delivered a tough critique of those breast-screening guidelines that the federal government pushed late last year. The ABC report was plenty tough, leading the broadcast, but still not tough enough, because while Sawyer and Dr. Besser refuted the government's effort to ration breast-screening, they didn't go further and tell us why the government wants to ration such care--and why even after this rebuke, the government will likely try again.
Sawyer began: "Less than a year ago, you'll remember a government panel said women do not need regular mammograms till the age of 50." Now, she continued, a new study of one million Swedish women found that "mammograms in your 40s can dramatically save lives from breast cancer."
Then she turned over the segment to Dr. Besser, who added that he sent the Swedish study to 24 doctors and cancer specialists around the country; 21 of them, he said, were already telling their patients just that--get checked regularly in your 40s, don't wait till age 50. Besser added that the screenings could cut deaths from breast cancer by 26 percent; saving the life of 1 out of every 1200 women screened. He concluded, "Today's study flies in the face of those controversial government recommendations last year when a panel found mammograms for women under 50 should be an individual decision, rather than a general recommendation."
OK, so scientific recommendations come, and scientific recommendations go. That's the flux of science, as scientists push toward the best answer. Right? Actually, no.
The original recommendation from a government panel, the US Preventive Services Task Force, which came to light on November 16, 2009, should not be seen as a scientific recommendation--they were a political recommendation, aimed at giving the Obama administration, and the overall cause of healthcare rationing, a boost. We're spending too much on healthcare, the larger argument went, and besides, much of our healthcare spending is counterproductive--so why don't we spend less and call it a win-win?
Those recommendations caused such a firestorm last year that they were withdrawn--or where they? In a bureaucracy, nothing ever dies. Bureaucrats wishing to advance a particular position might have to make a tactical retreat every so often, but they never give up.
So the original finding should not be seen as an isolated incident. There will be more. The bean counters and rationers--here at Serious Medicine we call them Scarcitarians--will be back. They have not in any way given up in their efforts to define American healthcare downward.
But there is hope, if the people are made aware of their own interests. And the media, too. Interestingly, while the politics of the Mainstream Media are firmly on the side of the Obamacare rationers, the ratings eyeballs are to be found on the opposite side of the argument--the Serious Medicine side. People want to know about how they can stay alive, and they will reward TV networks that help them in that perfectly understandable goal. It's real people, after all, who consume all the medical information in the larger culture; it's only a few policy wonks who think just the opposite--that people should have less information, and less access to care, pursuing, as they do, their "less is more" vision.
They are less interested in saving the government money in the shortest of short runs. In the long run, of course, we would be better off, financially as well as medically, if breast cancer were reduced and then eliminated.
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