Daily Archives: November 19, 2009

More Cost Control Looming In ObamaCare As Breast Cancer Screening Mammography Suffers Cutbacks In Guidelines

A Breast Cancer Preview – The mammogram decision is a sign of cost control to come.  WSJ.

A rational review of the basic ways Obamacare is already changing the way doctors will care for you.

It therefore concludes that the tests for the first group [women in their 40’s] aren’t valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Try telling that to a woman whose breast cancer was found incidentally by routine screening mammogram.  She might not be alive if her cancer had gone undetected for much longer.

But just to be sure this is all about money, and who is paying and who is deciding on how that money will be spent on care, understand the following clearly.

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel’s recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

Worse yet, federal advisory groups with very clear cost control mindsets, like the one that came up with the current short-sighted mammography guidelines, will ultimately be deciding you or your loved one’s care.  They will make the recommendations that ultimately become the rules on how health care will be paid for.  You can pay for the rest out of your pocket, or all of it if it is determined it is not a covered benefit.  That is, if you can afford it. 

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

Have these people lost their bearings?  Far be it for anyone but the most incongruous thinker, but most people expect their doctor to be their greatest advocate and take care of them as best as possible.  Rudimentary costs, particularly at the screening level, that may translate into a life long lived versus a death sentence, should not hinge on the statistics-driven rationale by appointed bureaucrats and academics that do not deal with patients, human beings, on the front line.     

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to “accounting exercises subject to interpretations and underlying assumptions,” and based on costs and large group averages, not individuals.

Do you want you, your mother, wife, daughter, sister, aunt, cousin, grandmother, great grandmother, etc. to be subjected to their care being dictated by “Panels” designed to decide their care?  Do you want you, your father, husband, son, brother, uncle, cousin, grandfather, great grandfather, likewise subject to the same?  Breast cancer happens in men too.  And so do other diseases that “Panels” will be culled to make the decisions for how Obamacare will take care of you. 

Check out the bills to see for yourself.  Do not skip pages.  Read every line.  Comprehension is critical.  It is you and your loved ones’ health care at stake after all.  It is all there.  Your representatives claim they read it.  But do they understand it?

H.R. 3962 Affordable Health Care for America Act 2009 House Bill passed.  (BIG bill, LONG load)

H.R. 3590 Patient Protection and Affordable Care Act 2009 Senate Bill pending.  PDF.

Should this be insufficient to drive the point home, consider the following illuminating posts.  Clear in point.  Like no other, Uppity Woman serves up the harsh reality.  Comments slam it down like a chaser.

For those who have forgotten their history and are doomed to repeat it, a little condensed version to put all of the above into proper perspective.  Uppity Woman and the the commentary round out the explosive discussion.  No holds barred begets brutal truth.  No Quarter cross posted. 

See: