[TunerSteve]

With the current ongoing debate about health care bills, and exactly how much involvement people want in their personal decisions, now comes another debate regarding women's breast health.

Will these discussions lead people to wonder if any government-run program will refuse to pay for breast exams for women that want them prior to the age of 50? It was a government sponsored study that arrived at the conclusion that mammograms prior to that age were unnecessary, so it's a worthwhile conclusion. I also wonder about the timing of releasing the results, and how that might impact the health care debate.

Any thoughts?

[Epaphras]

Nothing new. Insurance companies also keep abreast (yes, pun intended) of studies and new research to determine whether-or-not they will pay for something. If the research says you don't really need regular mammograms until after age 50, then insurance companies won't cover them if it is not in their financial interest to do so.

I would hope that a public insurance system would make decisions like this not based on the bottom line (what's the least I can cover to still make a profit?) but on solid research: it is good stewardship of taxpayer dollars not to pay for procedures and screenings that do not statistically produce results. It is stewardship/efficiency versus profit-motive, in my view.

[Nate]

Originally Posted by Epaphras

I would hope that a public insurance system would make decisions like this not based on the bottom line (what's the least I can cover to still make a profit?) but on solid research: it is good stewardship of taxpayer dollars not to pay for procedures and screenings that do not statistically produce results. It is stewardship/efficiency versus profit-motive, in my view.

I'm not sure I see the difference.

The parable of the good steward [i.e. talents] is about profit.

[Epaphras]

Originally Posted by Nate

I'm not sure I see the difference.

The parable of the good steward [i.e. talents] is about profit.

Yes but in this case, a government-run system that operates on effectiveness and stewardship, the "profit" does not go into individuals' hands but rather is savings from not wasting resources on unnecessary treatments.

In other words, the savings are the same for a public and a private entity; I just don't trust the private entity to make the best decisions/applications with that savings that a publicly-owned publicly-accountable entity would. Or at the very least, the power of the individual citizen/consumer to affect how that savings is applied is much greater in a public system than a private for-profit system.

[redbaron]

If my mom had waited until 50 to have a screening, she'd be dead by now.

[Nate]

Originally Posted by Epaphras

Yes but in this case, a government-run system that operates on effectiveness and stewardship, the "profit" does not go into individuals' hands but rather is savings from not wasting resources on unnecessary treatments.

In other words, the savings are the same for a public and a private entity; I just don't trust the private entity to make the best decisions/applications with that savings that a publicly-owned publicly-accountable entity would. Or at the very least, the power of the individual citizen/consumer to affect how that savings is applied is much greater in a public system than a private for-profit system.

I think that's more than a little naive.

The dollar is a vote, and private companies that misapply their cost savings tend to get voted out.

I am far from an evangelist for capitalism, but I don't think that government is all that much better.

Not to mention that governments are notorious for overspending on "solid research" meant to "cut cost".

That overhead [for determining "stewardship"] has to get applied somewhere along the line of production.

The idea of audits to save money has a fatal irony to it. It's necessary, but the process itself is costly.

The argument for paying for the new healthcare system is "Oh, we'll cut out all the waste of the old one."

Why the hell is there all that waste in the first place? If you could cut it now, you could have cut it out then.

The solution isn't to blame the previous administration's faults. The solution is to realize government is costly.

[Epaphras]

Originally Posted by Nate

I think that's more than a little naive.

The dollar is a vote, and private companies that misapply their cost savings tend to get voted out.

I am far from an evangelist for capitalism, but I don't think that government is all that much better.

Not to mention that governments are notorious for overspending on "solid research" meant to "cut cost".

That overhead [for determining "stewardship"] has to get applied somewhere along the line of production.

The idea of audits to save money has a fatal irony to it. It's necessary, but the process itself is costly.

The argument for paying for the new healthcare system is "Oh, we'll cut out all the waste of the old one."

Why the hell is there all that waste in the first place? If you could cut it now, you could have cut it out then.

The solution isn't to blame the previous administration's faults. The solution is to realize government is costly.

Good points, and you're right on the money as far as the OP question: what impact does this have on the health care debate?

[tlj009]

There was something on the news this morning about this. Someone involved in the study stated that it makes no difference at all if the cancer is found when the woman is 40 or when she is 50. That sent up more than a couple red flags. So is it true or not? Also how can self exams not be a good thing and why would they discourage a woman from doing them?

[Epaphras]

Originally Posted by tlj009

There was something on the news this morning about this. Someone involved in the study stated that it makes no difference at all if the cancer is found when the woman is 40 or when she is 50. That sent up more than a couple red flags. So is it true or not? Also how can self exams not be a good thing and why would they discourage a woman from doing them?

I don't think they're discouraging self-exams or doctor exams, they are saying regular mammograms are not necessary until age 50. There is radiation involved so there are risks with that, not to mention the costs associated with it (the machine itself, the technicians, etc.).

[nolidad]

Originally Posted by TunerSteve

With the current ongoing debate about health care bills, and exactly how much involvement people want in their personal decisions, now comes another debate regarding women's breast health.

Will these discussions lead people to wonder if any government-run program will refuse to pay for breast exams for women that want them prior to the age of 50? It was a government sponsored study that arrived at the conclusion that mammograms prior to that age were unnecessary, so it's a worthwhile conclusion. I also wonder about the timing of releasing the results, and how that might impact the health care debate.

Any thoughts?

Well the good thing is that folks in medicine who care not a whitr avbout politics have bashed this study thouroughly. There is no science behind it. This is nothing more than prepping people to do with less if one of the current health bills become law.

They offered no studies, no research, no sound medical reasons to stop this. It is all about cutting back on tests, and that is foolish.

[tlj009]

I don't think they're discouraging self-exams or doctor exams, they are saying regular mammograms are not necessary until age 50. There is radiation involved so there are risks with that, not to mention the costs associated with it (the machine itself, the technicians, etc.).

"The new advice says:

* Most women in their 40s should not routinely get mammograms.
* Women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown. (The task force's previous guidelines had no upper limit and called for exams every year or two.)
* The value of breast exams by doctors is unknown. And breast self-exams are of no value."

That last point seems like they are discouraging both doctor exams and self-exams.

[beanbag]

hmm. as a woman--even a young woman--I hear about the risks of breast cancer a lot. while I understand why it may not be necessary for those of us under 50 to undergo routine screenings at this time, I have heard some conversation about the possibility of birth control being linked to breast cancer. whether or not that is true remains to be seen, but if it does turn out that birth control is linked to breast cancer...well, a lot of girls start on it in their young teens, and routine screenings beginning in the mid-20s or early 30s may become necessary in time.

and...breast cancer does affect women under 50. one of my favorite professors was diagnosed with a very rare form in her mid-30s, so people need to still keep that in mind.

so, to the OP: I can see it becoming possible for insurance companies to refuse to pay for screenings for women under 50 so long as the government says that they are "unnecessary." also...I don't see why there isn't any value in self-screening. we should be in tune with our bodies enough (this goes for all areas--eating, breathing, exercising, etc) that we know when something is wrong. at least with self-screening, you should be able to tell if something isn't normal if you feel differently than you did three months ago.