SBE....Sooo what happens when

Colette37

Laura....that is exactly my question to Anne also.

This bill and how much power it gives the USPSTF and these changes is scary.  Any woman who knows the terror of Breast Cancer should be up in arms against what is happening.  They should be giving MORE tools for detecting cancers not taking them away from our sons and daughters like this!

This is what I see eventually happening..The insurances will stop all mammograms on women under 50..even if there is a lump that is felt.  Our future Doctors will be taught in school that you need to follow what the insurance/government will cover and you will get bonuses for the fewer people whom are diagnosed under you who are seriously sick with things like cancer...this will lead to more Dr. not listening to their patients and giving more excuses of why not to preform diagnostic testing, including biopsies.  This all will mean that cancer care will only be given to the rich and the rest of us will be under a panel to decide our care.  No longer will it be between Dr. and their patients..the government will then be in the middle.  Then the government will plead ignorance and say that there is no money to pay for the testing...all the while the government itself will continue to have raises and their own private insurance paid via the tax payers, while the working middle class slowly dies from lack of health care to EVERYONE...not just the people who are poor, who already have medicaid right now.  The Dr. will be protected because they will be government employees and everyone knows how hard it is to sue the government!  They will be given a "Free" card time and time again.

The above scenario is just my opinion, but it is definitely closer to truth than what you are getting from any of the politicians right now!

AnneW

My fervent hope is that women will get good advice from their health care providers about examing their breasts. But I don't think most women DON'T touch or feel their breasts. And in feeling a lump, will get it checked out.

It takes years to get new messages out, to change old ways of thinking, to develop new paradigms. For the general public as well as health care providers. I hope there will be enough advocates to reach the media and the companies/groups with the big bucks who shape the way we think...advocates who are objective enough to hear both sides of the issue and begin to formulate a new plan.

It's in the works at the ASCO conference in December. There's a scheduled panel discussion on this very issue, and I know two of the panel members. They take this very seriously--how to get the message out, and just what exactly the message should be.

Anne

Anonymous

"fervent hope"...No offense Anne, but that puts us back many, many years. I simply refuse to accept those words when it pertains to my health care. Hope is a good thing, after all else has failed. Quite frankly, I really don't care what the panel's message will be. It is totally absurd for a group of Drs to decide whether BSE's should or should not be performed. What goes on in women's bathrooms or showers, etc. is not their business. Perhaps mirrors should be outlawed. Many skin cancers are found by way of a mirror. Next recommendation will be to stop looking at your body. Finding skin cancer early doesn't save lives.

AnneW

I totally disagree with you, Linda. Doctors will never tell women to stop examining their breasts. Or their skin.  

Anne

Colette37

"I totally disagree with you, Linda. Doctors will never tell women to stop examining their breasts. Or their skin."

AnneW...Hate to break it to you, but this USPSTF panel of Doctors already has done exactly that.

Joviangeldeb

The thing that scares me is insurance companies will start to follow this new government guidelines.  I know, because I work everyday billing insurance claims and filing pre-estimates/approval for peoples upcoming treatments..  Insurance companies will grab these new government guidelines and run with it.  they will come up with any excuse NOT to pay a claim or approve treatment.  They're in the business to make money, period. They've got it down to a science, so to speak.  Insurance companies deny claims or pre-treatment estimates alot for bogus reasons because they are aware a percentage of people will not bother to investigate or fight their refusal.  some patients will go ahead and pay for the service and never question the claim or denial.  Next, insurance companies will ask for 'further' information from either the patient or the doctor's office, knowing another percentage of patients will not follow up on that, so the insurance has gotten out of paying another percentage of claims or processing pre-treatment estimates.    

On a whole, we might not see insurance companies cease paying for mammograms, biopsies, etc now, under age 50, right away,   but we should start seeing changes in insurance policies come 1/1/10. It may not be all of them, but some companies will begin disallowing mammograms until age 50.  Other's will allow it if a patient has a symptom or strong family history, but it will need to be approved first.  This could take precious time.  They'll send you and your doctor's request for testing to a 'review board' they have on their staff.  The review board may or may not approve the treatment.  Then you have to appeal it.  It the mean time, the cancer is still in the patient, growing. 

I know.  I see this every single day at my job. I may not be filing claims on mammograms, but I see insurance review boards deny proposed treatment on other kinds of procedures, where I work. 

Like my oncologist told my local newspaper in an interview, 'these new guideline will lessen the # of lives saved.'

This will deter many women from having routine mammograms prior to age 50, if their insurance does not pay for it, and that's a shame.  We are going backward, not forward.  The government should be focusing on making mammograms more available to women. 

this is just my two cents worth, but I had to get it off my chest. Pardon the pun.

Deb 

mlrbelle

I must say (as someone diagnosed at 35 and was told even with a family history that I had plenty of time to screen even though my mom and great-grandmother had BC and I have a family history of prostate and colon cancers), I've already told my under 40 cousins and my 25 yr old sister to claim they have found a small lump and have been having some pain - whatever it takes to get someone to screen them!  My lump was huge by the time we even felt it and was likely there for many years.  I don't want my sister to find herself in the same situation, or even worse if they make her wait even longer.

I agree with many that this is just the beginning of rationed treatment by government mandate (which is even worse than what the insurance companies have been doing).

BTW - love the anti-anxiety meds comments!  But I also agree that they won't approve them - my surgeon was loathe to prescribe me the 5 pills (5!!!) of Valium I requested, after being diagnosed as possible Stage II with 2 young daughters, for my MRI.  I did fight for it thoug!

Anonymous

The rationing has already begun. I thought that Sebelius said they were not going to enforce the new guidelines. Although this might be a state by state situation. Regardless...it's not right.

If women are being turned away at these clinics...what happened to women under 50 being able to "discuss the option with their doctors"? These women are falling through the cracks. It's a disgrace.

Poor Women Turned Away From Free Cancer Screenings  

ALBANY, N.Y. - As the economy falters and more people go without health insurance, low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society's Cancer Action Network.

In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears. Just how many are turned away isn't known; in some cases, the women are screened through other programs or referred to different providers.

"I cried and I panicked," said Erin LaBarge, 47. This would have been her third straight year receiving a free mammogram through the screening program in St. Lawrence County. But the Norwood, N.Y., resident was told she couldn't get her free mammogram this year because there isn't enough money and she's not old enough.

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50...

mlrbelle

Yeah, I'm not sure if it's official yet, but it's my understanding that here in California, they are already changing the rules for the free/assisted screening offered for women as far as BC is concerned.  I have repeatedly told family and friends that I'm so thankful I was able to find this before all this started and before health care reform.  Now, I'm just scared for others, especially my daughters - although I'm hoping like heck that things have been scrapped and taken care of by the time they would be affected ...

Anonymous

I just sent Kathy Sebelius a fax - asking why this is happening. Her press release - after the new guideline report aired, clearly states that the HHS's policy would not change based on the report.  

lewing

This is not about "enforcing" the new guidelines, and it has nothing to do with health care reform.  It has to do with the dire budgetary situation in many states, brought on by plummeting state revenues.  If we're concerned about cuts in health care services for poor women, then we need to be advocating for new sources of revenue (or suggesting other programs to cut - higher education? K-12? long term care? corrections?). 

The reason we need publicly-funded screening programs in the first place is because so many women are uninsured (or have crappy insurance) under our existing system. 

Linda

AnneW

Thank you, Linda.

iodine

Yep, Pittsburg is considering taxing college tuition to raise money for the city.  Now isn't that just what a college kid working her way thru school wants to hear? Or, her parents?  and get this, it's to pay for the retirement benefits of city employees.

Anonymous

Linda - You obviously didn't read word for word what was in my post.

"resident was told she couldn't get her free mammogram this year  because there isn't enough money and she's not old enough."

Enforcement of the budget cuts AND the new guidelines are to blame.

And...this thread is about the new guidelines not healthcare...let's stick to the topic. Thanks!

----------------------------------------------

Iodine - I thought the new admin was ALL ABOUT education! Taxing college kids is a real good way to promote education! GEESH! The next thing we'll hear is that we'll be taxed every time we sneeze! Cha-ching!

lewing

Laura, trust me: I did read your post word for word. 

I'm at a loss as to how you can loftily accuse me of being "off topic" (even though I was responding directly to previous posts, including yours) and then shift to the topic of taxing college kids (which you erroneously link to the Obama administration). 

I guess in your mind, it's never "off topic" to bash the President.

Sheesh.

Anonymous

Linda - Trust me...the new taxes are being created to fund the proposed HC takeover.

--------------------------------------------------------------

New mammography guidelines continue to spark debate

BY SUSAN MCCLURE | DECEMBER 12, 2009

The American Association for Cancer Research (AACR) released a response to the new guidelines which stated that they recognize that these are complex issues that encompass a broad range of areas - medical, scientific, public health, economic and sociological - and that the interpretation of these data can result in legitimate disagreement among respected leaders in their fields. Decisions on the delivery of screening methods and treatment of cancer should be evidence based and that the "state of the art" in the field is evolving and will continue to change as our understanding of the biology and genetics of cancer is better understood. They also recognized that mortality rates from breast cancer have been falling since the mid-1990, and they believe that this is attributable at least in part to the more widespread utilization of mammography screening and other factors. Their statement concluded by saying that the issues are simply too complex to make a clear statement at this time supporting either the existing guidelines or those proposed by the USPTF.

To me, that response equates to issuing a "no comment."

The Breast Cancer Network of Strength took a much more definitive stance. Margaret Kirk, the foundation's President and CEO said, "We know that earlier diagnosis and treatment of breast cancer leads to better outcomes. As an organization that hears from tens of thousands of women through our 24/7 YourShoes support center, we would be disappointed if this new recommendation became yet another barrier that women will have to overcome to get the care they need."

http://www.curetoday.com/index.cfm/fuseaction/blog.showIndex/susanmcclure/2009/12/12/Debate-over-new-mammography-guidelines-continues-to-spark-debate

lewing

Laura - trust me.  The proposed tax iodine was referring to was a municipal tax, and has nothing whatsoever to do with national health care reform. 

Was it GWB who said, "facts are stupid things"? 

(Edited to add: that line was actually from Ronald Reagan.  I'm getting my Republican presidents mixed up.)

Anonymous

Trust me...Municipal taxes will increase to offset the reduction of federal funds to the states. Was it BO who said, "I've visited all 57 states!". Those darned facts!

-------------------------------------------------------

I have my annual GYN appt at the end of this month. I am curious as to what my GYN's opinion is pertaining to this topic.

Bren-2007

The Breast and Cervical Screening program is funded by the CDC.  Each state is awarded a piece of the pie.  You can see how the money was allocated state by state on the CDC website.  It shows the 2009 budget and the 2010 budget.  The states are given the money by the CDC, the state then must work within the funds given to them.

In the Commonwealth of VA, screening begins at age 40.  Women between the ages of 18 and 39 are also eligible to be screened if they find a lump or something else suspicious.  Because there is such a disparity of wealth in our state (northern part well off ... southern part unemployment off the charts and vast amount uninsured or underinsured), our state has maintained the 40 year-old screening criteria.

Our municipal (local) taxes have nothing whatsoever to do with funding from the CDC.

I have discussed this with my doctors ... they are against the new recommendations and will ignore them for their private patients.

This is a financial issue based on the amount of funding each state receives from the CDC.  In my state, screening includes mammogram, pap test and STD screening and prevention. 

If either breast or cervical cancer is found, the state administered medicaid program kicks in to pay for further tests and tx.

You can also visit the CDC website for info in your particular state for statistics by age, race, dx and further treatment.  The budgets for each state are listed and specifically where the funds were spent.

Bren

http://www.cdc.gov/cancer/nbccedp/data/summaries/illinois.htm

mlrbelle

Yep - municipal, county, state taxes will all increase!  One of the ways they are trying to make this new HC seem "free" and rush it past people is to make a lot of the benefits and mandates the responsibility of the states.  Which means that the states are going to have to pay for it - guess where that $$ is going to come from? 

These new guidelines, along with whatever else they manage to get in under the wire, are specifically made part of the bill.  Even if it's not a requirement per se, any administrative bean counter worth his/her salt (no matter who they answer to) is going to jump on that and use it as a rationale to deny the procedure in order to save $$.

Sorry if I seem bitter, but we here in California have really been getting the shaft already in the way of taxes and government taking, taking, taking.  This new HC bill just seems to be shaping up to make it even worse.

And I do agree we need to fix things.  I just don't agree that government taking control (either openly or covertly) is going to accomplish what we need.  The government does not have the track record ...

Anonymous

mlrbelle - Exactly!

Bren-2007

Perhaps some of the issues in California (I'm a native Californian) and other states that are raising the age level of free (CDC funded) screening should bring this up locally within their state government, as the states are the ones who request specific funding from the CDC. 

California has been a mess for a very long time ... maybe a change in government at the state and local levels would be an option for improvement. 

I'm just wondering if the problems are more at a state level .. so, blaming the problems of the individual states on our President seems ... well, out a little out of reach.

For many, the problems of the individual states are being attributed to big government, when in my opinion, the problem appears to be at a local and state level.

Our President did not create the financial problems in California.  Why not look to the governor, state senate and local legislators for some of the answers.

The states need to start taking responsibility for their internal problems.