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NPR Helps Set Stage for Health Care Rationing

Posted on November 20 2009 8:59 am
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This week, as we near the controversial health care debate to take place tomorrow in Congress, National Public Radio aired stories on two controversial studies that put forth new guidelines reducing screening recommendations for two forms of cancer frequently diagnosed in women.

They were just the two latest reports, in a series of stories aired over the past few months by the government-subsidized radio network, on new federal guidelines calling for decreased preventive and early-detection screening of several diseases that affect a wide range of the American population – the elderly, men, women, teens and newborns.

According to the most recent report on NPR, new guidelines from the American College of Obstetricians and Gynecologists call for women to get Pap smears every two years, between the ages of 21 and 29. Previous guidelines called for annual pap smears every year for three years after the start of sexual activity, or 21 years of age, followed by one every three years if all three previous exams were normal. Pap smears have been very effective in the early detection of cervical cancer, a growing problem for young women.

The ACOG’s new guidelines come just days after new screening guidelines for breast cancer were announced to much public fury, and the day before Congress begins debate on the health care reform bill.

“It’s just pure coincidence that these guidelines have been released now,” says Dr. David Soper, the Chairman of ACOG’s Gynecology Practice Bulletin Committee.

The new mammography guidelines established by the U.S. Preventive Services Task Force call for women, ages 50 and older, to have mammograms once every two years, as opposed to previous guidelines that recommend women 40 and older get annual mammograms.

The USPSTF, a group of experts convened by the Department of Health & Human Services, led by Kathleen Sebelius, is taking a lot of heat from women’s advocacy groups and physicians. But, in their coverage of the debate, NPR chose to talk first to a physician who said of the new guidelines, “It’s about time!”

“I was never convinced that mammography screening worked that well in younger women,” Dr. Susan Love said in support of the government-backed guidelines in an interview with NPR.

The American Cancer Society disagrees with the conclusions of the White House-convened USPSTF, and released a statement the same day the new government guidelines were released.

“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider. When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions.”

— statement from Otis W. Brawley, M.D., chief medical officer, American Cancer Society

The American College of Surgeons followed with a press release supporting the American Cancer Society’s position on the new guidelines.

“The College is supporting the ACS guidelines despite the recommendations from the U.S. Preventive Services Task Force stating the women should have regular mammograms once every two years beginning at the age of 50. The College believes the ACS guidelines have resulted in an effective approach toward dealing with the possibility of breast cancer and that women should continue to follow them in consultation with their physicians.”

— American College of Surgeons

The National Medical Association was also quick to react to the government-backed guidelines of the USPSTF, issuing a press release to caution women about the potential harm.

“The NMA is concerned about the USPSTF recommendations that women have routine mammography screenings beginning at age 50 instead of 40. The new recommendations could have serious implications for African American women since studies have shown that African American women develop breast cancer at an earlier age, are often diagnosed at a later stage of the disease, and develop more aggressive types of breast cancer. The USPSTF recommendations could result in even higher death rates for this disease and further exacerbate the challenges for the uninsured and the under insured.”

— National Medical Association

Women are not the only ones to have their health and wellbeing subjected to new screening guidelines. In the Nov. 11th issue, the Journal of the American Medical Association noted a disparity between recommendations of the USPSTF and those of the Centers for Disease Control and Prevention for screening for the hepatitis B virus.

According to the JAMA report, “More than 500 million persons worldwide are infected with hepatitis B or C virus, estimates the World Health Organization, and more than 5 million US residents have such infections, according to the U.S. Centers for Disease Control and Prevention (CDC). Yet these infections often go undetected and untreated because patients and physicians may be unaware of who is at risk or may fail to pursue testing.

“Although prevention efforts have helped dramatically reduce the incidence of hepatitis B and C viral infections in the general U.S. population, demographic shifts are leading to growing numbers of chronically infected patients who may develop severe complications such as cirrhosis and hepatic cell carcinoma.”

Despite these alarming facts, the USPSTF still “recommended against routine screening for HCV infection in asymptomatic adults who do not have risk factors and found insufficient evidence to recommend for or against routine screening in those at risk. The task force also recommended against routine screening of asymptomatic individuals for HBV.”

The list of USPSTF-recommended cutbacks in preventive and early-detection screening goes on:

  • Favors ending screenings for all forms of cancer if and when an older patient is more likely to die of another condition than of cancer
  • Supports reductions in screening for prostate cancer
  • Suggests there is insufficient evidence available to support guidelines calling for regular skin cancer screening.
  • Finds insufficient evidence to support screening for newborn jaundice, despite the fact that 60 percent of babies are born with jaundice – a condition that can lead to brain damage.

A Single Agenda for Legislating and “Researching”

The perfectly-aligned agendas of the Obama Administration and Sebelius’ department (which oversees the work of the USPSTF) are causing increased concern among Americans that these new and more restrictive guidelines – put forth by a government agency leading up to the most critical health care reform debate in our nation’s history – are veiled attempts by our federal government to pave the way for rationing of health care through a phased conditioning of expectations.

The unity of purpose among Democrats in Washington – defying all obligations to the American people – is tough to deny.

DISCLAIMER: I love many NRP programs – Car Talk, A Prairie Home Companion and Wait, Wait, Don’t Tell Me, in particular. And I enjoy their human interest stories from around the world, which is I why I contribute financially to NPR. However…
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