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Behind the Angst over Mammogram Guidelines

Behind the Angst over Mammogram Guidelines

Opponents of health care reform are using the new U.S. Preventive Services Task Force guidelines for mammograms as proof that a rationing of care in preparation for a “government takeover of health care” has already begun. 

One might argue that neither the House bill nor the Senate bill is a government takeover of health care, and it should be noted that the Task Force does not set government policy or health insurance industry policy. That doesn’t mean that it’s not good ammunition for enemies of reform. 

Women have a lot to gain from reform and are at the heart of debate on both sides. Julie Menin of the Huffington Post put it this way: “It is completely disingenuous for a party that is trying to kill health care reform to now try to stand up for women’s rights and women’s health with this false politicization of this issue. While the health reform legislation that is before Congress may indeed severely and unfortunately curtail a women’s right to choose, what it does do for women’s health is monumental. It ends the decades long practice of discriminating against women with their health care coverage.”

I wrote about some of those practices in a previous post, 6 Shockers about Women’s Health Care. While I question the wisdom of the USPSTF telling women in their 40s that there is no need for self-breast exams, the question of the correct age to begin mammogram screening has been at issue for some time.

Young women are not immune to breast cancer and that concerns us. Christina Applegate, age 36 at diagnosis, and the late Stefanie Spielman, 30 at diagnosis, are two cases that come immediately to mind. In Christina’s case, a family history of breast cancer resulted in a doctor-ordered MRI, and in Stefanie’s case, it was a self-exam that first caused concern.

Ultimately, decisions about health care — which procedures are warranted and which are not — should be left to doctors and their patients, based on physical exams, family history, and risk factors. When reading about the USPSTF, beyond broad guidelines, that actually does seem to be their intent. In a perfect world, the new general guidelines should be no cause for concern.

So why are women so angry and upset about the new guidelines? Because it’s not a perfect world and we know from experience that many health care decisions are not made between us and our doctors, but by for-profit insurers. We fear that if they latch on to a new reason to deny coverage of certain procedures, particularly procedures that have to do with that pre-existing condition of being female, it will happen.

Perhaps some mammograms are unnecessary and cause needless anxiety and worry, but they are certainly not forced on women who don’t wish to have them.

Breast cancer survivors of all ages, however, are concerned about the message of complacency is sends to young women, and about the potential for blocking women from receiving the tests that may detect breast cancer in its earliest stages and offer them a fighting chance for life.

Higher premiums for women on the individual market, denial of care, and higher out-of-pocket expenses are keeping millions of women from getting the health care they need. Angst over the new mammogram guidelines is not unjustified. Women simply want to gain more control over their own health care decisions. We certainly can’t afford to lose any more. 

More on Breast Cancer:

New Mammogram Guidelines: How many deaths are enough?

RIP Stephanie Spielman, Diagnosed at 30

Care2 Action Items:

Click to Cure Breast Cancer 

Breast Cancer Awareness: I Support this, Too!

Fighting Cancer Requires Health Care Reform

Get my updates on Twitter @AnnPietrangelo

 

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Photo: U.S. Centers for Disease Control

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14 comments

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2:10PM PST on Nov 30, 2009

I agree

10:31AM PST on Nov 28, 2009

I think prostate cancer is even more common?

7:34AM PST on Nov 28, 2009

I am tired of health issues like this being used in politics on either side. This is just trying to win a vote and get into office without caring whom it affects in the long run. We see this with the hungry and those on welfare in this country being used as political pawns. Now it is our health care that is being used.

Many women in my family have had breast cancer, ovarian cancer, utern cancer, anong other diseases at an early age and so we understand the importance to being tested earlier then later. Plus the earlier found the chances of success goes up and the chances of losing a breast etc. goes down. So to allow and encourage women to go for mammograms and other preventive care helps not only her, but her family as well as all those around her. The woman is someones Mother, Grandmother, daughter, etc. and when we lose her we lose a lot to this disease.

8:40PM PST on Nov 25, 2009

I don't know what percentage of the population is the liberal, but the last election showed that more people are liberal than conservative and most people in this country are in favor of health care reform. Insurance companies have had the right to "compete across the nations just as you do for auto insurance" for my whole lifetime and the result is the mess we have now. You have far too much confidence in the benevolence of corporations. One would think that the recent events on Wall Street, where the banks and financial industry showed how little they care about us, would have made you less credulous.

2:25PM PST on Nov 25, 2009

Are you for real? The right, moderates, conservatives represent 80% of the country and nobody is saying not to reform healthcare. Obama and sounds like you have an attitude of "my way or the highway." What they and the American public want is good reform Obama/liberals have put into such debt from which we may never recover. Do health reform by allowing insurance companies to compete across the nation just as you do for car insurance, initiate tort reform, don't take money from seniors medicare wiping it out fromthe Advantage plan and reducing seniors to 50% of healthcare. Obama/and I guess you certainly are a liberal (only 20% of population is liberal) and give it to approx 12 million....even Robin Hood did not do that. Give me a break! You sound like that whack job Pelosi.

I am sick of your liberal garbage. Look at all the polls the American public do not agree with this crazy liberal, high costing healthcare. And yes, unfortunately, Mr. Obama and the likes of you want a socialist/Marxist government.

Give me a break!

2:04PM PST on Nov 25, 2009

It is not so much about creating and modifying recommendations and standards for health screenings but about buying into beliefs that are constructed by industries to advance the health care machine.

Money is made when tests and screenings are done. Insurances loose money each time they have to pay out. Insurances get pressured by adopted standards of care that recommend screenings. The groups to most profit promote campaigns to get the public to "buy in" to the need for high standards of care. Those who "buy in" have been manipulated by media messaging, sound bytes and emotionally charged stories that saving lives is the name of the game.

Once a large enough number of people become convinced that the only way to save lives (even if it's just one, it's worth it), is established it becomes the absolute truth. What everyone fails to understand is that science and medicine are more about theory than absolute truth. Science and medicine change on a daily basis as to what is fact and what makes more sense or works better.

Unfortunately most lay people want to place their trust in something that is more constant so they are more likely to want to hang onto prior constructed beliefs.

The sooner the public learns to recognize that they allow most of their reality to be externally constructed so they may satisfy profit motives of the storytellers, the sooner they can release their anxiety surrounding their health...trust in their own innate wisdom to live natural health

11:48AM PST on Nov 25, 2009

The article says that mammograms are not forced on women, but at my HMO, they are. You have to have them yearly to receive coverage. These new guidelines are a welcome relief for those of us with dense breast tissue, for whom mammograms are painful and lead to constant false positives, leading to more tests, some of which may have side effects. It will be nice to have some choice on this issue, based on actual science rather than just fear.

9:38AM PST on Nov 25, 2009

The problem is not medical procedures. The problem is the system interfering with women's health. It is called gender discrimination You don't hear these kind of pronouncements, etc. about prostate cancer. Men are allowed to consult their doctors quietly and receive treatment. Women are run up a flagpole for popular debate.

7:42AM PST on Nov 25, 2009

Both the governmet and the insurance companies have, are and always will stress prevention, yet they do not pay for check-ups, do not want to pay for check-ups and have no plans for the future to pay for check-ups of any area of your body.

A person may feel fine and during a check up find out they have high blood pressure, diabetes, heart problems and so on.
You have to pay on your own for dental, hearing and eye tests.
If we have a public option perhaps the competion amongst the insurance companies and the government will start including
these exceptions.
The Republicans have tried to kill any subsidy to private health by government as they receive the finest health care from the government on the tax payor dollar.

6:17AM PST on Nov 25, 2009

The National Breast Cancer Coalition has shared this position for years. The truth is that in the 40-49 age group mammographies do not make a difference in survival rate.

It has never been the position of the group that women should not have mammography, just that the limitations of mammography should be recognized and as a policy issue the money spent on advocating for mammography could be better spent.

The truth is that the tumors most often detected by mammography are slow growth tumors, it misses the more lethal and fast growing cancers. So when the interval of detection is not looked at, there is no difference in survival between women having a mammography and those who do not

In other words women who had mammographies did not live longer than those who did not. Also women in the 40-49 age group have more dense breast tissue which makes it more difficult for the test to be effective.

In regards to the monthly BSE what the research found is that women most often find lumps during a shower, or their partner locates it, it does not happen during the monthly BSE.

For greater clarification on this issue please visit the National Breast Cancer Coalition's web site.

http://www.stopbreastcancer.org/index.php?option=com_content&task=view&id=978&Itemid=179

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Colleen H. Colleen H. is an Online Campaigner with Care2 and a recent transplant to San Francisco from the East... more
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