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Do New Mammogram Recommendations Patronize Women?

 
 
Miller
 
Reply Sun 22 Nov, 2009 12:16 pm
http://feministlawprofessors.com/?p=13758
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Type: Discussion • Score: 8 • Views: 4,692 • Replies: 44
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Bi-Polar Bear
 
  1  
Reply Sun 22 Nov, 2009 12:34 pm
after 50 we generally trade you in on a younger model anyway.. so what's the diff?
tsarstepan
 
  0  
Reply Sun 22 Nov, 2009 12:38 pm
@Bi-Polar Bear,
What's their trade in value? Have you taken advantage of the Federal program, Cash for Clunkers B-P Bear?
Bi-Polar Bear
 
  1  
Reply Sun 22 Nov, 2009 03:36 pm
@tsarstepan,
My model still has a few years to go and a few miles left on her. I say that because she's not here to hear me. Laughing
0 Replies
 
Foofie
 
  1  
Reply Sun 22 Nov, 2009 08:11 pm
In my own opinion I have to wonder if there is a connection between these new guidelines and the eventual public option for health care - money wise that is.

I do not believe the rationale for these new guidelines, since many false positives (in mammograms) can be dealt with with non-invasive approaches I thought. And, if a biopsy is performed one year later, based on the new guidelines, then what "anxiety" was eliminated? The "anxiety" was just postponed one year? And, if there is cause for concern, under the current guidelines, a woman's life may be saved. Or, am I deluded to think that catching breast cancer one year earlier has no positive effect on a prognosis?

Being a cynic, I did wonder if these new guidelines are really just the Democratic Party's announcement of Hillary's running in 2012, as the protector of women, and the one to beat a certain Alaskan?

soozoo
 
  1  
Reply Sun 22 Nov, 2009 09:02 pm
I believe this is the beginning of the rationing we will see if the government passes their health care bill. If the recommendation is 50 and over, insurance companies will use that as an excuse not to pay for mammograms. And things will escalate from there.
Miller
 
  1  
Reply Sun 22 Nov, 2009 09:05 pm
@Foofie,
Foofie wrote:

In my own opinion I have to wonder if there is a connection between these new guidelines and the eventual public option for health care - money wise that is.

I do not believe the rationale for these new guidelines, since many false positives (in mammograms) can be dealt with with non-invasive approaches I thought. And, if a biopsy is performed one year later, based on the new guidelines, then what "anxiety" was eliminated? The "anxiety" was just postponed one year? And, if there is cause for concern, under the current guidelines, a woman's life may be saved. Or, am I deluded to think that catching breast cancer one year earlier has no positive effect on a prognosis?

Being a cynic, I did wonder if these new guidelines are really just the Democratic Party's announcement of Hillary's running in 2012, as the protector of women, and the one to beat a certain Alaskan?




It's the start of rationing.

No flu vaccine for those 65 and over.

No mammograms before age 50 or after age 74.

No pap tests before age 21, which is a real joke since girls are having babies as early as 11 years of age.

More to come and by the way I don't think Mrs Clinton is in favor of rationing.
0 Replies
 
ossobuco
 
  1  
Reply Sun 22 Nov, 2009 09:06 pm
Checking in warily.
0 Replies
 
Miller
 
  1  
Reply Sun 22 Nov, 2009 09:06 pm
@soozoo,
soozoo wrote:

I believe this is the beginning of the rationing we will see if the government passes their health care bill. If the recommendation is 50 and over, insurance companies will use that as an excuse not to pay for mammograms. And things will escalate from there.



I agree 100%. It's also been proposed that end of life care be also rationed.

What next?
ossobuco
 
  1  
Reply Sun 22 Nov, 2009 09:14 pm
@soozoo,
Yes, this is routine for insurance companies. I won't entirely negate them on their judgements, just that I do figure this will be a pulled benefit.

I'm most interested in women in their later forties, whose results show up in their fifties (not that I am not interested in younger). So many of our mothers have been there, but maybe they're right re the bother of checking -

how could they be.. I don't get it. This whole scenario seems to equate drama/angst against pathology. People need to be educated about the breast and how it works and its possible pathology.

I will vote for information.
0 Replies
 
Miller
 
  1  
Reply Sun 22 Nov, 2009 09:17 pm
Some women develop breast cancer in their 30s. Perhaps mammography should be the rule for those 30 and over in age.
ossobuco
 
  1  
Reply Sun 22 Nov, 2009 09:21 pm
@Miller,
I can see that. It is not all that expensive. I did have a friend who had bc in her thirties, worried about it in her twenties.
The trick is to have screening methods improve, as I gather they are doing. It is a red herring to cut out women in their thirties.
Methodology must improve.
Miller
 
  1  
Reply Mon 23 Nov, 2009 07:00 am
@ossobuco,
The cost, without insurance, is about $500.
engineer
 
  1  
Reply Mon 23 Nov, 2009 08:54 am
@Miller,
This type of recommendation is based on "results based" medicine. It's not too hard to actually look at risk versus benefit numbers to make recommendations. The problem is that everyone has an anecdote of someone who benefited from method A and no one can see who was harmed from A but would have been fine under method B. We have an inherent belief that "more is more" when sometimes "more is less". Here's a link to an excellent story about how our health care system works from the doctor/patient side. (There is a part two covering other aspects.) The section that I found fasinating was "Act Two" where a doctor describes having to persuade a patient's father that demanding a cat scan would actually be BAD for his daughter even though it would 1) make more money for the hospital 2) make more money for the doctor and 3) reduce the liability of both.

There is a cost to excessive testing besides money. The patient has to give up significant amounts of time and productivity. The care providers have to do the same. Doctors have to spend more time analyzing the results meaning that they tend to spend less time on each test and increase their chances of missing something. They also have less time to spend with patients and every doctor will tell you that most of the time, patients can tell you what the problem is faster than a test.

This is not a problem just for breast cancer screening, it is endemic to the industry. I think it would be fair to ask to see the numbers. What are the downsides to mammography (or prostate screening, or pre-natal testing)? What are the benefits? When do the lines cross? I think those are better questions than posing conspiracy theories. We must accept that more is not always better and that math does essentially work, even if lives are on the line.
Foofie
 
  1  
Reply Mon 23 Nov, 2009 11:16 am
@engineer,
engineer wrote:

...This is not a problem just for breast cancer screening, it is endemic to the industry. I think it would be fair to ask to see the numbers. What are the downsides to mammography (or prostate screening, or pre-natal testing)? What are the benefits? When do the lines cross? I think those are better questions than posing conspiracy theories. We must accept that more is not always better and that math does essentially work, even if lives are on the line.


Why must "we accept that more is not always better," if your definition of "better" is not everyone's definition of "better"? And, since statistics can be played with, to back a particular viewpoint, I do not accept that the "math does essentially work"?

Remember, that not everyone believes that there is a price on a life. Plus, not everyone agrees as to the priorities in society that money should be budgeted. It really comes down to one's value system, and I cannot accept that the value system that you subscribe to is an objective truism in society, since values are inherently subjective.
JPB
 
  1  
Reply Mon 23 Nov, 2009 11:27 am
@Miller,
Hopefully health care as we know it.

For one thing I'd like to reverse the way we approach end of life care. I'd much rather dnr to be the default instead of the other way around for anyone over the age of 18 and on publicly financed health care. Go ahead and indicate that you want to stay on life support forever but at least give it some thought.
0 Replies
 
Bi-Polar Bear
 
  1  
Reply Mon 23 Nov, 2009 11:41 am
On a serious note.... I hear talk now that anual prostate and PSA blood testing is beginning to be looked at as a waste of time as well. Anyone bitchng about that? Personally I'm for annual mammograms and prostate exams. Also colonoscopys after 40.
chai2
 
  1  
Reply Mon 23 Nov, 2009 11:42 am
@Miller,
Is not.

I'm getting a mammogram today, from Austin Radiological Associates, at their Womens Imaging Center. I've gotten at least 4 or 5 mammograms there, and they are top of the line.

I just called them and asked them how much a private pay mammogram would be.

They said if you paid at the time of service, it would be $150.



Of course these new guidelines are about the $$$.
So what else is new?
0 Replies
 
chai2
 
  1  
Reply Mon 23 Nov, 2009 11:45 am
@Bi-Polar Bear,
Bi-Polar Bear wrote:

On a serious note.... I hear talk now that anual prostate and PSA blood testing is beginning to be looked at as a waste of time as well. Anyone bitchng about that? Personally I'm for annual mammograms and prostate exams. Also colonoscopys after 40.


I thought colonoscopys where after 50.

I'm having one on Dec 15, along with a endoscopy.
I had a pelvic exam last week. If only I could have convinced them to do that at the same time.....I've always wanted to have a 3 way.

Mark you calendars everyone.
Bi-Polar Bear
 
  1  
Reply Mon 23 Nov, 2009 12:06 pm
I was pretty sure it was 40. I had a nasty case of acute ulcerative colitis in my 30's so Im supposesd to get one every year. Can't afford it though.
0 Replies
 
 

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