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

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

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.

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Originally Posted by Synnen

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

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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

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Originally Posted by Synnen

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.

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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

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Originally Posted by Synnen

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

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

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Originally Posted by Synnen

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

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

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Originally Posted by Synnen

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.

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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.

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Originally Posted by excon

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

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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.

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Originally Posted by J_9

Come spend a night with me.

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Quoted for posterity. :D

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Originally Posted by NeedKarma

Quoted for posterity. :D

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

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Originally Posted by J_9

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

Come spend a night with me.

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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.

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Originally Posted by J_9

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

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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.

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Originally Posted by excon

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

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I agree. Here in Tennessee we have 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.

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Originally Posted by Synnen

I REALIZE why doctors run late, J.

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

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Originally Posted by Synnen

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?

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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.

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Originally Posted by speechlesstx

denying treatments based on cost and the odds

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Hello 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

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Originally Posted by excon

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

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

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Originally Posted by speechlesstx

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

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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)

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Originally Posted by speechlesstx

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. .

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I agree.

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

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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?

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

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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?

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Originally Posted by asking

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?

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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

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Originally Posted by asking

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?

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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.

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

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

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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?

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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.

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Originally Posted by speechlesstx

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.

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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?

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Originally Posted by asking

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

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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

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Originally Posted by ETWolverine

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?

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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.

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Originally Posted by ETWolverine

They should be between the doctor and the patient, without "public" (read: government) input.

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And that's what happens in Canada.

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Originally Posted by ETWolverine

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

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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.

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Originally Posted by Synnen

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

How does that work, exactly?

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"Maximizing the public good" is just a platitude. If we don't begin with reform being patient driven 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).

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

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Under Obamacare will I be able to?

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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.

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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.)

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Originally Posted by tomder55

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

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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. .

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Originally Posted by tomder55

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

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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')

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Originally Posted by tomder55

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

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Exactly my point.

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Originally Posted by tomder55

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

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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.

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Originally Posted by tomder55

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.

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Which is EXACTLY why nationalized medicine will not work.