Mammogram Debate Rages On and Splits Along Party Lines


We all continue to be somewhat baffled over how often to get mammograms and whom to trust as the last word on this critical issue for women. Hey, we all want to grow up to be old women, right?

Weeks after the release of the report on new recommendations for mammograms by the 16-member U.S. Preventative Task Force, the firestorm rages on, even splitting parties as Republicans argue that the recommendations could be used to ration healthcare under reform legislation before Congress, a charge Democrats denied.

According to Reuters, Republican Representative Joe Barton suggested in a congressional hearing that under Democratic healthcare reform legislation passed by the House of Representatives, the task force could decide which preventive services, including mammograms, would be covered for many Americans.

“To have a task force make the recommendation that has been made, and to have in this bill the authority that’s given to various unelected bureaucrats to make healthcare decisions, including coverage frequency, in my opinion, is wrong,” Barton told the House Energy and Commerce Committee’s subcommittee on health.

The Senate is debating its version of healthcare reform legislation, seen as President Barack Obama’s top domestic priority, especially among American cancer doctors, who are outraged about the challenge to the accepted guidelines. It has touched off a heated debate among those doctors, as well as various groups.

The American Cancer Society, perhaps the most prominent of these groups, says it is sticking to the current recommendation to start annual mammogram screening at age 40 because the breast X-rays have been proven to save lives by spotting tumors early on when they are most easily treated.

Current standards say women 40 and older should get mammograms every year, while the revised recommendations suggest only we gals over 50 get screened, and that they do so every other year. Women over 74 can dispense with the test altogether, says our government.

An analysis by ABC News suggests money is the motivation. Professor Theodore Marmor, a health care policy specialist at Yale University, said cost-benefit analysis is routine in the health insurance biz.

“Although screening every woman between the ages of 40 and 50 would turn up some breast cancer”¦the question is what is the cost per diagnosis per relevant harm,” says Marmor.

“The question is going to be, between the ages of 40 and 50, what is the frequency with which you are going to find a true positive cancer finding, how many cases would we miss, how many of those cases would develop into cancer and what is it going to cost to treat them,” says Ian Duncan, president of Solucia, a company that provides actuarial health care analysis for insurers.

Duncan explains further that mammograms are actually a value-based benefit because they are preventative and only run about $125 per exam.

It’s  believed the new research doesn’t take into consideration the savings of newer technologies in screenings. ABC reports that digital mammograms are 1.5 to 4 times more expensive than conventional film-based mammograms, according to the National Cancer Institute, which also reported in 2005 that only 8 percent of the country’s breast imaging units provide the technique.

Either way, should we be thinking about money when it comes to prevention and saving lives?

“I definitely think this is the beginning of rationed care and I am very upset that women are the first to get slammed with this,” said Dr. Elizabeth Vliet, a women’s health care specialist based in Tucson, Ariz., and an opponent of health care reform. “I think that this change is designed to cut costs, not improve women’s health.”

Meantime, we women must decide for ourselves. What else is new?

Personally, at 51, I’m usually a year late in getting my own exam so I’m not overwhelmed by this debate. I don’t beat up on myself when I’m late but I know I cannot let it go too long. I know because of the number of women lost to this horrible disease, and the pink ribbons that symbolize we must keep asking the important questions and donating to our own cause when we can. I trust the pink panel more than the government panel. How ’bout you?


Luanne Bradley

Luanne Sanders Bradley is the West coast Editor at EcoSalon and currently resides in San Francisco, California.