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.

The new recommendation from the U.S. Preventative Services Task Force that women under 50 should not undergo routine mammography is generating a lot of controversy—it is a direct challenge to the strong message women have been receiving for two decades that they should have yearly screening starting at age 40. The task force also recommends that women age 50-74 have a mammogram every two years (rather than yearly) and finds that there is little benefit in screening women over 74 at all.

To the experts who have been questioning the benefits of mammography for several years, these recommendations are no surprise—and they are welcome. The World Health Organization, and many European countries where the government pays for routine mammography screening, already follow these guidelines. But how is this news playing in Peoria?

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In an 11th hour attack on health care reform, a coalition of employer groups, including the Chamber of Commerce, wrote to House Speaker Pelosi and Republican Leader Boehner at the end of October opposing the Democrats' health reform bill. (The group includes The Business Roundtable, the American Benefits Council, the Corporate Health Care Coalition, the National Association of Manufacturers, the National Association of Wholesaler-Distributors, the National Coalition on Benefits, the National Retail Federation and the Retail Industry Leaders Association.)

Over at THCB, two commentators have suggested that these business leaders may “Send reform back to the drawing board.”

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[Below an Op-ed that I wrote for the Washington Post’s “Outlook” section. It appeared yesterday Sunday, November 15, 2009.  Many readers have commented on the Washington Post website, but I’d also be interested in hearing from HealthBeat readers here.]
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If you're a progressive like me, and you're upset by the Stupak amendment, which bars federally subsidized insurance from covering abortions, consider this: What if we had a single-payer health-care system and someone like Jeb Bush were running the country?

Many liberals remain angry and disappointed that single-payer legislation never stood a chance in Washington. From the beginning the Obama administration made it clear: we cannot wipe the slate clean and start over from scratch; we must build on what we have. Yet, to single-payer advocates, a government-run health-care system seemed such an obvious way to put patients ahead of profits. I understand their frustration.

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The Truth about the Public Option

For reasons I don’t understand, progressive pundits have been swallowing Congressional Budget Office Director Douglas Elmendorf’s dispiriting speculation about the public plan, hook, line and sinker.

Elmendorf claims that in 2019 (six years after reform begins), less than 10 percent of the population will be shopping in the Insurance Exchange where there can choose between private insurance and the public plan.  Few will choose the public plan, Elmendorf asserts, and many of those who do will be in poor health. The government plan will be puny—giving it little market power when negotiating with providers. Thus, he declares, the public plan will be more expensive than private insurance. (This may be why Senator Joe Lieberman has claimed that the public option will somehow add to the deficit)

What is remarkable is that if you read Elmendorf’s  commentary you will find that he has no hard evidence to back up  his claims. His assessment is based on “probably’s.”

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Boston: HealthBeat reader, nurse and healthcare advocate Ann Malone has passed along this invitation: Please join us for the screening of Money Driven Medicine: What’s Wrong with America’s Healthcare and How to Fix It” on Wednesday, November 18th and 6:00 PM at Northeastern University,.

UPDATE "Based on an overwhelming response, " the location has been changed to Room 101 in Churchill Hall, Northeastern University.

The film will be followed by a panel discussion featuring healthcare leaders and policymakers in Massachusetts.

Seattle: Northwest Film Forum on the 22nd at 8:00pm.
click here for information http://www.nwfilmforum.org/live/page/calendar/1132

Consumers Union's “Safe Patient Project” is hosting a Patient Safety Forum at the Kaiser Family Foundation in Washington, D.C. (1330 G Street, NW) Tuesday, November 17, 10 a.m. – 3:30.

The forum marks the 10-year anniversary of the Institute of Medicine (IOM) study on medical errors, “To Err Is Human.”  Consumers Union  explains: “Unlike most anniversaries, we’re not gathering advocates, journalists and policymakers to celebrate–we’re gathering to call attention to the fact that we find ourselves asking the same question the IOM asked 10 years ago: ‘Must we wait another decade to be safe in our health system?’” 

I’ll be speaking at the forum.  The conferencewill be webcast live for online viewing. For more information on the forum and the webcast, go to  http://www.safepatientproject.org/2009/11/delaying_is_deadlyjoin_our_pat.html 

Following the forum there will be a reception from 3:30 to 5.

At 5:00 Consumers Union is hosting a free screening of Money-Driven Medicine, the film based on my book, produced by Alex Gibney,  the Academy-Award winning documentarian best known for “Taxi to the Dark Side” and “Enron: The Smartest Guys in the Room. ”  I’ll be answering questions following the film.  

(Kaiser Family Foundation: 1330 G St. NW, Washington DC)  If you want to attend the screening, please RSVP here http://cu.convio.net/site/PageNavigator/spp_MDM_DC   Seating is limited.

Health policy is best when it stands on the shoulders of rigorous scientific research—for example, restricting tobacco makes sense because it’s proven to reduce cancer rates and mortality. But sometimes health policy is built on a slightly shakier premise; one that balances sound science with the need to avoid controversy. The government’s policy on the pandemic swine flu vaccine is an example of this latter approach.

The decision to make the vaccine voluntary for health care workers (except in New York) is one way the government has avoided public outcry. The decision by the Center for Disease Control to not add adjuvants—substances that activate the immune system and make the vaccines more powerful—to the shots, even though doing so would have helped alleviate the delays and shortages we are currently experiencing, is another. Neither of these decisions was rooted in evidence-based concerns about public safety. And they ultimately reduce the widespread health benefits of the vaccination campaign.

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I’ll be doing Fire Dog Lake’s Movie Salon live, this evening, answering questions about Money Driven Medicine.

You’ll find the salon on www.firedoglake.com

We Have Been Driving Our Soldiers to a Breaking Point

The
Ft. Hood massacre is not about one soldier suddenly “snapping.”And
whether Maj. Nidal Malik Hasan was a devout Muslim or not is of little
importance.

This tragedy calls attention to the fact that as we
send young men and women into what many now realize are unwinnable wars
where they will see unimaginable horrors, we are risking, not only
their young bodies, but their minds.

Below, a post I wrote last
year about how the U.S. Army has ignored the serious mental health
problems of our soldiers.  Instead of helping them, it has attacked
them, accusing them of “faking” mental health problems. In the post, I
quote a February 2008 VFA report: “the leader of the mental health
treatment clinic at Fort Drum asked soldiers not to discuss their
mental health problems with people outside the base. Attempts to keep
matters ‘in house’ foster an atmosphere of secrecy and shame,” the
report observed “that is not conducive to proper treatment for
combat-related mental health injuries.”

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