Mammograms and Rationing: The Future of American Healthcare

As Hippocratic physicians dedicated to saving lives, we fear the new breast cancer screening recommendations foreshadow what is yet to come. Enamored with European universal healthcare, Washington is hell-bent to push through some form of government-run health plan. But at what price? If America adopts European style medicine, Americans must expect European style results.

The five-year breast cancer survival in the U.S. is 90.1%. The five-year survival for breast cancer in Europe is 79%. American women must ask themselves one question: Is cutting the budget for screening mammograms in half worth this 11.1% drop in breast cancer survival? 

Patients must realize not even one member on the task force that made this recommendation was a radiologist, an oncologist, or a surgeon — the specialists that actually diagnose and treat breast cancer every day. As a result, the recommendations will not save lives. However, these recommendations will save the government money. 

One in 1,900 mammograms diagnoses cancer in women ages 40 to 49. Given that statistic, the US Preventive Services Task Force determined that screening mammography for this age group was not “cost effective.” However, only one in 1300 mammograms diagnoses cancer in women 50 to 59. As the budget tightens in the wake of soaring deficit spending, will screening mammograms for these women be cut as well? Who decides if one in 1,300 is “cost effective” where one in 1,900 is not? Who determines what care is needed?

As a radiologist, I have diagnosed hundreds of cancers in women between the ages of 30 and 49. Imagine if an asymptomatic breast cancer (detected only on mammography) in a 43-year-old woman continues to grow undetected. Most likely, that woman will not live to see her first government-sanctioned exam.

Yes, women without cancer may undergo additional testing if a mammogram suggests a cancer that isn’t there. Many women without cancer undergo an extra MRI or ultrasound. They may even undergo a biopsy only to yield a benign diagnosis because of a false positive study. However, most women are willing to do whatever is necessary to guarantee a clean bill of health.

Americans must soon decide if they trust government-appointed panels such as the US Preventive Services Task Force. Physicians for Reform, a coalition of patients, working physicians, and business leaders, believes the personal and complex proves of medical decision-making belongs in the hands of patients and their physician. Physicians for Reform offers fiscally responsible, life-saving alternatives to healthcare rationing to keep the patient at the center of American healthcare.  

The question at the center of the debate is “Who should control the personal and complex process of medical decision making? You and your physician? Or Washington?” Will patients remain free to choose whether or not to have screening mammograms? Or will the government secure the right to determine what life-saving tests Americans should or should not have?

It is significant the US Preventive Services Task Force is referenced four times as a primary source of medical information in the latest Senate healthcare bill. Washington is consumed with politics and power, not patient care.

Patients, physicians, and the business community must link arms and stand up for common sense solutions. Together we can reduce the cost of healthcare, make health insurance affordable for every American, and keep patients at the center of American healthcare. There is a better way.

Government compassion sounds so noble. But in the end, whoever pays holds the power to choose. The US Preventive Services Task Force has made its recommendation. Now American women must ask, “Is the rationing of mammograms the first indicator of what lies ahead if we continue down this road toward government-run healthcare?”