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.
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Photo: U.S. Centers for Disease Control