OFF THE GRID

And We Thought We Hated Mammograms

Nov 18, 09 | 2:40 PM   byCaroline Miller
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No one likes to get a mammogram. Still, it’s hard to find a woman anywhere who was pleased to hear the new ruling that women in their 40s don’t need to endure the annual indignity of baring their breasts to the radiologist after all. That’s because it’s hard to find a woman anywhere who believes that the federal panel changed its recommendation for her benefit.

It’s not that the decision doesn’t make sense: It costs a lot to screen women for breast cancer in their 40s, and very few actually have it—something like 1.4%. At the same time, it produces almost 10% false positives, which cost a lot more to follow up with further imaging and biopsies.

But that’s not the way it’s been presented. It’s been rolled out with a lot of rhetoric about saving women the “anxiety” of false positives, about the “risk” of false-positives outweighing the risk of breast cancer. As if these two so-called risks were in some way comparable.

C’mon. We’re not that dumb. As an NPR reporter I heard put it to a doctor trying to justify it, it’s patronizing to tell women this is all about saving them from the discomfort of unnecessary biopsies.

What it’s about is efficiency. As the Cancer Society’s chief medical officer put it somewhat baldly, the task force concluded that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save one life is not. But worth it—or not worth it—to whom?

To the nation’s medical system, not to the woman in her 40s with breast cancer—and they’re all over cable TV talking about it.

That’s just the kind of cost-benefit calculation that’s going to be used in cutting those “unnecessary tests and procedures” everyone in Washington has been talking about, to find the money to cover 40 million uninsured people.

Would it be fair to drop broad coverage of an inefficient test that might save a few Americans to extend basic care to 40 million uninsured? Probably would be. Beats the rationing we have now, which is, essentially, all the tests for the haves, and none for the have-nots.

But it comes just a bit more than a week after the Democrats—in a cost-benefit calculation of their own—essentially voted to give away even private insurance coverage for abortion in order to get health reform passed. Sorry, women, your turn to sacrifice.

At least we didn’t read that that was for our own good—though I do recall an argument from some group on the right that abortion should be banned to protect women from the bad feelings they might experience after undergoing one. Sheesh.

Caroline Miller is the editor in chief of Newser. She can be reached at cmiller@newser.com.

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