Stop Targeting Women
November 23rd, 2009
The following post represents my personal opinion and not that of any groups or organizations with which I am affiliated.
Okay, it’s enough already! Why is it that women are always the target? First it’s abortions, then mammograms, pap smears following closely, behind and now cosmetic surgery (although that’s not only women!) It looks like the Congress is desperate to find any savings anywhere. Why not tell it like it is, it’s raising taxes. Whether it is through so called elective procedures or levying taxes on devices and diagnostics, to be passed on to the patients, it’s a tax.
Instead of rewriting the rules on mammograms which will cost lives, maybe not that many, but if it is your life that’s all that matters and focusing on false positives and unnecessary screening, why not invest money in better mammograms that are more effective in identifying a lump or even distinguishing a fast growing one from a slow one. Taxing companies who make these diagnostics, while lowering reimbursement rates is not exactly a motivator for more research and innovation.
And by the way, these recommendations for mammograms are a classic example of “comparative effectiveness”, which it very well may be, but the reaction from the American public is an indication of how difficult cutting any services will be—not a great start. And no sooner does the US Preventive Services Task Force come out with recommendations then the Sec of HHS tell us to ignore them. Will private insurers ignore them?
Let’s talk about cosmetic surgery, according to the physician groups, in a survey done of people who are planning on having cosmetic surgery in the next two years, 60% reported a household income of $30K to $90K, 40% of the 60% reported incomes of $30K to $60K, this is the middle class and insurance does not pay for it. While some of the procedures may be considered elective by some, it is in the eye of the beholder and who is to make that distinction, the doctor, the patient or the government? Another bad idea.
Why are women being targeted? I thought this was all about giving women more access to health care, many of the changes in regulations are definitely positive, but what the government gives with one hand, it seems to take away with the other.
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November 24th, 2009 at 6:30 am
Speaking of MEN — the same preventative services task force panel in 2008 made rather counterintuitive albeit little-noted recommendations on screening for prostate cancer. In short:”The USPSTF recommends against screening for prostate cancer in men age 75 years or older.” (!!!) http://www.ahrq.gov/clinic/uspstf08/prostate/prostaters.htm
(It found prostate cancer to be the second leading cause of cancer death in men.)
The problem with government-run insurance, when it becomes a monopoly or nearly so, is that decisions will be bureaucratic and have no relation to any market process.
Things may work out as you wish on the breast cancer front, but should they do so, it will be “the exception that proves the rule” — the rule will be that diseases with emotion and public sentiment behind them (or very well organized and vocal providers) are going to be favored, but others — well, not so much. Not the sort of health system I dream of.
November 24th, 2009 at 6:46 am
By Jeanne Ryer
More access to more health care is not the end goal, is it? Shouldn’t it be more access to better health? And the fact is that more pap smears and more mammograms that don’t improve outcomes actually probably decrease our overall health. We have been sold the idea that screening=prevention. They are not the same.
Try this: NYT Op-ed:Aronowitz: Addicted to Mammograms
http://tinyurl.com/yebhzfg
November 24th, 2009 at 6:47 am
By Shannon Marmion Watts
There are too many screenings, though… If it was up to medical equipment manufacturers, we’d have a mammogram every week. If you have risk factors, insurance should pay. Otherwise, follow the recommendations or pay for yourself. As for taxes, I don’t understand why we’re not taxing the companies that make Americans obese (eg, soda manufacturers) and add to the ballooning cost of health care.
November 24th, 2009 at 6:49 am
By Maureen Cassidy Palumbo
Jeanne – a welcome sigh to read your comment and the article you cited – thank you for citing it.
“We have been sold the idea that screening=prevention. They are not the same.”
ah -but insurances pay for what they are calling prevention aka screening – while true primary care – aka prevention- is not reimbursed – and the consequesnces of over screening and over treatment are rarely addressed.
We have moved far away from promoting health much less asking a population to take personal responsibility for their health.
November 24th, 2009 at 5:51 pm
“Sadly, we can’t afford all the medical care everyone wants. Now health care is rationed by income. I think it woudl be far better to set limits based on what actually works – and what is cost-effective. I don’t want to pay for a test I don’t really need and I don’t want my tax dollars to be used to pay for tests you don’t really need. And I don’t want unnecessary radiation either. I appreciate that there is a body that tries to sort out what care is really needed – based on science – and what isn’t.
And by the way – the USPSTF is an advisory body that doesn’t dictate federal policy. Insurers don’t have to follow the USPSTF – in fact – they can deny anything they want – based on the coverage they sell (and you get through your employer on a take it or leave it basis.) So if they deny your care, you have no real resource. Welcome to the the market.(That’s why some refer to insurance companies as the ultimate death panels-.) So do you really prefer that construct to a government that is likely to listen to constitutents – particulaly those who vote – because they are accountable to them and not to their shareholders? “
November 25th, 2009 at 2:03 pm
I am wondering where the outrage is with the Congress and particularly the Democrats capitulating to the Catholic Bishops on insurance coverage for abortions. I thought this country was founded on the principle of separation of Church and State and where is it written that one religion can make policy for all religions or for that matter all people whether they ascribe to a religion or not.
Apparently, not even the majority of Catholics support their political involvement or position. Here are some quotes from “Catholics For Choice” “The antichoice lobby with the US Conference of Catholic Bishops and its Office of Prolife Advocates has shown that it is willing to stop at nothing to ensure that it own views, which are shared by very few Americans, hold sway. And they continue” this is the only the first salvo in the bishop’s campaign against women’s health. There will be absolutely no access to abortion—even in cases of rape and incest which 76% of Catholics support, eventually no IVF, no contraception, or treatment for ectopic pregnancies or medical anomalies during pregnancy. There will be nothing that doesn’t meet the litmus test prescribed by a small group of men”
Additionally 68% of Catholics disapprove of US Bishops saying that all Catholics should oppose the entire healthcare reform plan if it includes coverage for abortion, 56% don’t think the Bishops should take any position on healthcare reform legislation in Congress. And more, according to Catholics for Choice “there are 65 million American Catholics and their voice should not be represented by a few Bishops. I recommend readers to go on the website of Catholic for Choice for additional information.
Where is the outrage!?
November 30th, 2009 at 9:25 am
This tax is as said another affront to women. Congress thinks this will only apply to Aesthetic Procedures (enhancements) but with the dawn of a new era in healthcare and the distinct possibility of a decease in benefits, any procedure that is not a covered benefit could be subjected to this tax. Such as a cleft lip rhinoplasty or a breast reduction for back pain. In addition, state examples such as New Jersey have demonstrated that it is a buracratic nightmare and does not raised anywhere near the monies predicted.
January 6th, 2010 at 5:41 pm
I appreciate your initial statement regarding your thoughts being your personal thoughts, and not the opinion of any group you represent. I, too, represent some groups and need to specify that the following statements are my personal beliefs.
Gender based disparity is not new to Amercian healthcare, nor the world. The lives of men have been more valuable than women’s lives for centuries in some cultures. Just as racism is not en vogue in this modern society, and must be disguised, sexism cannot be openly expressed. Some laws, such as the Bo-Tax legislation, have sexist ideas embedded into them. Beauty and youthfulness for women are emphasized by the world. Eventhough men have elective procedures, women will be taxed for electing to enhace their looks. As a women’s advocate I hear many women complain that they must die their hair and take heroic measures to remain youthful, in order to remain employed in certain fields. (Some people in the computer industry, for example, boast that they are in a youthful profession.) A loss of employment means a loss of healthcare benefits for many people. Women are a target!