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Thread: Breast Exams revisited.

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    Default Breast Exams revisited.



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  3. #2

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    Default Re: Obama on Health Care

    No specialist on the panel..hmm, sad, but not even the least bit unexpected. I heard the same thing is going to happen with prostate exams. Well that's one way to save money.

    "More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies—because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

    It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.
    “Most men and women will grow up to love their servitude and will never dream of revolution.” - Huxley’s Brave New World

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    Default Re: Obama on Health Care

    But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group 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.

    Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.
    Tell it to the woman it saves. Now we are getting on the slippery slope. Granted this study was done a 1.5 years ago according to another article I read or seen and it is normal for this panel to review and make new recommendations. The timing is bad for health care reformers and may give the public a looking glass into what they may be in for under Obamacare. It is leaving a bad taste for many women and the media is really playing it up. I watch the Nightly News with Ann Curry interview HHS Sec. Sebelius and Ann was not kind to her.
    Socrates: "Democracy, which is a charming form of government, full of variety and disorder, and dispensing a sort of equality to equals and unequaled alike."

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    Default Re: Obama on Health Care

    Quote Originally Posted by CountryBoy View Post
    ...
    It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.
    I think I would call a foul on this claim- in fact, if you read the report, they don't even use cost as a criteria in the evaluation. Instead, they use a scientific approach as to what works, evaluting various studies on how much is gained by a test, vs. changing the existing protocol.

    See the summary of their findings here:
    http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm#summary


    You can read the whole document here:
    http://www.ahrq.gov/clinic/uspstf09/...er/brcanrs.htm

    It's better to evaluate with your own brain what the work of the independent panel, which has nothing to do with the political administration one way or another, and see what they used for the scientific evidence, rather than simply depend on some opion piece in the Wall Street Journal, written by a guy who - in the opinion piece, wrote this:


    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.
    A political slam by an opinion writer at the WSJ, rather than fact based scientific study reviewed by medical professionals.

    Yes, I believe medical science and review of the current state of the art medicine SHOULD be part of the decisions going into what basic coverages should be in health care plans. It was this panel who recommended mamography in the first place. Without this panel's recmooendations in the past, based on the state of the art medical studies at the time, we never would have had mamorgraphy as a covered treatement in the first place. Insurance companies would have called it "experimental treatment", and refused to cover paying for it.

    This panel, who released this report, made RECOMMENDATIONS- They are NOT the government, they only review medical science, and make recommendations. it's not a politicial body.



    Here is who studied and made the recommendations:
    Members of the U.S. Preventive Services Task Force

    Members of the U.S. Preventive Services Task Force* are Ned Calonge, MD, MPH, Chair (Colorado Department of Public Health and Environment, Denver, Colorado); Diana B. Petitti, MD, MPH, Vice-Chair (Arizona State University, Phoenix, Arizona); Thomas G. DeWitt, MD (Children's Hospital Medical Center, Cincinnati, Ohio); Allen J. Dietrich, MD (Dartmouth Medical School, Hanover, New Hampshire); Kimberly D. Gregory, MD, MPH (Cedars-Sinai Medical Center, Los Angeles, California); David Grossman, MD (Group Health Cooperative, Seattle, Washington); George Isham, MD, MS (HealthPartners, Minneapolis, Minnesota); Michael L. LeFevre, MD, MSPH (University of Missouri School of Medicine, Columbia, Missouri); Rosanne M. Leipzig, MD, PhD (Mount Sinai School of Medicine, New York, New York); Lucy N. Marion, PhD, RN (School of Nursing, Medical College of Georgia, Augusta, Georgia); Bernadette Melnyk, PhD, RN (Arizona State University College of Nursing & Health Innovation, Phoenix, Arizona); Virginia A. Moyer, MD, MPH (Baylor College of Medicine, Houston, Texas); Judith K. Ockene, PhD (University of Massachusetts Medical School, Worcester, Massachusetts); George F. Sawaya, MD (University of California, San Francisco, San Francisco, California); J. Sanford Schwartz, MD (University of Pennsylvania Medical School and the Wharton School, Philadelphia, Pennsylvania); and Timothy Wilt, MD, MPH (University of Minnesota Department of Medicine and Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota). *Members of the Task Force at the time this recommendation was finalized. For a list of current Task Force members, go to http://www.ahrq.gov/clinic/uspstfab.htm.


    Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.


    How about we look at medical facts, and scientific evidence, rather than one more slam against the President?
    Last edited by James48843; 11-19-2009 at 08:25 AM.

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    Default Re: Obama on Health Care

    This article doesn't mention that included in the report was advice to discourage self-exams...they stated self-exams were ineffective, and they were to be discouraged. It is hard for me to understand `they' can make such statements, obviously believing them, without a review of various cancer patients, asking those women and men, how they came to the situation of asking for a mammogram... which, obviously, is why the government doesn't want any self-exams done, cuz then mammograms won't be demanded. Don't you know some insurance companies are going to pick up on this!! I am curious as to whether the women in these peoples' lives are as duped as the men who put this obnoxious report together.

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    Default Re: Obama on Health Care

    Quote Originally Posted by grandma View Post
    This article doesn't mention that included in the report was advice to discourage self-exams...they stated self-exams were ineffective, and they were to be discouraged. It is hard for me to understand `they' can make such statements, obviously believing them, without a review of various cancer patients, asking those women and men, how they came to the situation of asking for a mammogram... which, obviously, is why the government doesn't want any self-exams done, cuz then mammograms won't be demanded. Don't you know some insurance companies are going to pick up on this!! I am curious as to whether the women in these peoples' lives are as duped as the men who put this obnoxious report together.
    They said that self-exam had a very low detection rate compared to clinic exam (in a doctor's office), and that the only two studies that had been done on self-exam showed statistically that it was inferior to the other options, and caused more harm than good.

    Again, they just evaluate the studies that have been done and compare them with the scientific results and outcomes.

    I guess we need to do a lot more studies on breast self-exams. I will go home tonight and study with my wife. It may take repeated homework on that one.....

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    Default Re: Obama on Health Care

    I have to agree with James. The panel looked at statistics only not at the money. Some outside the panel may use this to save money but these guys are looking at just the medical side.

    They are trying to determine if the amount of false positives and unnecessary procedures out weight the number of people saved.

    As Grandma mentions I can not fathom why they would recommend against self examinations. To me that is a first line of defense.

    I also understand about the physiological effect. They are saying around 10% false positives cause unnecessary medical procedures and stress. Compared to the 1 in 1900 that actually have cancer.

    10% of 1900 is 190 women that are told they may have cancer and end up not. That may be causing more harm that good. Those 190 women are going through hell thinking they have cancer. The physiological effects can make you sick thinking you are sick. Been there done that.

    To me it goes back to taking charge of your health. If your family has a history, grab your physician and have a serious talk. Risk factors are the key.
    Socrates: "Democracy, which is a charming form of government, full of variety and disorder, and dispensing a sort of equality to equals and unequaled alike."

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    Default Re: Obama on Health Care

    You know- this probably should have it's own thread- as I bet we'll hear lots of voices about this study, and this thread was meant more for the Congressional health care debate, than the merits of just one panel's study.

    Would someone like to start a breast cancer panel recommendation thread?

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    Default Re: Obama on Health Care

    I got time I will move it.
    Socrates: "Democracy, which is a charming form of government, full of variety and disorder, and dispensing a sort of equality to equals and unequaled alike."


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    Default Re: Breast Exams revisited.

    I know a lot of people, to include Dr.s, who believe that mammograms only make the problem worse by pushing the cancerous tumor cells into the blood stream. They believe that thermal mammographies are the way to go. However, they are more expensive and most insurance companies don't cover them. Think the govt. run health care system will?

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  21. #11

    Default Re: Obama on Health Care

    Quote Originally Posted by grandma View Post
    included in the report was advice to discourage self-exams...they stated self-exams were ineffective

    hard for me to understand `they' can make such statements

    obviously believing patients will ask for a mammogram...

    insurance companies are going to pick up on this!!
    Was totally 'shocked' by this Thread !!

    Grandma, these are my sentiments exactly.

    Would like to include that 'we' have screenings now that go way beyond the Mammogram --- -for breat cancer -- Lab on a Chip and that will likely be the most dominate wave of the future because the screening is so accurate and can catch things way before a mammogram.

    So 'Medically' -- 'Technology' we are making incredible advancements.

    Heath Care System -- however -- is a different story

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    Default Re: Breast Exams revisited.

    Under a government public option, how many different panels would have to approve/disapprove measures for this type of preventative/diagnostic care?

    I'm not up on this specific debate, but would like to know more!

    My wife is a few years older than me and she is still on the ceiling about this one!
    THIS IS WHERE I WOULD PUT SOMETHING TO REPRESENT MY THINKING, BUT THEN THEY SHOW UP!
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