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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (4118)	1/29/2008 3:24:43 PM
From: TimF	Read Replies (1) \| Respond to of 42652

What's wrong? Well there is no consideration of the positive side of not getting treatment or tests if your exposed to at least some of its cost. Many tests don't tell a whole lot (the false positive rate may be fairly low, but if the incidence is also low you may have more chance to have a false positive than a real positive if the rest shows you have the condition). I'm not sure if this idea applies to breast cancer or not (after all breast cancer isn't a rare disease) but it does often apply. Also tests can themselves be harmful, as can treatments in response to false positives. Another thing is it doesn't speculate about any differences in the plans or the people likely to pick each plan, other than the copayments that might be a factor in mammogram rates. Moving away from just considering mammograms, letting people feel some of the cost and decide based on that whether they will have a procedure is generally a good thing. Containing costs is important, as resources are always and everywhere limited. The savings can even increase health care quality because they might be used to deal with other health care concerns.

To: Lane3 who wrote (4118)	2/3/2008 12:26:19 AM
From: Joe NYC	Respond to of 42652

Lane3, As a matter of public health, Dr. Trivedi said, the reason for ending such co-payments is simple. “We should do it because it is the right thing to do,” he said. As a practical matter, he said, it may cost insurance companies less in the future by catching cancers earlier. Some of these cancers could be cancers caused by mammograms. Radiation from mammograms can cause cancer, and compression can cause small dormant tumors to rapture and spread: -------------------------------------------------------------- Dangers of Mammography Radiation Risks Radiation from routine mammography poses significant cumulative risks of initiating and promoting breast cancer (1– 3). Contrary to conventional assurances that radiation exposure from mammography is trivial— and similar to that from a chest X-ray or spending one week in Denver, about 1/ 1,000 of a rad (radiation-absorbed dose)— the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest (2). Thus, premenopausal women undergoing annual screening over a ten-year period are exposed to a total of about 10 rads for each breast. As emphasized some three decades ago, the premenopausal breast is highly sensitive to radiation, each rad of exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of premenopausal screening, usually from ages 40 to 50 (4); risks are even greater for "baseline" screening at younger ages, for which there is no evidence of any future relevance. Furthermore, breast cancer risks from mammography are up to fourfold higher for the 1 to 2 percent of women who are silent carriers of the A-T (ataxia-telangiectasia) gene and thus highly sensitive to the carcinogenic effects of radiation (5); by some estimates this accounts for up to 20 percent of all breast cancers annually in the United States (6). Cancer Risks from Breast Compression As early as 1928, physicians were warned to handle "cancerous breasts with care— for fear of accidentally disseminating cells" and spreading cancer (7). Nevertheless, mammography entails tight and often painful compression of the breast, particularly in premenopausal women. This may lead to distant and lethal spread of malignant cells by rupturing small blood vessels in or around small, as yet undetected breast cancers (8). preventcancer.com