Saturday, December 05, 2009

Carly Fiorina Pulls a Sarah Palin

In the GOP weekly address, Senate candidate and former HP exec Carly Fiorina talks about her cancer.
She also talks about the mammogram recommendations from the task force, or what Sarah Palin would call the "death panel." Republicans exploded the conversation on new scientific information from the task force into the realm of the irrational. Then the media got a hold of it and it spiraled out of control.
This debate is maddening. We lack the ability to analyze new information, without it getting twisted from various world views. Most people today are fed information.
The simple fact is republicans aren't interested in health reform, except when it benefits the industry. Carly does what Sarah couldn't do. She puts a pleasant spin on "death panels:"

I, for one, took note of the new recommendations. Dr. Susan Love, an expert on breast cancer, is the most clear voice in the debate:
This brings us to the current task force which again went through a thorough review of the data supporting screening young women. They found that although there is a reduction in mortality by 15% in this group, it does not appear until the women are followed 11-20 years, in other words until they are over 50. The risks of getting mammography early in life include extra radiation. One estimate of the cumulative radiation risk for women 40-50 is that as many deaths could be caused versus prevented with yearly screening. Other risks include false positives or finding abnormalities that require investigation and even biopsy but do not turn out to be cancer. Finally, there is the over treatment risk from finding lesions that may look like precancerous lesions but in fact would never develop into cancer.

Are these new guidelines an example of rationing? You bet. They are an example of exactly how we need to ration health care, based on science. It is exactly this approach, health care standards by popularity rather than science that raise the cost of medical care in this country. The lack of a "comparative effectiveness" body to come up with recommendations and then enforce them, means that it is the third party payers willingness to pay for procedures that determines the standard of care. The absence of a government run screening program means that the uninsured cannot get screened at any age unless they are poor enough to qualify for a CDC program. The best way to improve the health care of all women and to prevent deaths from breast cancer is not supporting screening that is not effective but rather a health care reform that covers all with evidence based medicine. HP