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TUESDAY, FEBRUARY 9, 2010
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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.

8 comments
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lauriec
Nov 18, 09 3:44 PM CST
Couldnt agree more!!!! who do they think they're fooling? NOT us!!! speaking for everywoman over 40 in America.. Reply
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BleeBloo
Nov 18, 09 4:39 PM CST
I'm so furious about the Stupak amendment. Preventing even private insurers from covering abortion? Really? Because the majority of women getting abortions already have children to feed and clothe and house. It's not just going to prevent women from having abortions; it's going to stretch those families further, since no plan is going to cover 100% of prenatal care either. So either scrape together $500-$1000, or be bled slowly by prenatal care! Because women's bodies don't matter, and poor women's bodies REALLY don't matter. Reply
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MrsK
Nov 19, 09 11:50 AM CST
Or use birth control and stop expecting the taxpayer to pay for your sexual escapades.
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fancygapva
Nov 19, 09 3:20 PM CST
You know, I'm pro choice, or I was, until so many elections were lost on that single issue that it finally ended us up on a stupid "regime-changing," WMD seeking war of choice that has cost this country and Iraq too much in blood and treasure--and NOW this single selfish issue is about to cost us universal health care. I'm sick of the whole stupid argument about a woman's right to choose. Birth control is a lot better than it was at the time of Roe V Wade. Adoption is an option. I don't believe we ought to have bad politicians and bad laws because some women insist on having the government pay for abortion and others insist it's baby murder. There are more important issues and I'm really tired of this one. I'm just as sick of Planned Parenthood as I am of holy roller fundamentalists who would impose their will on others.
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BleeBloo
Nov 20, 09 1:16 PM CST
MrsK, are you really that out of touch? Kindly do some research or shut your mouth. And fancygapva, I'm appalled that you are so willing to concede this essential right. Look up birth mother stories; from those who have done both, adoption has caused MUCH more pain that abortion. All of our environmental issues are solved by curbing overpopulation. And babies born disabled, or to a mother of color, are not NEARLY so adoptable as perfect white babies. Is there misery an acceptable compromise just to keep the conservative and misogynistic happy?
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fancygapva
Nov 18, 09 9:57 PM CST
And if we all get our mammys grammed we'll live forever, right? The debate about breast density and mammograms for women between 40 and 50 had been going on since I was between 40 and 50 and I'm 67 now. The panel is not making government policy it is framing best practices guidelines and has been doing so on many subjects for quite sometime. It is coincident with the Health Insurance Care bill in congress. It is not dependent on the bill nor is the bill policy dependent on it. Reply
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Reader83547816
Nov 20, 09 9:32 AM CST
Le Sigh. If you WANT more mammograms, you can, you know, elect for them, if you want. The government is simply choosing to no longer tell every woman in the country YOU ARE GOING TO GET BREAST CANCER IF YOU DON'T PAY FOR UNNECESSARY MEDICAL PROCEDURES. That's what anyone gets for listening to the government for medical advice. Seriously, people. Know your bodies and stop letting The Man tell you what to do with them. Mammogram? No Mammogram? That's between you and your doctor, not some distant Board. Reply
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Rocket448
Nov 22, 09 8:50 PM CST
Exactly so, 7816. A recommendation is not a rule, and as I understand it the new recommendation seems sensible. For women with a family history of breast cancer, of course early detection and treatment if necessary is preferred. So, women have been screened mostly unnecessarily til now? Oh, well.
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