Part 1 of this post described how the US Preventive Services Task Force’s (USPSTF’s) message about mammograms has been distorted by the press. Despite what you may have read, the Task Force did not recommend that women in their 40’s skip mammograms; it advised them to discuss the risks as well as the benefits with their doctors. And the USPSTF was not trying to save money; it is not charged with cutting the cost of care. Its only goal is to give women full information about the benefits and the limits–of mammography screening.

Below, I explain that what the task force just explained about the risks of mammography is something that it tried to tell us years ago. But Congress stood up and said “No—we don’t want women to know that.” Why? Because lobbyists for those companies who make mammography equipment did not want women to know that mammograms can lead to unnecessary surgery.

Below, I also note that some patient advocates as well as many disinterested physicians applaud the Task Force’s message. It’s just not as controversial as the media pretends. Indeed just one month ago the chief medical officer of the American Cancer Society was questioning the advantages of mammography in the pages of the New York Times.

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Monday, December 7th @ 7:00 PM
Cinema Village
22 E 12th Street
New York , NY10003
212-924-3363
featuring a Q&A with producer Alex Gibney

Below a snapshot of how health care reform would help one underinsured household.

A single profile is hardly a definitive assessment of how reform will affect the many  families that are now paying far too much for far too little insurance.

But so much commentary on health care reform focuses on the uninsured or the well-insured. Most middle-class American families fall somewhere in the middle. This ProPublica assessment throws a spotlight on how reform would change their lives. (The analysis is based on results of a questionnaire that ProPublica did with American Public Media’s Public Insight Network.)

At the end of the Kroner’s story, I comment on what it highlights about reform legislation.

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News reports on the mammography controversy reached a pitch of high hysteria last week, the baseline syncopated with the language of hate and fear.

Minnesota journalism professor Gary Scwitzer tracked the dismal progress (“descent” might be the better word), of the debate over the US Preventive Services Task Force (USPSTF) recommendations regarding mammography on his blog, Health News Review. There, he points to the fear-mongering and rampant exaggeration that has distorted media coverage.  For example, “On ABC’s daytime talk show, ‘The View,’ co-host Elisabeth Hasselbeck made the stunning claim that the recommendations [represent] ‘gender genocide.’” 

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Money Driven Medicine will be playing at 10 a.m. at the Texas Capitol Auditorium in Austin, and at 7 p.m. at the Millennium Youth Center Complex. Both shows are free and followed by a discussion with Consumers Union and the Center for Public Policy Priorities.

Consumers Union—publisher of Consumer Reports—has been sponsoring screenings throughout the country. Thank you CU!   

For more information about the film, see www.moneydrivenmedicine.org.

Over the weekend, Senate Democrats found the 60 votes needed to press forward with the health care debate. I wasn’t surprised. As I have suggested in the past, I doubted that three or four moderates really wanted to be remembered as the Senators who let the conservatives talk health care reform to death.

This doesn’t tell us what will happen in the weeks ahead, but I remain hopeful that, in the end, we will wind up with a bill that closely resembles the current Senate and House proposals (which are not that far apart)—one that includes a public option.

My confidence is buoyed by the opposition’s growing virulence. Fear has turned to rage as they realize that the liberals may win.

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What if in 2012, unemployment remains relatively high, the recession continues, and voters blame President Obama, voting him and his Congressional supporters out of office?

Consider how that would affect health care reform. If the House bill prevails on the timing of reform, the the Exchanges will open in 2013, subsidies will be available, private insurers will be regulated, and the Public Plan will be available to tens of millions of Americans. Conservatives elected in November of 2012 would have only two months to try figure  out how to derail the roll-out scheduled for January 1, 2013.

By contrast, the Senate legislation now under consideration would push reform forward to 2014. The Exchange, the public plan, the subsidies –none of the above  would be scheduled to become  a reality until one year after Conservatives took control of both the White House and Congress.  In a year, determined politicians could repeal and dismantle most if not all of the reform plan.

Could they do such a thing? Yes, particularly if, during the 2012 election they continued to fuel voters’ fears about the upcoming overhaul of  the U.S. health care system.

I haven’t had time to think this through. I may be missing something.  But on the face of it, I have to say that I'm  opposed to delaying reform until 2014.

 I understand that this gives reformers more time to bring down the cost of care, and find the funds needed to fund the overhaul. But, much as I hate to say it, we can’t afford to ignore the possibility that the conservatives return in 2012—even if only for one term. In a single term, they could undo everything that reformers had achieved.

As Naomi has pointed out below, the news about mammograms is not brand-new information based on one study that just can out.

The recommendations that the Preventive Services Task Force (PSTF) has released is based on research that experts have known about for some time. Thanks to reader Greg Pawelski for calling attention to this post by Dr. Herman Kattlove, a retired medical oncologist who did research on mammograms in the early 1990s.  For the last seven years, Kattlove has served as a medical editor for the American Cancer Society where he has helped develop much of the information about specific cancers that is posted on the website at www.cancer.org

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HeatlhBeat readers may remember that, in the past, I questioned whether Dr. Sanjay Gupta should become Surgeon General.

Today, after I read Naomi’s thoughtful post on Mammography Guidelines (see below), I heard Dr. Gupta on CNN, grilling a nurse who is part of the Task Force that has raised questions about the benefit of mammograms for many women.

“So you’re saying that some lives just aren’t worth it?” Dr. Gupta demanded. He went on to suggest that he could not imagine how a health professional could be so lacking in compassion.  It wasn’t just that the spot was too short to address a complicated issue. Gupta’s idea of exploring the topic was a classic example of “attack TV.”

At least he’s not Surgeon General.