Obama on breast cancer

As I've commented before, both the right and left seem to miss the boat on this. The right takes the study as a sign of death panels to come, the left frames it as a women's issue and seems to think the more mammograms the better regardless of what science tells you is optimal.

This is a sign of how tough it will be to control medical costs. If neither side can bear to control how often mammograms are recommended, how will they ever control much tougher decisions such as end-of-life care, dialysis, palliative surgeries, excessive angiograms and stenting, etc, etc?

We don't agree often, DaGoat, so let's celebrate the moment and be thankful. I agree that neither side is prepared to make tough decisions about healthcare costs. For all the flaws of the current system, one of its unheralded virtues is that it keeps certain decisions out of politicians hands (although with Medicare, etc., plenty are in them, too.)

One more time, we will try sanity.

Studies have shown that screening women between the ages of 40 and 49 every year will create roughly as many cases of breast cancer as curable cases it finds.

The panel thought this is a result doctors needed to know when deciding how they would advise their patients in that age group.

To the panel this indicated that annual x-rays might not be advisable for every women in this age group. (Remember first do no harm ... ?) But they leave the decision to the patient in consultation with the doctor.

There is no discussion of the cost in dollars. Certainly it is reasonable to assume the number of x-rays would decrease. But it also points out a desperate need for less evasive cancer screening tests. The search for such a test would be very costly.

Cost reduction is not the point, good medicine is. They would just as quickly recommended more tests if they found out it saved lives.

This is the way science works. You look at the facts and do the best you can. You don't hesitate to correct mistakes that have been made. You try alternate paths even though you know most will not work out.

The problem, as with everything it seems these days, is that this well reasoned advisory has become a battle in the ongoing cultural war. And as a result is now a guarantee only half of the people will now follow it because it is an evil dictate of the libs/cons repbubs/dems or commies/nazis.

I don't care what Dick Gregory,’s pundits say about this. (I don't even know why a dead comedian would have pundits).

It is only projection that assumes a political agenda on the part of this panel. People who assume a political agenda always will always project that assumption on to everyone else.

The only way to stop this and go down a rational path is to just do it. As a start on our 12 step return to rationality let us declare hands off of this one subject. We will coolly, without using any of the weapons of the culture wars, patiently explain why the panel did this. Please, raise your right (or left hand) and take the pledge.

Don't rush to misinterpret what Obama said then (which was a basis for increasing oversight and future control and direction of health care by the federal government, and a rationalization for cost control and future allocation and rationing and care-denial decisions), with the elevated squawking now about the revisions to mammmogram screening criteria that outraged the Left by being counter-current-like, as well as upsetting those with an entitlement mentality.

We who were correctly critical about what Obama and his team was doing then (preceding any official health care "reform" -- the first steps were made during the "stimulus" effort at the start of this year, try to recall or to understand) knew what was being sought, and this screening decision is consistent with the logic of such things (which aren't limited to Dem political tainting -- by decades of history and related facts that only the feeble-minded cannot grasp and only the dishonest and perverse would deny now -- or authoritarian misuse, which concerned us Americans all along, those of us who can perceive and can reason, at least).

This isn't a surprise. Aside from the politics that concerns better people, the underlying issues always have been there (allocation, priorities, cost containment). It never has surprised some of us (nor has the deliberate refusal of the Dems to reform what they're trying instead to expand surprised us, either).

Welcome not only to ugly political reality but to _ triage _, people, It's the future and clearly evident.

"This is a sign of how tough it will be to control medical costs"

That the Democrats, who had the best opportunity ever, refused to reform and rescue Social Security in the Bush years (when the Republicans attempted a quasi-private replacement scheme for the program), was remarkable, but not surprising. They went on not to reform Medicare as part of negotiating with the Republicans during the creation of the Medicare drug benefit.

That the Democrats have specifically chosen not to reform Medicare now, while trying a much greater expansion of federal provision and takeover of health care now, is even more disappointing; but again, not surprising -- and did anyone really believe Obama's insistence that we needed Medicare and other entitlement reform to save future finances and the programs, or his vow to do it?

The more lowly Demmies and related people hype the GOP-bashing, about the "party of No," whereas it has been the Democrats that are the party of "no" when it comes to prudence and propriety with federal finance, with limiting the size and scope of government, and when limiting entitlements and vote-buying.

I think testing - as a form of "defensive medicine" , and as a lucrative sideline-has gotten out of hand; but what layperson can make that statement without being sliced and diced ?

According to Wikipedia, Dick Gregory is still alive. I'm not sure what this has to do with David Gregory, current host of Meet the Press.

Also, this is still about money. If the research shows the test has no benefit, patients will be discouraged from having the test for precisely the reason the President specified. In a system desperate to keep costs under control, things will come back to money.

Triage is the present, DLS, and it's been the present for decades now.

Welcome back, Kathy. I hope you're better (which your return implies!).

No, triage is not the present. We don't even have rationing of health care (by monetary measures).

We don't even have the equivalent of triage (priority-setting, acceptance of limitations, and allocating resources rationally due to implicit scarcity) this year in fiscal matters, thanks to the Dems, who view everything as valuable and are spending wildly and borrowing heavily on everything. (That's so even if they aren't as crazy as they could be with health care as you might wish -- instant Medicare for All.)