In California gubernatorial election, outdated ideas linger
With the gubernatorial election tomorrow, Jerry Brown appears to have opened up a sizeable lead. Women are emerging as a bulwark of support for Brown, as they favor him by 21 points, according to the latest Los Angeles Times/USC poll.
That’s surprising, as Brown’s stance on mammograms could not be much more anti-woman. “Can we get off of mammograms? [T]here’s no statistical evidence that mammograms help anyone at any age,” he said during a 1995 interview with William F. Buckley at Stanford University.
The millions of women whose lives have been saved by mammograms would beg to differ. With more than 10 percent of all new American breast-cancer diagnoses coming in California, keeping mammograms available and affordable for all women should be an absolute priority for the state’s elected officials.
The most prevalent type of cancer among American women, breast cancer claimed more than 200,000 lives between 2002 and 2006.
And yet last year, the U.S. Preventative Services Task Force — a Department of Health and Human Services advisory panel — made a surprising change to its stance on mammograms, recommending against routine mammography for women between the ages of 40 and 49.
The Task Force appealed to the same sort of flawed analysis that Jerry Brown did 15 years ago.
Federal officials concluded that only women 50 to 74 years of age needed mammograms — and that they only needed them once every two years, not annually as had long been the case.
The panel reasoned that 1,900 women in their forties would need to be screened in order to save a single life. But only 1,300 screenings would be required to save a woman in her fifties. And it would take just 377 screenings of women in their sixties to save a life.
Thus, as women grow older, it becomes increasingly cost-effective to screen for breast cancer.
But does that mean that women in their forties shouldn’t get mammograms? Should the government really have the power to consign one in 1,900 women in their forties to death at the hands of breast cancer, just to save a few bucks?
It’s no wonder that Dr. Otis Brawley, chief medical officer for the American Cancer Society, said, “With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”
Following a public outcry, federal officials softened their proposed guidelines by instructing individual patients and doctors to make the final decision. But they maintain publicly that the guidelines are correct.
Under the new health reform law, this drama is likely to play out again and again.
For instance, the law establishes a new 15-member Independent Payment Advisory Board (IPAB) tasked with recommending to Congress ways to rein in Medicare spending. Its recommendations are not supposed to be used to raise taxes, change benefits, or ration care. But it’s almost certain that the Board’s proposals will lead to these outcomes indirectly.
For example, if IPAB’s recommendations were used to cut payments to doctors and hospitals, Medicare patients would end up waiting longer to receive care — effectively rationing it.
This year, it’s estimated that nearly 210,000 more American women will be diagnosed with breast cancer. If California’s share of new diagnoses is the same as it was four years ago, that’s another 23,000 mothers, grandmothers, daughters, and sisters in the Golden State who deserve access to the best the healthcare system has to offer.
Hopefully, after all these years, Jerry Brown agrees.