Tuesday, November 17, 2009

Greta Van Susteren Olivia Newton John: Government Breast Cancer Guideline Rationing

Greta Van Susteran interviewed singer and actress, Olivia Newton-John, about a new live show she is promoting to recognize women and the role they play in battling cancer as a patient, a caregiver and an advocate. " The theme: a story of survivorship and providership."  Newton-John is a breast cancer survivor, so naturally, the conversation quickly got to the new government breast cancer guidelines, which are the first steps to health care rationing. See videos below.

Breast Cancer graphic courtesy Southern Sass on Crime

One in eight women will be diagnosed with breast cancer. In 2007, $7 billion was spent on treatment, including government and private payments. In President Obama's stimulus bill, he set aside $7 billion to "expand high-speed Internet access across the country." How ludicrous is that? If you cannot understand that your health care is of no consequence to this administration, then you are not doing your homework.

Greta and Olivia discussed disease and what it must be like to be a woman in a Muslim country. She first has to have the permission of her husband to get a mammogram. Then he, or some other approved male must drive her to the testing location. A woman performs the mammogram and looks out through slits for eye holes. If the diagnosis a bad one...it is often hopeless for that woman. The primary male in her life decides if she receives treatment.

Will we allow the the "Task Force" to decide our treatment? The guidelines recommend delaying mammogram screening until age 50 for American women. The recommendation allows ten years for undiagnosed breast cancer to grow.  American women have government making the decisions now, yet every doctor I've seen on television so far, has denounced the study as irresponsible and dangerous. And it is from a "government sponsored expert panel" - the U.S. Preventive Services Task Force.

Interpretation: If you want a mammogram before age 50, you will pay for it, if you can get someone to perform it for you.

We also learned there is no longer a need to do breast self-exams. In fact, the recommendation is "against teaching" the proper exam method, and if you are 75 or older there is no evidence you need mammography.

Rationing has begun. Death panels have convened.

I am a breast cancer survivor. I was diagnosed under 50 years of age. I found the cancer in a self-exam that I was carefully and meticulously taught to perform.

Ironically, Secretary of Health and Human Services, Kathleen Sebelius said in October 2009 that 4,000 cancer deaths can be prevented with early screening, but now, if these guidelines are adopted, those 4,000 will fall the cracks. I can find no statement from Sebelius about the "Task Force" findings.

Are 4,000 women just so much garbage to this elitist government, who will make sure their women are covered?

The "Task Force" assigns their recommendations a letter grade: A through D, with A being the best finding for the highest net benefit. Here is how they explain the grades:
Each recommendation is linked to a letter grade that reflects the magnitude of net benefit and the strength of the evidence supporting the provision of the specific preventive service. The recommendation is graded from "A" (strongly recommended) to "D" (recommended against). When the evidence is insufficient to determine net benefit, the Task Force assigns a grade of "I."
Where is the supporting evidence? There is none. There is only concern that many women being screened do not have breast cancer. There is only concern that women will endure tests to rule out cancer, and those tests cause emotion pain. And the unspoken concern is that government money is going to test those cancer free. The government wants to free up the money.

Delaying mammograms until age 50 received a grade of C. The following is the actual wording of the guideline.
The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual
The recommendation to no longer teach breast self-exam received a grade of D, which means:
The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.
How can breast self-exam do harm? There is "moderate or high" certainty that there is no net benefit?" What if you find a lump or tumor? Where does that fall between moderate to high? There is only one reason for this evil, evil guideline, and that is money. Doctors and their staff spend time teaching the proper method for self-exam. The instruction is usually done only one time for each patient. How many appointments can be shaved by 15-30 minutes? What is the bottom line for the Doctor and insurance companies from this savings? What about the cost of more extensive treatment when the cancer is found years later in a more advanced stage? Surely the cost is more than the cost of a one-time instruction on self-exam.

Cancer at a later stage in women over 50 - probably will not be treated at all.

I know so many women of all ages battling breast cancer. Most had no family history. Most are not overweight. All are, or were, devastated. Some survived. Too many did not.

One Saturday afternoon I looked up at the television and there was Condoleeza Rice at a podium after a Susan G. Komen 'Race for the Cure' event. She said her mother was a breast cancer survivor. She talked about the things her mother accomplished in the 16 years she lived after dealing with the disease. When her mother died of breast cancer at the age of 61, Rice was 30. Without early detection and treatment, she could have lost her mother at as a teenager. See this video below.

I have a few years between me and "the event," of breast cancer. I passed 5 years and then  passed 7 years...and began to breath easier. I was beyond 7 years as I listened to Secretary Rice.

I made an appointment with my doctor, and asked: do people surpass 15 years, 20 years - do they ever die of anything other than breast cancer - how long did your longest survivor live? I'm not sharing his answer here because I know how "numbers" can influence our thinking, but I will tell you this, I plan to be his longest living breast cancer survivor. That's the plan, the hope, the prayer, of every diagnosed woman.

The truth is, you never stop battling breast cancer. Surgeries and treatments and check-ups...it goes on and on, and what a privilege it is to see my doctor and receive a good report. I am grateful for my doctor, grateful for modern medicine, grateful for the time with my husband, especially grateful that I lived to see my son a grown man.

These guidelines are designed to suck-in insurance companies to support Obama's audacious dream of government control of our health and private information. No surprise this comes just as the House health care bill is passed, just as Harry Reid says the Senate plan is about ready to be revealed, just as a report popped up tonight that drug manufacturers have already raised the price of their products in anticipation of what comes next from this government. Insurance will drop coverage of mammograms. To think they will not, is naive.

But...the "Task Force" says this is not about money. It is about concern for the healthy women who are recommended for follow-up tests and biopsies that may yield no negative results...it's about the angst a healthy woman might have:
With these recommendations, the task force has made "a value judgment that's subject to discussion and interpretation," says Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which is sticking to its recommendation that women begin annual screening mammograms at age 40.
Harms are tricky to measure. It's hard to quantify the psychological impact of additional tests and biopsies, for example. And estimates of overdiagnosis generally range only between 1 percent and 10 percent, according to the review consulted by the USPSTF. (Monetary costs weren't considered by the task force, says USPSTF Vice Chair Diana Petitti.) Lichtenfeld is also concerned about using computer models as the basis for the every-other-year recommendations, since so much is at stake. 
Marisa Weiss, a Philadelphia oncologist and founder of Breastcancer.org, says the task force's conclusions were based on outdated assumptions about treatment and mammography. For example, studies show that digital mammography is more accurate among young women, but the USPSTF discussed only the standard film mammography.
And it figured in certain harms that have been ameliorated over the years with procedures such as core biopsies rather than the more invasive open biopsies, as well as tests that can predict which women are likely to benefit from chemotherapy and which can skip it. She worries these recommendations will result in young women being entirely bypassed, so that women in their 50s will be diagnosed at later stages of cancer and will need more treatment.
 The above quote is from US News and World Report, by Katherine Hobson. I hope you will read the entire article.

This from Susan G. Komen for the Cure:
October 9, 2009:  According to the results of a study presented at the ASCO 2009 Breast Cancer Symposium, nearly three-quarters of breast cancer deaths occur among the minority off women who do not get regular screening mammograms.

Although breast cancer remains the second-leading cause of cancer death in U.S. women, breast cancer mortality rates have been declining for the last 20 years. The decline in mortality is thought to be due to improvements in both treatment and early detection.

Mammography (an X-ray of the breast) is an important part of routine breast cancer screening. The American Cancer Society recommends that women at average risk of breast cancer receive annual mammograms starting at the age of 40. Women at higher risk of breast cancer may need to begin screening at a younger age, and may be screened with breast magnetic resonance imaging (MRI) in addition to mammography.
Studies have indicated that mammography reduces the risk of death from breast cancer. To explore the relationship between mammography and breast cancer mortality in the general population, researchers collected information about 6,997 women diagnosed with breast cancer in Massachusetts between 1990 and 1999 and followed until 2007 (median follow-up period was 12.5 years).
Cady B, Webb M, Webb M, Michaelson J, Smith BI. Death from breast cancer occurs predominantly in women not participating in mammographic screening. Presented at the American Society of Clinical Oncology (ASCO) 2009 Breast Cancer Symposium. Abstract 24.
 I've heard several doctors say this "Task Force" is independent from the government. That is not true. This is not an independent panel. Their website is a .gov url, and the banner, U.S. Department of Health and Human Services banner runs across the top. Sixteen doctors sit on the panel for a period of 4 years. Some are always rotating out at the end of the year. View a list of doctors here.

Kathleen Sebelius, the Secretary of Health and Human Services, released a statement in October 2009 about the need for health insurance reform and breast cancer. I find no statement on the findings of the "Task Force." She advocated for just the opposite of what this  "Task Force" is trying to do:
This year alone, an estimated 192,370 American women will be diagnosed with breast cancer and 40,170 will die from the disease, making it the second leading cause of cancer deaths in women.
America, you must understand that this is just the beginning. Your health care will soon be under government control. Here is something coming out of the Presiden't office that should shock you: President Obama's Chief of Staff, and close, close friend, Rahm Emanuel's brother,  Ezekiel Emanuel tells us how the government can cut costs:

Dr. Emanuel is a health policy adivser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research. He has the President's ear:
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).
The only way to come close to paying for the health care plan proposed, is to cut medical care to others. If you think cuts in medicare will pay for your insurance, think about the women not yet 50 - far too young for medicare. Everyone has a daughter, a mother, a niece, a wife, a grandmother, an aunt...Rationing has already started. Death panels have convened. The first video below is Condoleeze Rice and the second, Greta and Olivia.

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Condoleeze Rice - Vreast Cancer (video)

Greta Van Susteran and Olivia Newton-John (video)

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