The latest alarmist claptrap that's emerged in the debate over health care reform involves a study that's been done by the US Preventive Services Task Force (USPSTF) on breast cancer screenings. That study led that agency to formulate a new set of recommendations on when and how often women should receive mammography exams that were subsequently published in the November 17th edition of the Annals Of Internal Medicine, and which are now being debated by the medical community. The recommendations included suggestions that women not receive routine screenings before the age of 50, and adjusting the "screening interval from 1 year to 2 years.
This has led health care reform opponents to screech about how this is an indication that Nancy Pelosi will ration breast cancer treatment, resulting in women getting riddled with tumors. They seem to be confusing this agency's study and subsequent recommendations with a policy decision that impacts the health care reform bills being debated in Congress. In reality, this has nothing to do with policy, or health care reform, or pending legislation, or previews of coming health care apocalypses. There are just some recommendations that have been made and stuck in a scholarly journal.
How will these recommendations impact your life? Dr. Victor G. Vogel, the national vice president for research at the American Cancer Society, says, "Clinicians should recognize that very few agencies, including the ACS, are altering their screening guidelines based on the USPSTF modeling results, which simply reanalyze previously published data." The ACS recommends, and will continue to recommend "annual mammograms... starting at age 40 years and continuing for as long as a woman is in good health." USPSTF Vice Chair Dr. Diana B. Petiti has said that, "This recommendation is not a recommendation against ever screening women age 40 to 49; it is a recommendation against routine screening of women starting at this age."
And between those two points of view, there is a healthy debate on the merits, based on scientific data. But there's also a lot of confusion, because people like Representative Dave Camp (R-Mich.) go around braying nonsense like this:
"Some people discounted the idea that the government would actually put people to death...And this actually is really showing how the insidious encroachment of government between the patient and their doctor plays out. And it's not a pretty sight."
But the USPSTF has been doing research and making recommendations since 1984! And they've been doing so entirely independent of whatever health care debates have been going on in Congress. There's nothing about their mammography study that involves an "insidious encroachment of government" and they can't force a doctor to do anything to a patient or oblige the government to start "put[ting] people to death." Anyway, Kathleen Sebellius is, I guess, pushing back with what I guess, to Dave Camp, is the equivalent of "reverse insidious encroachment":
"There is no question that the [USPSTF] recommendations have caused a great deal of confusion and worry among women and their families across this country," said US Department of Health and Human Services Secretary Kathleen Sebelius in a statement issued yesterday. "I want to address that confusion head on. The [USPTF] is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government."
Despite new evidence presented by the USPSTF, Dr. Sebelius noted that "our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."
As you might suspect, the media is doing a terrible job at providing clarity. Even as I write this, MSNBC is teasing a segment on this story this afternoon by asking, "Did the government back down on guidelines suggesting mammograms for women at age 50 instead of age 40 because of critics comparing it to rationing and even death panels?" Uhm... no! Because there's nothing to back down from!
This article, from NPR, is pretty typical of the coverage this study has garnered. You get plenty of news on the "political brouhaha" that's flared up, with one side spewing shrill doomspeak and the other side trying to point out that no one's going to be denied breast cancer screenings. What's missing are any of the actual facts: what the study recommends, how cancer care agencies are treating the recommendations, what practical effect the agency has over patient care, and, last but not least, the most vital point, pursuant to the health care reform debate, of all: THAT IT HAS NO BEARING ON THE HEALTH CARE REFORM BILL.
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