Health Reform Bill – Mammo Guidelines NOT “JUST Guidelines” –
Well... here it is. If anyone thought the mamo guidelines were "just guidelines" - "just suggestions"... I present, part of page 17 of this 2,000+ page H.R. 3590 / Senate "To Amend The Internal Revinue Code of 1986" bill they are trying to pass.. I see a bait and switch now.
I read "in the current recommendations of USPS TASK FORCE"... to be, if insurance companies are within the task-force guidelines, they don't have to pay.... am I wrong? Is this not how it reads?!?!?!? This is only page 17. I haven't read the other 2,000 pages yet! I was too enraged to go on!
Does this not show, they will no longer accept 'self examination' (and possibly doctor examination) as a plausible reason to pursue a mammogram before 50? Since their new recommendations are SBE are NO GOOD DON'T DO THEM...
Merely the beginning of their HELL CARE REFORM
Comments
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Yes. That is how it reads to me. I knew there was something up with the "big" change and bringing in these "experts" to reveal this new big "news". It is all part of the plan. They cannot roll back expenses/coverage unless they drum up some "scientific" information to back their argument. BUNK!!! We are smarter than that!!! We have survived this breast cancer nightmare because many of us were able to get the mammogram in time to detect and fight this monster. If I had to wait to 50 - well I would not have survived and would have left a small child behind. Mine was detected at age 39 with a mammogram. It would have not been detected by any other means! Mammograms save lives!!! I think the baseline mammogram should be done younger than 40. I have met several 30 somethings with BC. Why don't the people recommending these changes interview the children and families of these women and see if they believe it is still a good idea? If they impose this on us then there will be families missing mothers, daughters, aunts and nieces. Is it worth it? Also, if you can get the BC detected EARLY your treatment options are better. This recommendation just doesn't make sense to me.
- Jennifer
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I agree with you Jennifer, this is absolutely insane! And this is the wake up call. It's not just a 'suggestion' anymore. We all have a name. We all have a face. I will fight for my daguhter. Our daughters, nices, cousins, aunts, future mothers.... and every female under 50!
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LIttle C .. which healthcare bill is this in?
Did you read anywhere if the "guidelines" will be enforced by Medicaid and Medicare?
Most of the women in my area are poor and are screened by the Breast and Cervical Cancer Screening program, which is state administered and funded by the CDC.
Thanks,
Bren
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Wow.
Here is what I'm dealing with right now. Our local government is in charge of the H1N1 shot. They have not released it to doctors. They have not released it to stores or schools, like much of the rest of the country. Only the government can give it out. So, they have set up dsisngated health clinics in homeless shelters and community centers on specific dates around metropolitian area - a large area. I am supposed to get my shot two weeks before chemo - which is in 11 days. I was going to go to a clinic tomorrow near me. The only one nearby, I might add.
The government cancelled it, due to rain. In the first place, there is no rain in the forecast for tomorrow. However they said that they didn't want people to slip on wet sidewalks, and that is a direct quote. They are also worried about parking. So, I cannot get H1N! in a timely manner because the government has decided that people are not capable of standing in the rain. On a personal level, if I can't get the shot, I can't go back to work as I work in a school.
Now, I should add that they don't cancel professional basketball games, concerts, black friday or any other event because of rain. So, why this?
I see a correlation between that thougth and this healthcare bill. They are rationing these shots and they will be rationing mammograms, cervical exams, and many other tests. The only people who should decide what your healthcare needs are is your doctor and you.
I have urged women to lie to their doctors and say they have a family history of breast cancer, even if they don't. That will override the recommendation - if and when it is ever implemented.
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This is very sad. -
Bren, This is in the H.R. 3590 / Senate "To Amend The Internal Revinue Code of 1986" it is a 2,074 page document. (I freaked on page 17 - continues on page 18 to describe following "guidelines" AND "suggestions" - have a lot to read yet.) I have not read medicaid and medicare yet, but I'm sure those will also have to follow "guidelines" as well.
Anyone who wants a copy of this entire bill amendment what ever you want to call it, in computer file, PM your e-mail address to me. (it is a 2.51MB Adobe Acrobat file)
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Cool Breeze - ya know I keep telling my self "I'm not surprised" by anything the government tries to pull, but not standing in the rain... what an excuse. Thing about the gov't now is, they SOUND stupid. They can't even be "over intelligent" trying to fool us. (prayers to you during your treatment)
Anyone who wants a copy of this entire bill amendment what ever you want to call it, in computer file, PM your e-mail address to me. (it is a 2.51MB Adobe Acrobat file)
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HI all,
I heard on the news this morning that they are also changing the guidelines for pap smears. Instead of screening beginning at age 18 and then annually, they are changing to 1st pap smear at age 21 and then every two to three years!
How many women are we going to loose to female cancers??
http://www.msnbc.msn.com/id/34046944/ns/health-womens_health/
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Maybe I'm too doped up on meds right now, but the quote reads to me like the insurer is required to cover it without expecting a co-pay.
It states that they shall not impose any cost-sharing requirements.
Again, maybe it's the meds and I'm not reading it correctly.
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Marie317 - yes you are correct, the other half of that is AS LONG AS IT IS EVIDENCE BASED -WITH IN THE TASK FORCE GUIDELINES (so if you are 50, you have no need for a mammogram and a finding a lump through self breast exams (which they now laugh at) is no longer considered evidence to get one.)
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Jean09 - yes, now you won't get a pap after 30 yrs. old except for every 3 years. Cancer can appear and kill you quite easily with in that time.
Anyone notice how they are trying to hurry up and change a bunch of guidlines so they will be "current guidlines" by the time this HELL CARE is passed?
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II am so mad I cant see straight. I am so worried for my two daughters. I blame all these changes on the insurance companies. They see the health care reform coming and are manipulating the system so they can still operate with BIG PROFITS. I do believe everyone should have access to health care, but not at the expense of killing people!
This is GENOCIDE of women!
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My insurance (Blue Cross) has NEVER covered mammograms. In 2005 when I racked up almost $80,000 in medical expenses for my breast cancer treatment--they paid for all of it, after the deductible, except for--you got it--the mammogram which discovered the breast cancer. That is considered preventive, and they do not cover it.
I do not understand the hysteria here.
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I have Blue Cross and they have covered my mammograms.
In fact, I got a "baseline" at age 35. Guess that isn't done anymore. -
Kate - I also have Blue Cross - they paid for my mammograms, biopsies, paps, everything. They paid for my $1500 wig and approved it even though the place was not part of the plan. I've not had one problem with them. But I also have a premium plan. Sometimes, if you don't sign the paper saying "yes, I had this test done" and send it back to them, they don't pay for things. Sometimes you have to make sure you jump through all of their hoops, and when I do, they pay out.
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I have Blue Cross also and they have paid for everything, mamograms & pap smears (to datethey have paid, who knows....sounds like that is going to change!). Maybe Kate's plan doesnt cover preventative care, only existing conditions....
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With BC/BS it depends on your individual policy (or company policy) as to what is or isn't paid. My BC/BS would only pay for one mammogram every physical 12 months until it changed 2 yrs ago (after my dx) to once every calendar year. I started having problems 4 yrs ago requiring monitoring digital mammos every 6 months and you guessed it, it wouldn't pay for any because they were closer than 12 months.
Sheila
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I do not believe the AHRQ arm of the US Government and USPTF are not connected by an umbilicus.
However, please do look at the "ratings" part of the OP, as defined by AHRQ:
http://www.ahrq.gov/clinic/uspstf/gradespost.htm#crec
The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms.
Grade: C recommendation.
The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
Grade: B recommendation -
THANKS TenderMight !
- I hadn't even gotten that far.... This seems to confirm insurance no longer has to pay for under 50. Because it only covers A and B.
"C = Offer or provide this service only if other considerations support the offering or providing the service in an individual patient."
((C = under 50 ....so insurance companies no longer have to pay?))We know they said self breast exams are an absolute joke to them. So, WHAT kind of "Evidence" could possibly be provided now to warrant a mammogram? The Mammogram was the evidence leading to biopsy for so many who never felt a lump etc...
Us big breasted and/or dense tissue women can't tell the difference in lumps. we need that mammo. But they don't care.
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I don't know how anyone can think this is fear based. The proof is in the pudding.
It's based on track record not fear.
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Won't they still cover diagnostic mammos? Surely they will, they're "just" not pay for the screening ones.
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Technically, diagnostic mammos wouldn't be affected... except that it's hard enough in the U.S. to get most run-of-the-mill doctors to believe a younger woman "really" needs a diagnostic mammo, and I'm afraid these new guidelines will just encourage that bad attitude...
However, doesn't the "C" about not screening women under 50 mean the evidence to support NOT screening is weak ? Kind of a double negative. Anyway, I'm writing all my reps asking for a new panel, because there is really "A" level evidence that annual screening of women 39-49 saves 1,200 lives per year...
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Two things 'bother' me about the publication of these 'guidelines'? One is: WHERE on earth can one fine the 'press release' and complete info on this 'study'? and Second: Who on earth was on this 'panel of experts'? These seem to be the two best kept secrets on earth!
Only one panel participant has been interviewed on any news channel...and that was the head of a Nursing School! Kind of makes me suspicious. Further? Having worked w/government grants and panels [who make grant AND policy decisions] It is quite possible THAT the wheels for this 'group' were set in motion by a prior administration - thus the folks on that 'panel' were specifically chosen to meet a particular 'agenda'. Then, Simply because it's not easy to get even four people, let alone a dozen or more [who knows?] together on any given date to debate and/or decide anything! Truly it's easier to herd cats! I've done both? I'd rather herd cats.
Further? How much does anyone want to bet that 'this' whatever it is...will give insurance companies that 'out' they want to change policies NOW for next year. Whether or not any Fed health bill is or isn't passed. Just look at the credit card businesses...they're rushing like crazy to 'beat their deadlines'! Need I say more?
I truly wish that it were different? But look at what the medical, pharma and other special interest lobbies are spending to 'get things' their way.. with out any shred of recourse in the long run.
Now if any one person can cite me the gummint agency that assembled this 'panel'? I sure would be grateful so I can actually see what their task was, then who decided what, and why. There is something soo off-kilter about this whole thing that is making me very suspicious about the timing of the report and the fact that real SOURCE documents and participants and their credentials are seemingly being kept hidden.
Lastly? Guidlines are just that! GUIDLINES. They can be ignored or considered or taken to heart. To learn that some few of the medical community have done a 180 degree turn on this is really puzzling. Let me know? I'll cut thru the 'gov speak' and get to the facts... Silly this all.
WE ARE ALIVE AND STILL KICKING STUFF!
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This is far from silly. I don't really care who started what or did what to whom, pointing fingers and blaming any particular president is a waste of time, what I want to do is STOP THIS before our daughters contract a serious disease and it has gotten so out of control before they are allowed to be screened. Which is why I posted part of the bill... Anyone who thinks this is not going to affect them (maybe it won't good for you!) anyone who thinks it won't negativly impact anyone's health in the future, I ask you to read HR3590 yourself instead of relying on anyone's word before you tell people it's hogwash.
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Little C's original post copies the language on preventive screening from the just released Senate Health Care Bill H.R. 3590.
Yes, Ann, a "C" recommendation is per the Senate Bill not high enough to reach their threshold, you'd need an "'A" or "'B". However the words "must have in effect an A or B rating" make me pause a tad too.
Since the USPSTF rating on mammograms for 40 to 50 years is a "C" recommendation, it should be insufficient for it to theoretically meet the standard described in Senate Bill 3590. However the USPSTF's recommendation for every 2 years for 50 to 79 years is a "B" recommendation, so that seems to meet the Senate HR 3590 criteria. Let's keep in mind too, that a merger of bills will have to occur between the House and Senate for finalization, before submission to the President so these recommendations might ultimately require an "A" (especially in light of this uproar).
Let's not loose sight of what many of us find upsetting: the publication of the United States Prevention Task Force's mammogram recommendations almost in tandem with the Senate's Health Bill, which Little C was kind enough to note, writes regulations on what "shall be provided" under preventive health for mammogram screening. The words "shall be" mean legally enforcable upon insurers. Of course, I don't know what the House Bill states on this matter.
What is the likelihood of two written government-associated publications on screening mammograms occurring within a week of one another? Those are dice you'd like to play with in Vegas. I'm really not making light here, it's flabbergasting to me how patently obvious this is, and I totally disagree that the AHRQ is not similarly linked to the USPSTF's writings through its sponsorship and direction of same. AHRQ didn't write the USPSTF's guidelines, but they didn't stop their production or put them out for comment before their publication either. Seems to me like an act of omission as well as some commission. I'm hoping this was just a big snafu on the part of AHRQ, but truly, a case can be made that it is not and they are outed.
If you look deeper, you should be able to find out how the task force was selected, but you may never know if an oncologist, a radiologist, and a breast surgeon or two were a) invited or b) not asked back because of their difference with the desired mammogram path on "efficiency".
I am a pragmatist by nature, not conspiratorial. This is difficult to cast aside...
Tender
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Homeagain,
The US Preventive Services Task Force guidelines were published this week in Annals of Internal Medicine, along with two papers that were the basis for the guidelines.
Here are the titles, and if you click on each title, a link should take you to the actual paper itself:
1) Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement
2) Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force
In another thread, I posted lists of (again, these should be links that you can click):
1) the members of the Task Force in 2008 who wrote the recommendations
2) the authors of the literature "update"
3) the authors of the "Model Estimates of Potential Benefits and Harms"
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Tender, I agree that the "B" rating for mammograms only every other year means, according to the language in the Senate bill Little C linked to, that insurance companies will only be required to pay in full for screening mammos every two years only from age 50 to 75. Completely horrible.
And it is mindboggling that these things all came out at the same time. My personal feeling is that it reflects incredible ineptitude and cluelessness in the AHRQ and DHHS... Which is a horrible thing when we're talking about people's lives...
Because the release at this time certainly doesn't help the case for healthcare reform! But I don't agree with some on the left who think it was deliberately released at this time to sabotage healthcare reform...
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"Testing the water" is a phrase often used in political strategy, and the current administration has been referenced as using this technique. It allows a new platform or program to be made public, for our digestion, at the same time allows gaging of our reaction by them, as well as getting the public to recognize sooner than later that different days lie ahead.
I have no idea if this was a goal in the USPSTF (un)timely (?) guideline publication on screening mammograms. But regardless, it is having the effect of "testing the water".
My best to you all,
Tender
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Carol, I KNEW that they were up to no good because the "Task Force" recommendations that the first year GYN told me when I was 35 that I needed to start having a mammogram when I was 40, even though I REQUESTED one and pointed out that my mother had breast cancer at a young age. I am now 37 with 3b cancer that would have been caught had she listened to my request 2 years ago. I had a 10 cm cancer which would have took between 4 to 6 years to get the size!
I agree we as a nation has to stop this BS and those who think that the government is out for their own good with this "Health Care"...well, let me as you how it has worked out with Social Security? The government dips into it at will and then screams how it is going broke.
Either you are with your sisters standing up against the government trying to prevent them hurting those we love with backtracking cancer diagnosis and care, or you are with the government in this atrocity which will kill those you love..since those who have relatives who have cancer are the most at risk for cancer.
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