Quick Fact: Media repeat conservative claim that nonbinding health guidelines foreshadow rationing
In recent days, several media outlets have repeated the conservative claim that a task force recommending that fewer women younger than 50 receive regular mammograms is a precursor to government rationing under health care reform. In fact, the recommendations are not legally binding on health care providers or insurers.
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Fox News, ABC, CNN repeat claim
Fox News' America's Newsroom: "Doctors say the new rules are an example of the kind of rationing we can expect from government-run health care." On the November 19 edition of Fox News' America's Newsroom, Alisyn Camerota stated:
CAMEROTA: There are controversial changes, as you all know, to mammogram guidelines out this week, leaving many women confused and even more doctors very upset: a government task force now recommending against annual screening for women in their 40s and mammograms only every other year for women in their 50s. Many doctors say the new rules are an example of the kind of rationing that we can expect from government-run health care.
ABC News' McKenzie equated recommendations to "countries with nationalized health care" then quoted doctor saying: "It's about the beginning of rationing care." On the November 18 edition of ABC's World News, correspondent John McKenzie reported:
McKENZIE: The new screening guidelines, created by an independent federal advisory panel of 16 health care professionals, concluded that, for most women, routine mammograms are not necessary in their 40s, and only every two years after that -- recommendations similar to those in Canada and most European countries with nationalized health care. That's why some doctors now question the panel's motives.
DR. PETER JOKICH (radiologist at Rush University Medical Center): I think it's totally ridiculous. I may not be politically correct, but I think this is really about money and politics. It's about the beginning of rationing care. And I don't think it's really about the health of individual women.
CNN's The Situation Room: Recommendations are a "sensitive political subject" for Dems seeking health care reform; "Republicans saying ... 'There's going to be rationing.' " On the November 18 edition of CNN's The Situation Room, host Wolf Blitzer stated:
BLITZER: Some Republican women in Congress are pouncing on the recommendations and raising red flags about health care rationing.
[...]
BLITZER: This, Gloria [Borger], is about a sensitive political subject right now for the president and for the Democrats in Congress who want to push through health care reform. And Republicans saying, "You know what? There's going to be rationing."
Fact: Task force recommendations not legally binding
Task force did not recommend blanket ban on mammograms for women under 50. The task force issued a grade C recommendation "against routine screening mammography in women aged 40 to 49 years" and stated that "[t]he decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms." As a grade C recommendation, clinicians are counseled to "[o]ffer or provide this service only if other considerations support the offering or providing the service in an individual patient."
Task force encouraged policymakers to include additional considerations and "individualize decision making to the specific patient or situation." In publishing its updated recommendations in The Annals of Internal Medicine, the task force acknowledged that other considerations should be included in determining what preventive treatment to provide, stating, "The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation."
NBC's Snyderman: "It's important to remember that these new recommendations from this independent task force are just that -- they're recommendations." In a Nightly News report on the task force recommendations, NBC chief medical correspondent Dr. Nancy Snyderman stated, "It's important to remember that these new recommendations from this independent task force are just that -- they're recommendations. They don't mandate any changes in who should get mammograms and when." [NBC's Nightly News with Brian Williams, 11/17/09]
BTW, this was a "task force" recommendation. The HHS sec said that she does not support it.
You can stop your right-wing freak-out now, drama queen.
But, of course, you could have looked that up yourself instead of falling for the right-wing spin.
Nobody, including you, has provided one bit of evidence to the contrary.
Bzzzt! Sorry, you lose: Burden of proof is on the claimant. It's not up to anyone to "provide evidence" that your "very real scenario" wouldn't happen. It's up to you to show that it would. Stamping your foot and going "Of course it would!" is not evidence.
It's also worthy of mention here that the recommendation is not against mammograms for women under 40, it's against <i>routine screening</i> mammograms. <i>Diagnostic</i> mammograms, ones where it appears there is some reason to check, are not touched.
One other thing to mention: Among the reasons for the recommendation is that while routine mammograms have saved lives among women in their 40s, the radiation used in the exam has resulted in fatal cancers for almost as many.
You keep stamping your foot like that, you're going to break your ankle.
Sorry, but the grownups around here understand things like logic and what constitutes evidence. Come back when you do.
The burden in on you. Period. You made the original assertion, it is up to you to back it up.
Provide evidence that your "scenario" is a certainty. (You said "She will." So yes, you did present it as a certainty.) And no, again, just going "It will!" is not evidence. Stop running away like a little child going "Can't make me! Can't make me!" Do that, give an actual basis for your claim, then we can talk about possible rebuttals. Until then, you've presented nothing to rebut.
Put up or shut up.
Being the word parser you are, unless you can prove with EXACTLY similar examples from past, you do not have much standing. Your sense of common sense will look very selective.
Please tell me that there's something wrong with my slight rewrite of your post. It's no more likely with a public health plan than with a private and it's possibly less likely with the public health plan.
The fact is that I don't believe that it would be used as a tool in a public health plan to deny mammograms. These recommendations, even if they were applied exactly as written, push very strongly toward having the patient work with her doctor to determine whether mammography is the proper procedure for that patient, regardless of her age. If they determine that it is the best thing I simply don't foresee any government official coming in and second-guessing the doctor. It simply isn't a rational expectation.
My point in rewriting your paragraph was to point out that it DOES seem likely for a private insurance provider to issue such strict guidelines to doctors as to what is covered. They have far too much history doing just that for me not to believe it.
I pointed out the flaw in your logic. You tried to pretend that there would be some sinister tendency on the part of government to use suggested guidelines to deny care and I demonstrated that it seems much more likely that private insurance would do that. I notice you haven't chosen to refute that assertion.
You never demonstrated any sort of real possibility. All you presented was an imaginative fantasy.
I have NO idea what you thought I put out as bait. I can't make any sense of that line at all. Pure paranoia, maybe?
You gave no plausible reason for that, and it's common sense, not supported by some liberal talking point. Which explains why you can't get it, I suppose.
Make a note of it.
Make a note of it.
Thanks for being consistent, Tommy.
Yes, I did give support for my position. You suggested based only on your imagination that the task force recommendations would likely be used as a basis for denying a mammogram under a public health plan. I pointed out that application of those recommendations would, in fact, be the doctor and patient working together to determine the best treatment on an individual basis. THAT was the meat of the task force recommendations. THAT was the substance I provided.
All you provided was what you claim is common sense. Your common sense is indistinguishable from flights of fantasy.
And you've still provided absolutely nothing to support your "real possibility" claim. I explained why I considered it to be very unlikely. It's clear to any objective observer who is dodging here.
I've now explained my reasoning twice. I won't repeat it again here. However, in addition to what I've said, I'd like to point out that under current public health plans treatments are determined by the doctor and patient. I'd need to have some reason to believe things would change and go according to your fantasy. That reason doesn't exist.
It's dishonesty.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
Who is the dishonest one?
The very quote you pulled out said that evidence is insufficient to judge benefits/harms of CBE beyond screening mammography.
Screening mammograms - that is, routine mammograms typically done as part of a general physical exam - are those addressed by the recommendations. Those are the sort I specifically referred to. Where the evidence is insufficient about mammograms is those beyond screening ones, those outside those addressed by the recommendations. Lacking enough information, no recommendation could be made.
So maybe I was wrong - maybe you're not dishonest. Maybe you genuinely just can't grasp the concept of evidence-based logic.
You can lecture me on logic when you prove to me you have more insight on it. So far, bzzt, you haven't.
But anyway:
From the San Francisco Chronicle:
"[T]he group found the potential harm - through false positives and radiation exposure - outweighed the risks."
Dr. Jeffrey Tice, who researches ways to improve risk assessment for breast cancer, quoted in the same article:
"Radiation causes 1 death for every 2,000 women screened annually starting at age 40, according to a study published in 2005 in the British Journal of Cancer. Another study shows that each mammogram increases the risk of breast cancer by 2 percent."
Meanwhile, the New York Times reports that screening women in their 40s saves "one life for every 1,904 women screened for 10 years."
Loser.
Lets be clear as well. The limits planed for private insurance is designed to drive corporations out or bankrupt leaving one player standing.
I would love to see health care severed from employment and employers required to pay you the money set aside for health care. No one purposes that as it would deprive washington of power. Likewise no one mentions vouchers to be used as people see fit and let the best company win. Throw in national database, and it gets a little scary
However, the humor is appreciated.
It bears repeating that in the US we pay more than twice as much per capita for health care as they do in other countries with much poorer results. Do you believe there's something inherent in the US system that would prevent us from improving on that?