recommend biannual versus annual exams after the age of 50? Did they simply pull this out of the thin air? No. It was based on scenarios played out using computerized mathematical modeling; they would get 81% of the benefit of early detection while cutting half of the false positives.
None of last Sunday's talk shows provided a "fair and balanced" picture of the situation:
Petitti said the panel was not influenced by the reform debate or cost issues. A spectrum of women's health advocates, breast cancer experts and public health researchers praised the new guidelines...Fran Visco, president of the National Breast Cancer Coalition, a Washington-based patient advocacy group,[said,] "Women deserve the truth -- and the truth is the evidence says this is not always helpful and can be harmful."The bottom line: The recommendations are based over women as a whole and do not apply to known at-risk groups, which require more stringent preventive care (e.g., women whom have a family history of breast health issues). And women should bring to the attention of their personal physicians any troubling new symptoms (and not simply ignore them, hoping they will go away).
The problem of misdiagnosed cancers or radical preventive measures (e.g., young women with healthy breasts having them removed) is not restricted to breast health; for example, there is a current British case where a woman had one of her legs amputated over a diagnosed malignant cancer tumor--confirmed by three other well-respected physicians--only to discover there was no cancer in the amputated limb.
As to my conservative critics, might I suggest that when they argue against the unnecessary costs of defensive medicine due to the sky-rocketing costs of medical malpractice insurance, why would they be against more cost-effective, humane preventive care of breast health? Breast exams cost billions a year. Democrats are talking about scaling up preventive care (whether funded or mandated); is it possible we are seeing just one example of obtrusive, unnecessary preventive care which adds needlessly to aggregate health care costs, ultimately paid by all of us?
My maternal grandmother died from complications of colon cancer while I was a toddler; the wife of one of my best friends underwent treatment for cancer. The high school best friend of one of my little sisters died two years ago from breast cancer. Cancer is a terrible disease, and I suspect anyone reading this post knows someone whom has gone through it.
For me, economical liberty, educational leadership, globally competitive business growth investment, income tax and regulation policies and related issues (e.g., immigration reform) are more than political bumper stickers; those are the seeds that have been responsible for American superior health care quality and innovations and will result in the more rapid emergence of life-changing technologies.
More on the AIG Bailout
I was just reading Peter Wallison's Friday Wall Street Journal column "Lack of Candor and the AIG Bailout". It just struck me that Mort Zuckerman's discussion of correlated issues (mentioned in yesterday's post) could in fact reflect the influence Democrats' nebulous justifications for regulatory empire-building.
There are a couple of salient points I want to pull from Wallison's piece. First is the disclosure that the AIG bailout was not based on then NY Fed President Geithner's belief that an AIG bankruptcy would set off a series of cascading failures to the other parties of AIG's derivatives transactions. Second is the fact that whereas Obama and Geithner have shamelessly attempted to blame the crisis (after Bush, of course) on "predatory lending", when in fact two-thirds of the 26 million gimmick mortgage loans were held by FHA, the GSE's Freddie Mac and Fannie Mae, and four banks under pressure to make the loans as a condition for desired mergers and acquisitions. Let's flesh that fact out a bit: Obama and the Congressional Democrats are trying to blame the private sector financial service sector for the housing bubble and collapse, when in fact the government had direct or implied power over the majority of the problem loans. How about that sage advice to doctors: "Physician, heal thyself!"? Before Obama and his crony progressive allies start attempting to micromanage the commercial financial services industry (after all, the government did such a great job with its own oversight over the FHA and the GSE's...), how about "Government, reform thyself!"?
Political Cartoon
Steve Breen reminds all of us no matter how you look at Democratic health "reform", it isn't a pretty picture...
Christmas Musical Interlude: Trans-Siberian Orchestra "Christmas Canon Rock"
What more can I say? Pachelbel's "Canon in D" (which I first heard at a religious retreat and often played at weddings) meets electric guitar, strong female vocals, simple, powerful lyrics, and tight harmonies. GLORIOUS! (I licensed a copy of the original hit version, featuring children's vocals.)
merry christmas
merry christmas
merry christmas
merry christmas
(add the new stanza at the end of the first time)
(2.)
the hope that he brings
the hope that he brings
the hope that he brings
the hope that he brings
(together)
brings...
(1.)
this night
we pray
our lives
will show
this dream
he had
each child
still knows
(simultaneously - add a new stanza each second time)
(2.)
we are waiting
we have not forgotten
(3.)
on this night
on this night
on this very christmas night
