Tuesday, November 17, 2009

Progressives for Breast Cancer: A Preview of the Medical Gulag

Here is a little thought experiment for you. The U.S. Preventative Services Task Force has made a new set of recommendations for the diagnosis of breast cancer that have implied that breast self-examinations are of limited value and that women should begin getting a regular mammography at 50 years of age (rather than the old recommendation of 40) and then only every two years instead of every year.

Their report states that screenings between 40 and 49 years of age only turn up one cancer for every 1900 or so women. They express concern that “false positives” and unnecessary tests are a cruel source of anxiety and mental suffering for many women and that women would be much better off if they waited another ten years before they put themselves through all that turmoil. Oh, yes, they added that hat a great deal of money would be saved along with the angst of all those hysterical ladies.

Well, ok, false positives are a problem when you do screenings but what about the non-false positives that don’t get diagnosed? If you take their number of 1900 to 1 it doesn’t sound so bad, really. Until you think a little more about it…

Just consider that detected early, the five year survival rate for breast cancer victims is in the neighborhood of 98%. Detected late, that rate falls to about 26% a decrease in survival of 72%. And that doesn’t begin to cover the additional suffering from the treatments and dislocation of families when diagnosis is delayed.

But how bad is the problem? Let’s take Gillette Stadium for an example.

Gillette is where the New England Patriots play. Like a lot of stadiums, it has been used as a venue for all kinds of events, soccer games, rock concerts- all kinds of things. So let’s make up a hypothetical event to fill the stadium. Let’s just say that in the run-up to the last presidential election, candidate Obama wanted to solidify his support among one of his best “demographics”, younger women. His staff planed a big rally to which only women 49 and under are invited.

Now, Gillette’s official capacity is 68,756 people. So at a diagnosis rate of 1900 to 1 that means that 36 women there at the rally already have breast cancer. President Obama was a great draw in 2008 lets assume he would have filled the whole stadium so we can assume that there are 68,756 women in the seats.

Ok now picture a stage in the middle of the field. As the lights dim and the applause fades, a spotlight beam centers on the thin, serious figure of the future President of the United States and he lifts the microphone and pronounces his words very carefully.

“Ok, now, I have something to tell you that is very upsetting and I don’t want you to panic or get hysterical. Thirty-six of you women here tonight, and we don’t know who you are yet, are going to agree to reduce your chance of living for another five years by 72%. That means instead of 33 of you living at least five more years, only 9 of you will live. Not only that, you are going to give your consent to putting your self through a comparable amount more suffering and pain than you would otherwise have to endure. Also you will be saddling your husbands, parents, friends and children with infinitely more sorrow and desolation than they would have had to bear if you had not come to support my presidency tonight.”

In his usual style, the President is actually understating the case by a factor of ten. An astute friend of mine has pointed out that the 1900 to one ratio is a "yearly" crop of diagnoses based on yearly screening. so the actual loss of early diagnosis will be multiplied by the ten years of delay in receiving mammograms. This makes the actual death toll from that fateful rally more like 270 women.

It sounds like a non-starter doesn’t it? Do you think he would have gotten any of those women's votes that night? But the fact is that those 68,756 women (including the 36 doomed ones) have already been hoodwinked in to agreeing to that deal. Because, if Obama has his way and forces the single payer system down our throats, government then recommendations like these will assume the force of law for all but those are so wealthy that they can pay for medical services out of pocket.

These new recommendations are draconian, not just because it reminds us of how cold and callous a bureaucracy can be in its disregard for medical prudence and the value of an individual’s life but (even more) because it has given us an ominous forewarning of what the Medical Gulag of single payer, government run health care system would look like if the Blue Dogs and Republicans in congress don’t come to their senses soon and stop Obama’s high-pressure sales blitz for his “health care reform package”. It is tragic to consider the consequences of this push for cheap health insurance.

Just to put a human face on it, I have Googled "died of breast cancer", clicked on "Images" and selected a somewhat random sampling of the resulting pictures. I have posted 27 of them below to represent the first year's (remember there are another nine years worth of death, sorrow and suffering involved!) 27 extra deaths among the 68,756 rally attendee at that imaginary rally. Imagine that they are the ones upon whose bodies and families, Obama's health care reform would save all that money.

They are all kinds of women who have one infinitely sad thing in common:

Some are mysterious and exotic.
A Daughter who Died before her mother...
Sisters who lost a mother and a sister to breast cancer
A Champion marathon runner
A newscaster
A sister who inspired a movement
A coach
Some you might think you recognize
All will be missed

They will not see their children grow
They are remembered for all kinds of things
They leave holes that cannot be filled
Some were accomplished and famous
Others never got to fulfill their dreams
Some changed whole industries
Some inspired good works in their names
Their music is stilled forever...
..never to be heard again
They are fading into memory

If only we had taken more pictures...

Their laughter still echoes

Their courage still inspires
We still smile when we remember
They are gone
No matter how alive they once seemed
They live now only for those who remember
Reminder: this represents the first year's "beneficiaries" of the Obama "adjustment" to the mammogram regime. What other horrors will they come up with to make their takeover seem affordable?

And what is the money being saved for?

Incredibly, this is little more than part of a naked attempt to make it look "budget neutral" to take some of the excellent health care away from citizens who work, pay taxes and earn the right to have their own insurance and choose their own doctors and redistribute it to people many of whom are not even legal residents of our country. It is intended to rationalize the degradation of medical service for families that struggle to pay their own way in order to give an inferior but equal care to people who don't even value enough to work for it. It has even been proposed in the Health reform bill that the savings be used to increase the linguistic and cultural "sensitivity" of health care delivery in border regions to ease the lives of illegal aliens as they resist acculturation and assimilation.

If you are a woman, or care about women at all, picture that pro-Obama rally in Gillette stadium. Look at these pictures above and imagine these wonderful, unique, and irreplaceable people sitting side by side. They would occupy a little more that one row in an average section. Imagine them all dead within five years just because they voted for Obama. Then imagine ten more deadly swaths just like that over the next ten years. And that is just from the rally In Foxboro, Massachusetts. Fill all the football stadiums in the country and imagine eleven rows of breast cancer victims whose life is unnecessarily shortened because they invited government bureaucrats to decide on their cancer screening schedule. And even that would not approximate the real toll. Whose picture do you want in that group?

Important Update:

The reader who corrected my numbers on the toll from the rally also stated this in relation to cutting the screenings down from every year to every two years:

It gets worse than that.

Half of all screenings post-age-50 would be eliminated, meaning that half of all cancers discovered post-age-50 would have been incubating one extra year (and half of all cancers would post-age-50 would be detected as early as before).

How many women post-age-50 get breast cancer and by how much would the death rate increase for that half of them with one extra year of incubation pre-treatment?

Please correct your post accordingly.

(I do not have permission to use his name yet)


Ashan said...

Superb article. I am passing it around.

Matt H said...

Good post, as usual YBM. I don't believe I've ever commented here before as I only recently discovered your blog (and don't post comments all that often regardless) so I just wanted to say thanks for doing what you do. I will try to support your endeavours as I can.

I'm so sorry that America has to go through the Obama presidency. We Canucks saddled ourselves with the progressive stupidity of Trudeau and it's going to take generations to battle back. I just hope America doesn't repeat our error and return him to power, as four years of Obama is going to cause enough problems as it is.

As you're aware, if any sort of public option gets through, get used to this sort of medical rationing. It only gets worse.

General P. Malaise said...

an excellent essay. we are on more then a slippery slope.

another health care double standard.

Anonymous said...

Excellent essay. I could not agree more. Bernadine Healey was interviewed by Glenn Beck today. She observed that the U.S. Preventative Services Task Force has repeatedly flip-flopped on many of it's past recommendations. She also observed that it is a largely political group that often ignores input from physician organizations. She lamented that the new healthcare reform bill elevates the status of this task force above any other in regards to future health care policies. As a physician, I fear for the future of health care in America.

Mrs. Right said...

Thank you, YBM, for yet another excellent post. I read you often, usually on Bloglines but rarely comment. I just wanted to thank you for calling attention to these issues. My husband and I support you completely. You are not alone.

Anonymous said...
This comment has been removed by a blog administrator.
Jewish Odysseus said...

Outstanding essay even for you, brother Yaacov.

I think it's greatest strength is the emphasis on the personal and individual perspective instead of the collectivist/mass perspective, which is of course what the panel is dealing with. And collectivist/mass medicine, or "medicine," is what the Obamunists are ramming us ALL into.

"The doctor has just prepared the Kool-Aid for you, everyone. Drink it now."