Of all things, for the Obamanoids and progressives to attack first, is cancer and womens' health. The American Cancer Society has not scrubbed its site: "If you can't prevent cancer, the next best thing you can do to protect your health is to detect it early. Getting regular check-ups is the best way to do this." ACS :: Early Detection (http://www.cancer.org/docroot/PED/ped_2.asp?sitearea=PED)

But now: "New guidelines by the American College of Obstetricians and Gynecologists say most women in their 20s can have a Pap smear every two years instead of annually to catch slow-growing cervical cancer.

"The change comes amid a separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology." Report: 20-somethings can go 2 years between Paps - Yahoo! News (http://news.yahoo.com/s/ap/20091120/ap_on_he_me/us_med_fewer_pap_smears)

First mamograms, now pap smears.

There is a clear pattern of the government setting the stage to decrease the level of preventive care that they will pay for under government-run health care.

The rationing has already begun. The death panels are in session. The stage is being set. And they haven't even passed nationalized health care yet.

What's it going to look like if it becomes law?

Wake up, folks.

Elliot

I hate to tell you guys this, but most 20-something women are okay with the 2 years thing.

I HATE having pap smears. I know they're necessary, but they still suck.

And in my 20s--I didn't have the TIME to go for an appointment that SHOULD only take about 1/2 hour, but still manages to eat up half your day because it's a non-emergency thing and doctors are always running late.

I'm pretty sure that just like mammograms--if you DO have something unusual show up, you come back more often. Because I'm at a higher risk for breast cancer (mother has it, 2 aunts and my sister had it), I get a mammogram every year, and insurance covers it NO problem.

I hate to tell you guys this, but most 20-something women are okay with the 2 years thing. Hello Synn:

One of the reasons we spend MORE than any other country in the world on health care, and get LESS, is because we spend the money in the wrong places...

It should be noted, that since the righty's think our medical delivery system is the BEST in the world, and since they think that health care reform ISN'T really about health care anyway, but about a commie plot to take over the world, I think you can discount most of what they say...

If only they hadn't made themselves irrelevant...

excon

I hate to tell you guys this, but most 20-something women are okay with the 2 years thing.

I HATE having pap smears. I know they're necessary, but they still suck.

And in my 20s--I didn't have the TIME to go for an appointment that SHOULD only take about 1/2 hour, but still manages to eat up half your day because it's a non-emergency thing and doctors are always running late.

I'm pretty sure that just like mammograms--if you DO have something unusual show up, you come back more often. Because I'm at a higher risk for breast cancer (mother has it, 2 aunts and my sister had it), I get a mammogram every year, and insurance covers it NO problem.

If you CHOOSE to get a pap smear every two years, that's YOUR choice.

The question is whether the government should be the one making that decision for you or not.

Now... what happens when health care is nationalized, you are forced onto the government plan (which will happen within 5-10 years after the "public option" goes into effect), and they decide not to cover mamograms more often than once every two years. After all, they have an official study to rely on now to substantiate that position. The fact that YOU happen to be a high risk patient doesn't mean anything to them. They WON'T cover the annual exam because the study says so and they don't have to... and worse, you won't be allowed to pay for it out of pocket either, even if you can afford it. (That's the meaning of having a single-payer system.)

The bottom line is, whether YOU decide to get a pap smear or mamogram every year or every two years, the GOVERNMENT is going to use this as an excuse to set limits that may not be right for OTHER women.

Elliot

I hate to tell you guys this, but most 20-something women are okay with the 2 years thing.

Of course they are okay with it... they are the age group that believes "it won't happen to me."


I HATE having pap smears. I know they're necessary, but they still suck.


What sucks worse? A PAP smear or a long and painful death?



And in my 20s--I didn't have the TIME to go for an appointment that SHOULD only take about 1/2 hour, but still manages to eat up half your day because it's a non-emergency thing and doctors are always running late.



Sorry, Synn, but I'm going to tear this one up. You have a choice to "eat up a half" your day once a year, or have the worst that can happen... cancer, surgeries, even death. I think I'll go with missing a half day of work.

Why do doctors run late? Well, since we are on women's health, Let me fill you in. Now, this is all hypothetically speaking since I am bound by HIPAA (or is it HIPPA (LOL))...

Bertha Beauregard is at the doctor's office early at 8 am for her prenatal appointment and Gertrude Hornswagler shows up at her 9:00 OB/GYN appointment for her yearly PAP smear. Sally Mae (pregnant) went in to the hospital at midnight with contractions. Well, all was not going well with Sally Mae's labor and at 8 am her doctor calls an emergency cesarean section. This C-Section can take up to an hour before it is complete (dependent upon the grade of the emergency (emergent, non-emergent, or stat)).

So, now the doctor is already behind schedule and this was an unseen emergency. Doc gets back to his office at 9 to see Bertha since her appt was scheduled first... Well, Bertha has a ton of questions (remember we always tell people not to leave the doctor's office unless all of their questions are asked and answered). This puts the doctor behind some more. OH, NO!! L&D called at 10am and Josephine Johannesburg showed up at L&D dilated 9cm and is involuntarily pushing... doc has to run back to the hospital to deliver this baby, then he has to fill out all of the required paperwork. Finally, at 11:30 doc gets back to the office to see Bertha, who is having not only her PAP, but an STD is suspected so this pushes the doctor even further back in his schedule.

You see, it is a domino effect. We schedule patients approx every half hour, according to the DRG... which is how the insurance companies pay. If they don't fall into the DRG (and this includes time spent with the patient), then the insurance company won't pay.

While we thought that HPV can only cause one kind of cancer, cervical, it is now known that it can cause 5 totally different kinds of cancer.

While I am all for ACOG, this announcement astounds me. Is it the government mandating these tests? The insurance companies? OR the insurance companies and the government banding together.

I hope I made sense here... it's been a long busy night.

So, I will sign off now 'cause it's bedtime for me.

It should be noted, that since the righty's think our medical delivery system is the BEST in the world,

Sorry, Exy.. the righty's DON'T think our medical delivery system is the BEST in the world... just spend a night in the hospital and listen to us righties discuss the abuse of the system, how things could be better, what works and what does not work. But we are considered overpaid, overworked idiots. Of course the general uneducated public knows better than we medically educated people.

Come spend a night with me.

Come spend a night with me.Quoted for posterity. :D

Quoted for posterity. :D

Ummm, I meant a night at WORK with me! :rolleyes:

Sorry, Exy..the righty's DON'T think our medical delivery system is the BEST in the world....

Come spend a night with me.Hello again, J:

I agree, that IF you have money or insurance, we deliver the BEST, and you're a BIG part of it being that way...

But, when I speak of it NOT being the best, I'm factoring in those people who DON'T have those things

excon

PS> I'd love to spend the night with you.

Ummm, I meant a night at WORK with me!! :rolleyes:Of course I knew that. My sister's a nurse. I dated a british nurse for two years. Somewhat familiar with the working conditions. Having said that our family is rarely in the hostipal so the two times were there at Labour and Delivery for our kids we felt compelled to buy gifts for all the nurses. My city is a great place to have a kid.

But, when I speak of it NOT being the best, I'm factoring in those people who DON'T have those things


I agree. Here in Tennessee we have TennCare (http://www.state.tn.us/tenncare/), it's a form of medicaid. Do you have any idea how frustrating it is when a woman comes to my unit at 2 am complaining of contractions when all she wants is her drug "fix" (Tylenol #3 or 4-8 milligrams of morphine because that's all I will give her, or nothing at all if she has a history) or to find out if the baby is a boy or girl?

Or, since I do some moonlighting work in the ER, the patient who comes in by ambulance complaining of chest pain when all they have is a cold. This happens quite frequently because they think they will get treated faster if they come in by ambulance.

You see, our healthcare system is "broken" but there is no easy fix. It's not working the way it is, and I don't believe that a nationalized healthcare system is going to be any better.

I don't mean to be condescending, but all of you, at least most of you, are on the outside, you don't see what goes on behind the scenes.

I REALIZE why doctors run late, J.

And I currently spend most of a day at the doctor's office once a month because I DO get my annual tests done.

What I do NOT understand, though, is this: There are a BUNCH of women sitting around at the appointment desk doing nothing but gossiping. Why are they not assigned to call patients later in the day and give them the OPTION of rescheduling because the doctor is running late?

I get the first appointment in the morning now. Every time. It's the ONLY one that is ever on time.

In my 20s, though--even with insurance, I couldn't afford to take a half day off from work to spend it at the doctor's office.

You want to fix the problems with the cost of medicine? Screw going after insurance companies. They cover routine check ups (at least--they do now. Who knows under Obamacare?). What they do NOT cover is the loss of wages because your 1/2 hour appointment turned into 4 hours. It also doesn't cover when you lose your job because you were only supposed to be gone for your lunch hour, or only be 1/2 hour late in the morning.

Yes, I realize that I was taking my chances--but isn't that what the study released said? That the chances of something being wrong was lower in your 20s, especially if you aren't sexually active? Forgive me if I mis-read that.

Yes, it was MY choice. Yes, I was taking my chances. But frankly---I was weighing the possibility of not affording rent and food against the possibility of cancer. Guess which one had a higher chance?

And all it would take is someone picking up the phone and saying "Your doctor is running about 3 hours late today. I know you have a 3 PM appointment--would you like the option of re-scheduling?"

I'm off topic a bit, I think... but that's probably because I go today for my pap smear, annual physical, etc. My appointment is at 1:30, but I'm absolutely SURE that I won't be seen until 3, and won't get out of there until 5. Thank goodness my current job is flexible about WHEN I work my 40 hours.

I REALIZE why doctors run late, J.

You do Synn my love, but not all of our readers do.



What I do NOT understand, though, is this: There are a BUNCH of women sitting around at the appointment desk doing nothing but gossiping. Why are they not assigned to call patients later in the day and give them the OPTION of rescheduling because the doctor is running late?



Therein lies the snowball effect. If we push back one appointment, then we end up pushing back two... then three. Finally the appointments are pushed back a week, then a month, and on and on it goes. It's a viscous cycle.

I have to say this isn't the same as the mammogram issue (but it could have similar effects). The mammogram recommendation was from a federal panel, this is from the American College of Obstetricians and Gynecologists. These groups do this sort of thing all the time and doctors can either choose to follow their recommendations or not.

Where it's similar is that women will hear this and think no need to get a pap or a mammogram so I'll just wait - and insurance companies may cite these recommendations to avoid covering these tests for no more often than the guidelines say. Either way it may have serious consequences for some, but having a federal panel determine guidelines based on odds and cost is troubling. That's the sort of thing happening in the UK under their universal coverage more and more, denying treatments based on cost and the odds (http://www.reuters.com/article/rbssHealthcareNews/idUSLI72915120091119).

denying treatments based on cost and the oddsHello again, Steve:

Do you deny that insurance companies ration treatment based on cost? We've HAD that discussion before.. Of course, they do.

From a personal perspective, although I don't want my health care to be rationed, I'd sooner trust the government, who would ration my care so that MORE people could be treated, much more than I would trust the insurance company, who would ration my health care so the CEO's children can go to private school.

excon

Do you deny that insurance companies ration treatment based on cost?? We've HAD that discussion before.. Of course, they do.

And here I thought you might applaud me for not blaming this one on Obama.

And here I thought you might applaud me for not blaming this one on Obama.Hello again, Steve:

Next time.

excon

Hahaha. (Is there an emoticon for hollow laughter?) I can't believe anybody cares about this when there are so many worse things happening.
When I saw the title of this link, I thought it was about the fact that the blue dog dems sold women down the river and made it that much harder for women to get an abortion if they don't choose to have a baby. 35% of women in the united states (55 million) will have an abortion some time in their life. Eliminating abortion means at least 50 million unwanted children. If someone can't afford to pay for an abortion themselves, they certainly can't afford to raise a child well.

The mammogram issue has been controversial for a decade or more. There have always been questions as to whether having so many mammograms actually do any good overall. The consensus has moved to fewer mammograms. It was not about cost but health. My own sister had breast cancer (and five children, for the record), so it's not exactly an issue I don't care about.

And even if it was about cost, who says spending more no matter what is always better? It's not.

Debra Gordon addresses the mammogram issue well.
Debra Gordon on Medical Writing (and other medical topics of interest) (http://debragordon.blogspot.com/)

I have to say this isn't the same as the mammogram issue (but it could have similar effects). The mammogram recommendation was from a federal panel, this is from the American College of Obstetricians and Gynecologists. These groups do this sort of thing all the time and doctors can either choose to follow their recommendations or not. .

I agree.


Where it's similar is that women will hear this and think no need to get a pap or a mammogram

You don't think women can understand the message "Fewer mammograms" as opposed to "no mammogram"? I think most women and their doctors are smart enough to know the difference. Also, the recommendations are primarily aimed at younger women. Younger women are less likely to get breast cancer and when they do, it's more likely to be an aggressive, fast growing kind. Mammograms are less useful for catching those. And why increase your exposure to radiation if it's not going to do any good?


Either way it may have serious consequences for some, but having a federal panel determine guidelines based on odds and cost is troubling.

I don't think cost was one of the criteria in this case.

Public health decisions are about maximizing the public good--and that means the greatest number of healthy people. If we only need two-thirds as many mammograms to help women avoid breast cancer, why do more? Just as a symbol?

Public health decisions are about maximizing the public good--and that means the greatest number of healthy people. If we only need two-thirds as many mammograms to help women avoid breast cancer, why do more? Just as a symbol?

I'm going to ask you the same question that I asked others before:

Can you show me one case where LESS cancer screening led to a life being saved?

Can you show me how less cancer screening is BETTER?

Breast cancer is the second largest killer in the USA after heart disease. By 2010 or 2011, if the current trends continue, it is slated to surpass heart disease and become the number one killer in the USA. Can you please explain to me how prescribing fewer mamograms is going to help prevent breast cancer deaths, given that statistical reality?

It may save us some money, but will it save even one additional life?

Elliot

You don't think women can understand the message "Fewer mammograms" as opposed to "no mammogram"? I think most women and their doctors are smart enough to know the difference. Also, the recommendations are primarily aimed at younger women. Younger women are less likely to get breast cancer and when they do, it's more likely to be an aggressive, fast growing kind. Mammograms are less useful for catching those. And why increase your exposure to radiation if it's not going to do any good?

Unlike so many on the left I give more credit to the intelligence of the American people - but - that is exactly one of the objections raised by medical professionals on the mammogram recommendation. And it WILL happen.


I don't think cost was one of the criteria in this case.

Didn't say it was, I was specific on the reasons on guidelines by federal health advisory panels.


Public health decisions are about maximizing the public good--and that means the greatest number of healthy people. If we only need two-thirds as many mammograms to help women avoid breast cancer, why do more? Just as a symbol?

If my wife was the one saved by an "unnecessary" mammogram I wouldn't give a damn about "maximizing the public good." Health care is not about "maximizing the public good," it's about giving EVERY patient the best care. If it's not patient driven it's not reform.

If my wife was the one saved by an "unnecessary" mammogram I wouldn't give a damn about "maximizing the public good." Health care is not about "maximizing the public good," it's about giving EVERY patient the best care. If it's not patient driven it's not reform.

If it's not about maximizing the public good... AND it's about getting EVERY patient the best care...

How does that work, exactly? Will I get BETTER care for the same amount of money I pay now when all those people who choose to spend their money on something other than health care now get it for free from the government? I'll get the BEST care? Is that the same BEST care that the rich can afford? Or is it the "best care possible under the circumstances of overworked medical staff, at clinics and hospitals without enough supplies or room, with a greater waiting time for treatment, and the same abuses of the system continuing that happen currently", as I suspect it is?

PS...if your wife's life was saved by an "unnecessary" mammogram, wouldn't you be HAPPY to pay for it out of pocket?

I
Public health decisions are about maximizing the public good--and that means the greatest number of healthy people.

And that is why health decisions should not be "public". They should be between the doctor and the patient, without "public" (read: government) input. Because "public health decisions" don't take the needs of the individual patient into account... only the good of the whole community, which may not be what the PATIENT needs.

This is a question of whether you believe (as the Founding Fathers did) that individual rights supercede the good of the collective community as a whole or not. I, personally, do believe that the rights of the individual to make his own medical decisions are paramount over the "good of the community". That's why the Founding Fathers created the Bill of Rights (especially the 10th Amendment) and wrote the Declaration of Independence as they did. These documents make the rights of the individual paramount over the good of the community as defined by the government.

Elliot

I'm going to ask you the same question that I asked others before:

Can you show me one case where LESS cancer screening led to a life being saved?


Epidemiology doesn't work that way. You can look at the numbers and see that screening fails to decrease the death rate. But you can't pick out individual people and say, THIS person died because of x ray exposure.

I have a friend who is dying of lung cancer. She never smoked. My grandmother smoked like a chimney and never had lung cancer. Does this mean that lung cancer isn't caused by smoking? No. But it's really hard to show the exact cause of most cancers. Breast cancer is no different. You look at broad patterns.

You CAN say, this person was stressed for a 6 months and had an unnecessary biopsy because of a false positive mammogram.

They should be between the doctor and the patient, without "public" (read: government) input. And that's what happens in Canada.

And that is why health decisions should not be "public". They should be between the doctor and the patient, without "public" (read: government) input. Because "public health decisions" don't take the needs of the individual patient into account... only the good of the whole community, which may not be what the PATIENT needs

I'm baffled by this. You don't believe in public health? You think it should be every man for himself?

If you had your way, we'd still have polio, open sewers. And typhoid.

I'd like to point out here that the ONLY reason that the polio vaccine was able to save so many is that Salk refused to patent it.

Can you see that happening today? Can you HONESTLY see the company that finds the cure for cancer NOT profiting, and profiting GREATLY on it?

Take away patents on medicines that are for "public good" and you've got a heck of a way to reduce medical costs.

If it's not about maximizing the public good... AND it's about getting EVERY patient the best care...

How does that work, exactly?

"Maximizing the public good" is just a platitude. If we don't begin with reform being patient driven (http://www.heritage.org/research/HealthCare/bg2128.cfm) we can't maximize the public good. Every "solution" offered by the Democrats is cost-driven. Federally managed health care will be no other way. It may expand coverage but at the expense of something, quality of care, innovation, availability, etc. Which is Canada is experiencing a huge growth in private clinics in spite of the government's wishes (look it up, NK, I've posted several articles).


PS... if your wife's life was saved by an "unnecessary" mammogram, wouldn't you be HAPPY to pay for it out of pocket?

Under Obamacare will I be able to?

I'd like to point out here that the ONLY reason that the polio vaccine was able to save so many is that Salk refused to patent it.

Can you see that happening today? Can you HONESTLY see the company that finds the cure for cancer NOT profiting, and profiting GREATLY on it?

Take away patents on medicines that are for "public good" and you've got a heck of a way to reduce medical costs.


What did it cost Salk to do it? Nothing ;he was working on grant money from the 'Infantile Paralysis Foundation '.

Synnen,
Are you arguing with me? Not sure who your comments are directed to.

The first fungicide (and these are important medicines) was marketed only BECAUSE it was patented and rights to make it given to a single company. Nobody wants to invest in production, distribution, and marketing without some promise of exclusivity for at least a while.
I think we are agreeing...

(And I'm not exactly the number one fan of big pharma.)

What did it cost Salk to do it? Nothing ;he was working on grant money from the 'Infantile Paralysis Foundation '.

The cost of the research IS a public health decision in most cases. Who decides how much money to allocate to breast cancer or prostate cancer research? Policy people. Public health officials. They are the ones who think, this disease kills 2,000 people per year while this other one kills 200,000.

We have $20 million. If we invest in research or preventive measures for either disease, we can SAVE 10% of those people.

You HAVE to choose one of the diseases. If you split the money, you won't save anybody. So what's the right answer?

You can say, ask the patients because they feel most strongly, but you are going to get a different answer depending on who you ask.

So, the answer is obviously saving 10% of 200,000 people is a better than saving 10% of 2000. It's not "cold hearted" to save 20,000 people instead of 200.

The reality is that (in part thanks to our pointless wars overseas) there IS a limited amount of money for health care and health research. We only have so much to spend. Public health experts make the best decisions they can. Do I always agree with their decisions? No. But the idea that they shouldn't exist is absurd. Nobody thinks that!

If those evil pharmceutical companies pay for the funding they should indeed get exclusive patent rights and reap the rewards of their effort. As you point out ; Developing a drug is an expensive proposition. Take that right away and they will shut down their R & D. .

What did it cost Salk to do it? Nothing ;he was working on grant money from the 'Infantile Paralysis Foundation '.

How many organizations work under grant money? How much of that grant money is paid for by tax dollars?

Government Grant money gets distributed primarily through the NIH .But Salk was working with private grant money from what is now called the MARCH OF DIMES(formerly National Foundation for Infantile Paralysis ). He had no ownership claim for the vaccine ;the foundation that paid for it did... and despite the fame he got from his oft quoted interview with Edward R Murrow about patenting the sun;the truth is that the National Foundation for Infantile Paralysis lawyers explored the possibility and found that they could not do it under the standard laws of the day. Salk in his defense probably believed what he said. But in reality ,if the vaccine could've been patented ,it would've happened. (source.. Jane
Smith ' Patenting the Sun:Polio and the Salk Vaccine')

Developing a drug is an expensive proposition. Take that right away and they will shut down their R & D . .

Exactly my point.

... in reality ,if the vaccine could've been patented ,it would've happened. (source ..Jane
Smith ' Patenting the Sun:Polio and the Salk Vaccine')

Interesting. I have this book on my shelf and have never got around to reading it. Maybe I'll check it out this winter.

The government funds a HUGE amount of research. A single institute at the national institutes of health can have an annual budget of a billion dollars and there are 20? Institutes. I forget. And that's just NIH, which only does biomedical research. NSF has a much smaller budget. But then there's the Department of Energy, DARPA, NOAA, and several others.

I would say that public funding is an important source for the research and development of orphan drugs. But ,given a standard medical problem ,the private sector can identify and test new pharmaceutical products cheaper and more efficiently than through the public sector . Government efforts are far less accountable for failure, waste, ethics and safety than private initiatives.

I would say that public funding is an important source for the reasearch and development of orphan drugs. But ,given a standard medical problem ,the private sector can identify and test new pharmaceutical products cheaper and more efficiently than through the public sector . Government efforts are far less accountable for failure, waste, ethics and safety than private initiatives.

Which is EXACTLY why nationalized medicine will not work.

Tom, You are really wrong about this. I don't want to be rude, but this is actually something I know a lot about, thanks to a close friend whose non profit funds biomedical research. The private sector primarily puts into production ideas that are developed in labs funded by the government. Sure, you can name a few exceptions, but government funded basic research is the overwhelming pattern. You can mention a few private foundations, and there are more of them now then there were in the days of the polio vaccine. But their research portfolios pale in comparison to the research generated by federal funds.

Basic research is just too risky for most businesses. The irony is that by avoiding risk and following excessively conservative business practices, big pharma has hurt itself. For what they spend, they have shockingly little to show. Fortunately, they've been able to overcome their lack of novel product with just phenomenal marketing skill. One reason they need novel products of course is that the patent only lasts 17 years and it takes a big chunk of that just to get a drug through clinical trials.

I think drug companies' behavior should be reincentivized, but in exchange, they should get much longer patents than they now do. 17 years just isn't enough. On the other hand, my heart isn't bleeding for them, either.

Which is EXACTLY why nationalized medicine will not work.

What?

Government-funded biomedical research has been working spectacularly for 50 years. Every country in the world admires our ability to do scientific research and, indeed, other countries began emulating us, and this successful model is now commonplace throughout the world--BECAUSE IT WORKS!

Is it perfect? Of course not! Can you find things you disagree with? Of course.
But the overall model for funding science has been stunningly effective.

We wouldn't have the internet, annual flu vaccine, effective treatments for heart attack and stroke, or prostate, PAP, and mammogram screenings without it. The list is just endless.

https://www.askmehelpdesk.com/current-events/obamas-healthcare-plan-412092-20.html#post2089399

Mamograms are one thing:

The fact is, screening in women yearly under 40 DOES SAVE LIVES - 15% reduction in mortality - 6800 lives ACOG's own statement.
They have to compare similar endpoints - in this case death. You cannot honestly compare that to anxiety over a false positive mamogram or an un-neede biopsy.

That same organization ACOG is for the new pap smear recommendations

First Cervical Cancer Screening Delayed Until Age 21 Less Frequent Pap Tests Recommended (http://www.acog.org/from_home/publications/press_releases/nr11-20-09.cfm)


"A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs, and avoids unnecessary interventions that could be harmful."


I have yet to see the data, the evidence, that getting mamograms every other year in women 40-49 reduces death "just as well" as yearly mamograms.

Also ACOG [ pap ] and the USPTF [ mamogram ] are independent organizations, so to attribute these changes to Obama is not reasonable.


G&P

Which is EXACTLY why nationalized medicine will not work.
Apparently only in your country.

BTW you do realize that Obama has basically rejected the report of the OP, right?

Apparently only in your country.

BTW you do realize that Obama has basically rejected the report of the OP, right?

Of course: he would like to be more like 'me' in his public persona, but the cat is out of the bag.

I have yet to see the data, the evidence, that getting mamograms every other year in women 40-49 reduces death "just as well" as yearly mamograms.

Here's the source.

http://www.ahrq.gov/clinic/uspstf09/breastcancer/brcanup.htm

I have not read it.

Have fun!

https://www.askmehelpdesk.com/current-events/obamas-healthcare-plan-412092-20.html#post2089399

Also ACOG [ pap ] and the USPTF [ mamogram ] are independent organizations, so to attribute these changes to Obama is not reasonable.


G&P

You make many good points; but on this last, you are clearly wrong. You must understand, Obama is a puppet - a very small man in a very large office.

He is president at a time when powerful historical/philosophical forces are moving through this nation. Of course, Obama is not acting alone; the progressives have large majorities in both houses of Congress. Progressive beliefs are rampant, similar to what Nazism was in early 1930's Germany - some folk see how the political winds are blowing and jump on board (i.e. AARP); there are many believers, and numerous others just climb on board.

Check this: "Dems' slick fix: $210 billion of fiscal restraint" - "Something unusual and largely unnoticed happened last week as Democrats pushed the national health care bill through the House. In a complicated, late-night maneuver, on a party-line vote, the House Rules Committee used the health bill to pave the way for a $210 billion increase in Medicare payments to doctors, without any money budgeted to pay for it. Congress then combined that $210 billion with a measure that would force lawmakers to exercise fiscal discipline -- except when it came to the $210 billion...More importantly, they threw a very big bone to several physicians organizations, which badly want the increased doctor payments and to whom Democrats are deeply indebted for support of health care legislation." Dems' slick fix: $210 billion of fiscal restraint | San Francisco Examiner (http://www.sfexaminer.com/politics/Dems_-slick-fix_-_210-billion-of-fiscal-restraint-8523304-69917072.html)

You should know that progressives like me feel totally betrayed by this health care "reform" bill. It's so bad now, I'd can it and start over. But the politicians on both sides of the aisle are doing what they do best, trade favors. This bill is NOT what progressives wanted.

Similarly, "What does it take to get a wavering senator to vote for health care reform?

"Here's a case study.

"On page 432 of the Reid bill, there is a section increasing federal Medicaid subsidies for “certain states recovering from a major disaster.”

"The section spends two pages defining which “states” would qualify, saying, among other things, that it would be states that “during the preceding 7 fiscal years” have been declared a “major disaster area.”

"I am told the section applies to exactly one state: Louisiana, the home of moderate Democrat Mary Landrieu, who has been playing hard to get on the health care bill."
The $100 Million Health Care Vote? - The Note (http://blogs.abcnews.com/thenote/2009/11/the-100-million-health-care-vote.html)

Corruption is the name of the game: GOP, Democrat, Nazi, Commie, doesn't matter when this stuff is going on.

George, I agree, although I'm not sure where pork barreling ends and corruption begins. They all do it because they have to please their constituents to get reelected.

I don't know of any easy solutions to that, although there may be some election reform that would help. It's discouraging.

Last I checked American Pharmceutical companies spent almost $60 billion in private research in 2008 . This is what the CBO said about it.
“The pharmaceutical industry is one of the most research-intensive industries in the United States. Pharmaceutical firms invest as much as five times more in research and development, relative to their sales, than the average U.S. manufacturing firm.”..... "Many examples exist of major therapeutic gains achieved by the industry in recent years.... [A]necdotal and statistical evidence suggests that the rapid increases that have been observed in drug-related R&D spending have been accompanied by major therapeutic gains in available drug treatments.”

This at a time where R&D in other industries is being cut.
I agree that extending patent exclusivity' time frame would unleash even more innovation .
However losing the exclusivity is also a motivating factor for those big evil pharmaceutical companies to press on in the R&D .

But most of their "innovation" is altering drugs slightly and repatenting the same drug with an added methyl group or similar. I have also read that their R&D costs are puffed up with expenses that are really marketing. But I confess I don't have time to track this down and prove it to you right now. Pretty sure it's true though.

I've also covered some private meetings run by pharmaceutical executives and they do things like get a drug approved as an orphan drug (which has fewer restrictions and a quicker FDA approval process), then persuade doctors to prescribe if off label for a much more common disease. In neither case (orphan or common disease) is the drug significantly better than generics that are already available, but it costs a LOT more. It may be 10% better for half of patients, or something like that.

The other thing is that pharma is primarily interested in treating chronic diseases, not in curing people. That's not in the public interest OR in the interests of individual patients. It's just a more effective way for a business to make money. That is their job, of course. But what's good for Pfeizer and Merck isn't necessarily what's good for America.

George, I agree, although I'm not sure where pork barreling ends and corruption begins. They all do it because they have to please their constituents to get reelected.


They are not doing the health care takeover and destruction bill because 'constituents' want it; let us be clear about that.

They are not doing the health care takeover and destruction bill because 'constituents' want it; let us be clear about that.
I believe that was a large part of Obama's election platform, it's part of what the people voted for.

I submit that the Pharmaceutical industry would've been confined to the dustbin long ago if all they did was tinker with existing products. Your bias against the industry is showing I think .I did some checking and the FDA approved about 80 new drugs just this year. All of them are retreads ? I don't think so.

You make many good points; but on this last, you are clearly wrong. You must understand, Obama is a puppet - a very small man in a very large office.

He is president at a time when powerful historical/philosophical forces are moving through this nation. Of course, Obama is not acting alone; the progressives have large majorities in both houses of Congress. Progressive beliefs are rampant, similar to what Nazism was in early 1930's Germany - some folk see how the political winds are blowing and jump on board (i.e. AARP); there are many believers, and numerous others just climb on board.

Check this: "Dems' slick fix: $210 billion of fiscal restraint" - "Something unusual and largely unnoticed happened last week as Democrats pushed the national health care bill through the House. In a complicated, late-night maneuver, on a party-line vote, the House Rules Committee used the health bill to pave the way for a $210 billion increase in Medicare payments to doctors, without any money budgeted to pay for it. Congress then combined that $210 billion with a measure that would force lawmakers to exercise fiscal discipline -- except when it came to the $210 billion...More importantly, they threw a very big bone to several physicians organizations, which badly want the increased doctor payments and to whom Democrats are deeply indebted for support of health care legislation." Dems' slick fix: $210 billion of fiscal restraint | San Francisco Examiner (http://www.sfexaminer.com/politics/Dems_-slick-fix_-_210-billion-of-fiscal-restraint-8523304-69917072.html)



From your link





The bill reverses scheduled cuts in Medicare payments to physicians. For years Congress has vowed to make gradual cuts, and for years it has put them off. All those unmade cuts would add up to a 21 percent reduction next year, unless Congress put them off again





Cuts in payments to doctors for care of patients under the government system, medicare,
Have been delayed. This is NOT a pay increase, but rather prevention of a pay decrease.
Remember doctors are business owners or employees of business owners. A 21% cut in revenue to a business with generally over 50% overhead, means a 44% cut in pay. When current medicare payments are barely covering the cost of doing business, a 44% cut will force plenty of doctors to limit, or not see any medicare patients. Go ask any doctor how many medicare patients will they see if reimbursement is cut 21%?


G&P

Here's the source.

Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force (http://www.ahrq.gov/clinic/uspstf09/breastcancer/brcanup.htm)

I have not read it.

Have fun!

From table 1 of your link:

The risk reduction of breast cancer death for women 39-49 is the SAME, roughly 15%, as it is for women 50-59 years old.

The NNT, the number needed to treat, that is how many mamograms does it take to prevent a breast cancer death, may be 1 in 1907 in the 39-49 age group and 1 in 1339 in the 50-59 age group, but at what arbitrary number do you decide that a technique to prevent breast cancer death is not needed?

2 counterpoints:

1] The recommendations were based on a collation of multiple trials, Britain and Sweeden were mentioned. How can you compare British and Sweedish women to American women? I am not being facetious here. You have to compare melons to melons - sorry I could not resist. This is what I mean, in the US, breast cancer mortality differs on such factors as race. To extrapolate data from non-American women and apply it to American women is intellectuallly wrong.

CDC - Breast Cancer Rates by Race and Ethnicity (http://www.cdc.gov/cancer/breast/statistics/race.htm)

2] Where is the evidence from American trials that every other year mamogram in women 39-49 is just as effective in reducing breast cancer death as yearly mamograms?


Remember in the mid 1980s when airbags were supposedly better than just seatbelts? It was mandated, then after a year or so it was found that airbags can kill or harm small people [ women and children ]. You have to look at the data, is it good? How is it used? And are the conclusions drawn from the data correct? In this case airbag data was from 160 pond males. Tragically that data did not apply to smaller people.


G&P

What americans believe they want is free health care ( no one pays for it) and to a better standard than they have now.

What they are finding out they may get is something worst than medicare that they are going to have to pay for if they have income. Or perhaps lower pay since their work place will have to pay for it.

Remember America has felt that Medicare was good enough for that group of Americans, why would we expect better

What americans beleive they want is free health care ( no one pays for it) Everyone who has universal health care is aware that it comes as part of our taxes. To tell people that it's "free" health care is intellectually dishonest.

Airbags save more people than they kill.
Mammograms also have a risk, namely radiation.

In fact, treatment for breast cancer has a risk. My sister was treated for breast cancer with radiation 20 years ago. She received 5000 rads, enough to trigger another case of cancer in 20 years. It looks like that may in fact have happened. But she got another 20 years. I hope she gets another 20, but the fact remains that radiation exposure has a CUMULATIVE effect on cancer risk. So it's totally reasonable to weight that risk against the benefits of all kinds of screenings, not just mammograms. I just turned down an MRI for that reason.

Lets' be sensible.

Everyone who has universal health care is aware that it comes as part of our taxes. To tell people that it's "free" health care is intellectually dishonest.

Are you saying that about the Obama administration?

In the US, a 20 or 30 or 40 something is paying medicare tax - 1.45% and their employer is kicking in another 2.9%, for healthcare of the medicare recipient. So they are being taxed for someone else's healthcare.

FICA & SECA Tax Rates (http://www.ssa.gov/OACT/ProgData/taxRates.html)

In the US unfortunantly only the unisured get stuck with the full 100% of the bill. The 85% or more that have some insurance coverage pay a co-pay or something toward a deductible, but hardly 100% of the actual bill. Most who have employer provided insurance get the additional pre-tax benefit.

So healthcare is NOT free, but the means of payment are clearly not 100% out of pocket for the vast majority.


G&P

Airbags save more people than they kill.
Mammograms also have a risk, namely radiation.

In fact, treatment for breast cancer has a risk. My sister was treated for breast cancer with radiation 20 years ago. She received 5000 rads, enough to trigger another case of cancer in 20 years. It looks like that may in fact have happened. But she got another 20 years. I hope she gets another 20, but the fact remains that radiation exposure has a CUMULATIVE effect on cancer risk. So it's totally reasonable to weight that risk against the benefits of all kinds of screenings, not just mammograms. I just turned down an MRI for that reason.

Lets' be sensible.

Sure airbags save lives, but they were not predicted to kill them either when the became mandated. Was it sensible to make these mandates without testing beforehand the effects on smaller people?

In retrospect would she still have got treatment that you acknowledge as giving her 20 years?

I'm questioning the data, how they came to their conclusions and recommendations, that is the sensible thing to do.


G&P