Are they "Guidelines" or actually "Standard of care?"

I believe why we democrats are not speaking out against the health care bill is because we don't see the connection that you have made.  I do not agree that health care reform will give the USPSTF excessive power.  I do not agree that these recommendations are the beginning of rationing in the US of A.  I believe that these recommendations are short-sighted and I strongly believe that the release of these recommendations at this time is directly related to the health care debate even though these recommendations are not directly tied to the health care reform bills.  I am only speaking for myself but I hope I answered your question.

Colette, no matter what you put infront of some people, no matter the documents you show as proof, you can show them the bill itself, they will remain sheep going off that cliff. Because they have to protect their political stance at all costs.  Even at the expence of precious life.  They do not know how to put that aside and just do what is right.

I guess I must be the only person on the planet who thinks that it is possible that mammograms may not be the magic that we have been led to believe.

tl 

Nope, Tammy... you're not the only person.  I think there are quite a few of us who don't trust mammograms as the be-all, end-all of screening methods.  I do think the USPSTF guidelines should have been accompanied by better editorializing by that task force, to acknowledge the background of the controversy and the social impact of the change.  But that didn't happen, so the news media and blogs and discussion boards have filled in that void.

I am in near-total agreement with the points AnneW made in her post.  I, too, do not think the release of the USPSTF guidelines was politically motivated.  The timing was awful, but the review and updating of preventive-care guidelines takes place continuously.  Although the members of the task force who were responsible for the BC screening guidelines were appointed under a previous administration, appointments to committees like this are rarely influenced by traditional conservative vs. liberal political leanings.  Even if they were, there would be no way to "vet" the candidates for the committee, to be sure they had conservative, as opposed to liberal, opinions on the wide variety of topics the panel considers each year.

The timer had gone off for the BC screening guidelines -- the USPSTF had not reviewed their guidelines since 2002; so a review was overdue.  (Other agencies work on a 5-year cycle).

As for whether the USPSTF recommendations are now the "standard-of-care" for BC screening:  NO, they are not.  They are simply recommendations, released by a government-sponsored review panel that analyzed clinical research results.  Physicians' groups and professional organizations (NCCN, ASCO, ACOG, etc.) establish their own standards of care, based on consensus of the organizations or their leadership.  An example is the recent revision in the guidelines for cervical cancer screening:  http://www.acog.org/departments/dept_notice.cfm?recno=20&bulletin=5021

Or, are the gynecologists and obstetricians conspiring to deny care to women and shorten their lives, too?

otter 

What is so wrong with keeping the standards AS IS - UNTIL someone manufactures a proven-safe, cost effective, accurate diagnostic machine! HELLO! What am I missing?

If some of you want to wait until 50 - PLEEEEASE feel free to do so! I promise...I won't beg you to get a mammogram before then. Really, I  won't and nobody else will either! And guess what? Your Dr is not going to hold a gun to your head and force you have one done at 40! GEESH...

But instead...those who agree with the latest guideline recommendations think that EVERY WOMAN IN THE WHOLE FRICKIN' COUNTRY should simply shrug their shoulders and follow the herd! Talk about selfish!

It's the same clan who think that due to 15% of the population (supposedly) being uninsured, THE WHOLE FRICKIN' COUNTRY should submit to Universal Death Care. WHAT am I missing!

AGAIN - I ask you most dearest Government aka: Control Freaks...extend Medicaid to the 15%. Isn't that what Medicaid IS ALL ABOUT! It was designed for those who cannot afford health care. Seems like a no brainer to me.

BUT NOOOOOOOOOOOOOOOOOOO...that would be too easy. That would make way TOO much sense. BIG government - LITTLE BRAINS!

I've made reference to private sector companies in the past and I will again. If a successful, private sector company had a problem affecting 15% of their employees, would they OVERHAUL the ENTIRE company...NO - they would put on their thinking caps, work tirelessly, and create a solution to help the 15%.

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Collette - I could not agree with you more! And yes...high risk young women should be able to choose when they would like to have a mammo done. Is that really asking TOO MUCH! Gawd...help me!

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And BTW...when it comes to my body, I do consider myself an EXPERT. No one knows my body better than I do. I found my bc and it was verified by mammo. Every woman who thinks independently, should have the right to choose what's best for themselves. The government needs to keep their laws off of my body.

lewing wrote:

"...recommended guidelines actually say about screening is that women age 40-49 should talk things over with their doctor and do whatever they believe to be right for them"

Are you for real! Good gawd! Most women have better things to do than sit and have a cheery ol' chat/beg session with her Dr. Perhaps Drs. can start serving tea in the examining rooms. "Hello, Mrs. Smith, don't you look lovely today!...I understand you would like a mammo at the ripe ol' age of 40. Sit down my dear, let's have a cup of tea and talk this over. Mrs. Smith, do you realize how dangerous a mammo at your age is? Why, Mrs. Smith, why would you possibly think you need one? If you feel a lump, it's probably just your imagination. After all, it's very rare in a woman as young as you. Mrs. Smith, trust the latest reports. Don't read any news reports and stay away from those news stations on the television. And, by golly, don't listen to all the hog wash about women who had mammos in their 40's and tumors were found. And don't forget to keep those wandering fingers off of your breasts. (Three clicks of the Dr's tongue as he waves his pointer finger left and right) I certainly don't want you to waste your precious time my dear, doing something that won't even save your life. There, there, Mrs. Smith, don't cry...have another sip of tea, my dear. But please sip it on your way out. NURSE BRING IN THE NEXT PATIENT!"

OMG - Women shouldn't HAVE TO "talk it over" with their doctors! Dr's are being told to not waste their time talking and explaining BSE's. And you think they're going to "talk it over" about mammos or anything that's not explicit in the reform! Dr's will be afraid they will be penalized if they prescribe TOO many mammos before 50. And then all the women in this country who want a mammo at 40 will HAVE TO BEG, or fake some breast pain or cry and threaten suicide! Drs. won't have the time to "talk it over"...they will have to double their patient volume just to pay their medical office rent.

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lewing wrote: 

"In other words, what the guidelines say is EXACTLY what you seem to be recommending in your post."  

That is totally incorrect! I posted: "they should keep the standards AS IS - UNTIL someone manufactures a proven-safe, cost effective, accurate diagnostic machine!" HELLO! You must not have read this slooooowly and caaaaaarefully.

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lewing wrote: 

"(Except they say it with fewer capital letters and exclamation points.)"  

Now, now, now...sarcasm will get you no where. Remember...smarty had a party and NOBODY came!

Perhaps they should use capital letters and exclamation points, it would show a mere hint of passion in what they're recommending. Instead, they are about as passionate as a pile of boulders. But you and many others are falling head over heels into it. Better be careful about what you wish for.

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Written in the New York Times:  

The net cost of the coverage provisions would be growing at a rate of more than 8 percent per year in nominal terms between 2017 and 2019; we would anticipate a similar trend in the subsequent decade.

This is devastating. The plan was sold as a way to bend the cost curve, to reduce the rate of health care cost growth. Instead, the cost of the plan to the federal budget would rise by 8 percent a year, and there wouldn't be anything close to offsetting revenues to pay for it.

This is a loud trumpet for all health care reformers. Start over. Get serious about costs. We can either pass this kind of reform and bankrupt the country or we can pass another kind of reform.

Women with young children and grandchildren and nieces and nephews, etc...my heart goes out to you and them! They had better start saving their pennies now! Their financial future in this country is already mortgaged...just wait until then.

Colette -

"What will they do for the lumps that are then found on a mammogram in women under 50?"

They will amend the Death Care Bill, add an "E" catogory - stating that no woman under the age of 60 shall be allowed a biopsy.

Who is going to pay for all this?  Well, those of us who still have a job, will be dumped into the socialized medicine ghetto, and then we and our employers will be taxed out of business. Everything you buy, and use like your utilities, will be taxed.  It all trickles down, nothing is free, including your freedom.  Kiss it goodbye, if this health care reform bill passes the senate.

I'm with Leggy and Colette. Who is going to pay? 

These congressional bills purport to cover 30 to 45Mmm more people but at less cost. And here, one disease comes up, no "automatic" mammograms for women 40-49, but instead, decide between you and your doctor, all hell breaks looks. We can't Have That!  Mammograms for Everyone! It's your Right. Or, something. 

And so this will be at less cost? No, it won't. These health care bills, will bankrupt the US.

A mammogram caught my 2cm IDC, ER+/PR+, HER- cancer.  When I was 52. Although, actually, I really had the cancer 4 years earlier, when I had a false negative biopsy. It took 4 years to grow to 2cm. Which is less than 1 inch, BTW. 

Yet, the real problem that I see with all of these earlier mammograms, especially the digital ones, they just find the tiniest of cancers. Like a 2mm DCIS. And then, they just treat the hell out of it. And the women, all go along. They even have, mastectomies. When it would never have even been a problem.

And this all costs, $$$$. 

I just read a "Letter to the Editor"  in my local newspaper, today. Against the new guidelines. Signed by all of the Breast Cancer Treatment Centers in Seattle. 

Of course, they're against the new guidelines. The current guidelines guarantee 2mm DCIS women having Whole Breast Radiation, for $45,000. Feeds their bottom line. 

I didn't have any radiation for my 2cm IDC. Blew it off. 3.5 years later, no cancer recurrence. I still have my breasts. Blew off all of that other shit, too, the Tamoxifen. 

I don't know why women just don't listen, to themselves.  

I guess what I'm confused about is this:

 IF 50% (or so) of women under age 50 have breasts that are too dense to be properly mammogrammed and 30% (or so) of women over age 50 have breasts that are too dense to be properly mammogrammed...why are we mammogramming THEM?

I am looking for a better tool.  I don't want to use the same old tool that doesn't work...or at least didn't work for me.

 I have a BEAUTIFUL mammogram.  Diagnostic!  According to it, I don't have cancer and I have NEVER had cancer...taken with my Stage 3C cancer wrapped around my chest wall.

I didn't have a lump.  I had excrutiating pain in my shoulder and went to the doctor and told him emphatically that I think I tore my rotator cuff! 

That wasn't it...not by a long shot.

tl 

When I read articles like this, I am very confused...exactly what are the facts?

tl

 Won't let me paste.

Says that

Doctor Berry and his collegues found absolutely no difference in the death rates among women given mammograms no different from women not given mammograms (in a study of 150,000 women...singling out those who eventually developed cancer.) 

 Title of article:

Mammography detected cancers both good and bad news    Healthfacts September 2005

tl 

Colette wrote: What I would like to know, is how you can stand behind a bill that will KNOWINGLY be killing fellow breast cancer victims?

I just happen to think that health insurance reform (which should be the title, not health care reform) will actually save lives, because more women will be able to get basic screening and biopsies, etc that those of us with good insurance take for granted.

Our health care is woefully rationed as it is right now.

Anne

TammyLou - Haven't you read over and over again here, that mammos DID work for many women! The BIG GOVERNMENT/CONTROL FREAKS need to prove that they can effectively "run" the existing government controlled agencies before they TAKE OVER our nation's health care. Not to mention dictating that women shouldn't do BSE's and not have mammos until 50. Since when is the practice of rewarding bad behavior acceptable.

It's really very plain and simple: keep the standards AS IS - UNTIL someone manufactures a proven-safe, cost effective, accurate diagnostic machine! HELLO!

If some of you want to wait until 50 - PLEEEEASE feel free to do so! I promise...I won't beg you to get a mammogram before then. Really, I won't and nobody else will either! And guess what? Your Dr is not going to hold a gun to your head and force you have one done at 40! GEESH...