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  1.    #1  
    Really....you insurance company apologists should be so proud of yourselves.

    One after another, shortly after a diagnosis of breast cancer, each of the women learned that her health insurance had been canceled. First there was Yenny Hsu, who lived and worked in Los Angeles. Later, Robin Beaton, a registered nurse from Texas. And then, most recently, there was Patricia Relling, a successful art gallery owner and interior designer from Louisville, Kentucky.

    None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.
    The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.
    They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.
    Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.
    WellPoint says that even though the company routinely investigates policyholders with diseases such as breast cancer shortly after a diagnosis, it only cancels policies if it finds something wrong. It says the practice is necessary to keep down costs for other policyholders.

    In testimony before the House committee last year, Brian Sassi, the president and CEO of WellPoint's consumer division, asserted: "I want to emphasize that rescission is about stopping fraud and material misrepresentation that contributes to spiraling health care costs. Rescission is a tool employed by WellPoint and other health insurers to protect the vast majority of policyholders who provide accurate and complete information from subsidizing the cost of those who do not."

    But state regulators, congressional investigators and consumer advocates say that in only a tiny percentage of canceled health insurance cases was there a legitimate reason.

    A 2007 investigation by the California Department of Managed Health Care bore this out. The agency randomly selected 90 instances in which Anthem Blue Cross of California dropped the insurance of policyholders after diagnoses with costly or life-threatening illnesses to determine how many were legally justified.

    None were. "In all 90 files, there was no evidence (that Blue Cross), before rescinding coverage, investigated or established that the applicant's omission/misrepresentation was willful," the DMHC report said.
    Exclusive: WellPoint routinely targets breast cancer patients | Reuters
    Last edited by davidra; 04/22/2010 at 01:26 PM.
  2. #2  
    Do these people not have agents to help them? Good grief. In 25 years I have never...repeat....never had a client that had their health plan cancelled unless because of non-payment of premiums. This includes both group and individual coverages.

    Davidra, I'm dealing with a claim right now where an employee went in for an ER visit in Philly and while the hospital charges were paid, the ER doctor is about to send the client to a credit company for collection. So, the client calls me, somewhat annoyed at the insurance company (typical, always the insurance company's fault, heavy sigh) and turns out the ER doctor (who wasn't in the network) didn't file it with the emergency procedure code (grrrrrrrrrr). So, the insurance company processed it corrrectly as an out-of-network hospital doctor visit rather than an ER visit. Meanwhile, the doctor is going after the client for a mistake he made. Nice, huh? I'm sure I'll get it resolved, but holy cow, what a waste of time.

    I also had to deal recently with a claim where both the hospital and the surgeon billed for anesthesia (sp?, always have trouble with that one) and the insurance company was only going to pay it once. The insurance paid it to the hospital (FIFO) and so my client was getting harassed by the anesthesiologist for non payment. Well....once I and another person got involved it got taken care of. But it is amazing how many times the insurance company processes something as it is submitted, and guess who immediately gets blamed for it? Yup....the evil insurance company.

    So, I realize those examples really didn't have to do with the women whose coverage was cancelled....but I get a little annoyed when you only discuss the evils of them. Do you not have any example of the insurance company paying a claim and making someone happy? Not one? But, I do agree if all is how it was explained....what they did was very wrong. Did the article say they were later reinstated? Because if not, I gotta think they have a pretty darn good law suit.
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  3.    #3  
    Quote Originally Posted by clemgrad85 View Post
    Do these people not have agents to help them? Good grief. In 25 years I have never...repeat....never had a client that had their health plan cancelled unless because of non-payment of premiums. This includes both group and individual coverages.

    Davidra, I'm dealing with a claim right now where an employee went in for an ER visit in Philly and while the hospital charges were paid, the ER doctor is about to send the client to a credit company for collection. So, the client calls me, somewhat annoyed at the insurance company (typical, always the insurance company's fault, heavy sigh) and turns out the ER doctor (who wasn't in the network) didn't file it with the emergency procedure code (grrrrrrrrrr). So, the insurance company processed it corrrectly as an out-of-network hospital doctor visit rather than an ER visit. Meanwhile, the doctor is going after the client for a mistake he made. Nice, huh? I'm sure I'll get it resolved, but holy cow, what a waste of time.

    I also had to deal recently with a claim where both the hospital and the surgeon billed for anesthesia (sp?, always have trouble with that one) and the insurance company was only going to pay it once. The insurance paid it to the hospital (FIFO) and so my client was getting harassed by the anesthesiologist for non payment. Well....once I and another person got involved it got taken care of. But it is amazing how many times the insurance company processes something as it is submitted, and guess who immediately gets blamed for it? Yup....the evil insurance company.

    So, I realize those examples really didn't have to do with the women whose coverage was cancelled....but I get a little annoyed when you only discuss the evils of them. Do you not have any example of the insurance company paying a claim and making someone happy? Not one? But, I do agree if all is how it was explained....what they did was very wrong. Did the article say they were later reinstated? Because if not, I gotta think they have a pretty darn good law suit.
    Agents? Help? When the company tells them no? Not likely.

    My own personal experience with insurance is excellent....but of course I have as good insurance as one can get. While usually they wouldn't try this crap with docs, I am aware of a doc who had a stroke, was given emergency lytic therapy which probably saved his life, and it was denied...but not for long. The vast majority of insurance claims are handled. Not promptly, from what I've seen (as my hospital/group practice has sued two insurers, one being BCBS for breaking state law by delaying payments). But how many major claims do you deal with ? How many women recently diagnosed with breast cancer do you deal with? It's rare enough so that only by investigating can they sort this out,just as described in the article. They actually have a policy of targeting women when they are diagnosed with a major costly condition and look for reasons to drop them. They do not deny that. How can anyone justify that? These stories just reinforce what Sicko was about....it wasn't so much about the uninsured, it was about people who have insurance and get screwed by the companies. Just how frequently does this have to occur before you become disgusted with the industry? You know it happens much more frequently than it turns up on the web....people just aren't able to understand or don't have the resources to fight. As far as I'm concerned, one death due to this kind of crap is one too many and the company should be fined billions for each time this happens.
    That'll cover some uninsured.
  4. #4  
    Wasn't it the .gov just earlier this year that suggested early screening and self exams were not necessary because the cost too much money with false positives? Things will be so much better when they are in total control.
  5. #5  
    Quote Originally Posted by davidra View Post
    Agents? Help? When the company tells them no? Not likely.

    My own personal experience with insurance is excellent....but of course I have as good insurance as one can get. While usually they wouldn't try this crap with docs, I am aware of a doc who had a stroke, was given emergency lytic therapy which probably saved his life, and it was denied...but not for long. The vast majority of insurance claims are handled. Not promptly, from what I've seen (as my hospital/group practice has sued two insurers, one being BCBS for breaking state law by delaying payments). But how many major claims do you deal with ? How many women recently diagnosed with breast cancer do you deal with? It's rare enough so that only by investigating can they sort this out,just as described in the article. They actually have a policy of targeting women when they are diagnosed with a major costly condition and look for reasons to drop them. They do not deny that. How can anyone justify that? These stories just reinforce what Sicko was about....it wasn't so much about the uninsured, it was about people who have insurance and get screwed by the companies. Just how frequently does this have to occur before you become disgusted with the industry? You know it happens much more frequently than it turns up on the web....people just aren't able to understand or don't have the resources to fight. As far as I'm concerned, one death due to this kind of crap is one too many and the company should be fined billions for each time this happens.
    That'll cover some uninsured.
    Yes....if you have a good agent, that agent is supposed to help. I don't work for the insurance companies, I work for the clients. It's called service and if you provide service, you actually last 25 years in an industry. Apparently you don't believe me when I say I fight claim issues and an amazingly high number of problems relate back to the doctors. You can say I'm lying, but whatever, I know the time I waste cleaning up the errors. Do insurance companies also make errors? You bet. Name me one business where mistakes aren't made. The problem is that when a mistake is made at an insurance company it can often involve a good bit of money and so the mistake is magnified....but....if you help the client you can often get issues resolved. 100% of the time? Heck no, I'd would be lying if I said that....but I do have a pretty good batting average.

    To answer your question about how many large claims I deal with? Pretty cool.....people only call me when there is an error or a mistake. No one calls when there are no problems So I have no idea how many claims get processed that are done correctly. I did have a guy call me last year after his son had approximately $130k in expenses due to an accident. When he called, I said, "oh oh....problems?" He informed me he was extremely happy with the way the claims were paid but he was having an issue with a small claim (about $500). The father had paid the doctor up front (big no no) and when the insurance company paid the scheduled amount, the doctor refused to refund the amount paid over the scheduled reimbursement. We finally gave up and the client wasn't mad because he understood it was the doctor's issue. He was just happy that his son was doing well and that was really all he cared about at that point. But trust me.....I do hear it when they believe the insurance company is ripping them off.....and I enjoy proving, a high percent of the time, that the insurance company simply processed a claim as it was submitted to them (garbage in, garbage out). I will say that usually the doctor's office will reprocess the claim once they see they've made the mistake...but dang...they act all "high and mighty" until you can prove they made the error. I don't know if you know this, but some doctors (and their staff) have quite the attitude.

    By the way....I was working out a few weeks ago and the guy next to me had retired recently and eventually I said something like "well, at least you're on Medicare now", and dang if he didn't launch into all the problems he and his wife were having....especially when he called the service folks at Medicare. After hearing everyone in here say how great Medicare was, I was surprised by his reaction.
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  6. #6  
    Quote Originally Posted by cjgem View Post
    Wasn't it the .gov just earlier this year that suggested early screening and self exams were not necessary because the cost too much money with false positives? Things will be so much better when they are in total control.
    No, they recommended fewer routine exams for younger women, because the potential harm outweighed the potential benefits:

    Federal panel recommends reducing number of mammograms - washingtonpost.com

    Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.
    That's an issue that people can have reasonable disagreements about, but those disagreements don't happen if you simply respond to right-wing spin to miscategorize the issue.
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  7. #7  
    Clemgrad, I agree with you. I am an agent for over 25 years. Insurance companies do have to be careful when paying claims. I have seen many examples of people trying to pull one over on the insurance companies-fraud cost us all. I have NEVER had someone canceled because they came down with a health problem. I make sure my customers have my cell phone number and stress that if they ever have a problem call me right away. When someone ask for a claim form, I ask them to let me know when they file the claim so I can keep an eye on it. You would be surprised at how many claims are delayed because bills aren't sent in to the insurance company or doctor's offices/hospitals don't fill in the forms.

    Yes, a good agent makes a big difference. Our pay does come from the insurance company, but we are paid for KEEPING customers not losing them. I am employed by my customers. It is very rewarding when I see someone who had to go through a major illness, recuperate and send me a letter thanking me for my help and letting me know how pleased they are with the insurance company.
  8. #8  
    Quote Originally Posted by davidra View Post
    Agents? Help? When the company tells them no? Not likely.

    My own personal experience with insurance is excellent....but of course I have as good insurance as one can get. While usually they wouldn't try this crap with docs, I am aware of a doc who had a stroke, was given emergency lytic therapy which probably saved his life, and it was denied...but not for long. The vast majority of insurance claims are handled. Not promptly, from what I've seen (as my hospital/group practice has sued two insurers, one being BCBS for breaking state law by delaying payments). But how many major claims do you deal with ? How many women recently diagnosed with breast cancer do you deal with? It's rare enough so that only by investigating can they sort this out,just as described in the article. They actually have a policy of targeting women when they are diagnosed with a major costly condition and look for reasons to drop them. They do not deny that. How can anyone justify that? These stories just reinforce what Sicko was about....it wasn't so much about the uninsured, it was about people who have insurance and get screwed by the companies. Just how frequently does this have to occur before you become disgusted with the industry? You know it happens much more frequently than it turns up on the web....people just aren't able to understand or don't have the resources to fight. As far as I'm concerned, one death due to this kind of crap is one too many and the company should be fined billions for each time this happens.
    That'll cover some uninsured.
    Because their healthcare coverage was almost certainly provided by their respective employers, their HR departments would likely have been the ones to be the area dealing with any "Agent", though on a Corp-to-Corp basis.

    This phony baloney about these women calling their insurance "agent" regarding their healthcare coverage is just a disingenuous attempt to blame the victim. Which is ironically the position one has come to expect from an insurance carrier. With Wellpoint's algorithm for dropping coverage due to illness, this can only move in one reasonable direction.
  9.    #9  
    Quote Originally Posted by clemgrad85 View Post
    Yes....if you have a good agent, that agent is supposed to help. I don't work for the insurance companies, I work for the clients. It's called service and if you provide service, you actually last 25 years in an industry. Apparently you don't believe me when I say I fight claim issues and an amazingly high number of problems relate back to the doctors. You can say I'm lying, but whatever, I know the time I waste cleaning up the errors. Do insurance companies also make errors? You bet. Name me one business where mistakes aren't made. The problem is that when a mistake is made at an insurance company it can often involve a good bit of money and so the mistake is magnified....but....if you help the client you can often get issues resolved. 100% of the time? Heck no, I'd would be lying if I said that....but I do have a pretty good batting average.

    I will say that usually the doctor's office will reprocess the claim once they see they've made the mistake...but dang...they act all "high and mighty" until you can prove they made the error. I don't know if you know this, but some doctors (and their staff) have quite the attitude.
    What we are talking about here are not "errors". This company, and I sincerely doubt they are the only one that does this, has a set policy of investigating those paid-up customers who had the misfortune of developing a disease that was going to cost the company a lot of money.

    There are tons of simple billing mistakes made in doctor's offices that are responsible for delays in reimbursement. But large organizations track very closely the company's responsiveness. That's why our hospital has sued two companies, BCBS and Avmed, for delaying payment. Without evidence that delays on their end occurred, obviously the suit would have no basis...and both settled out of court, paying us back lots of money.

    But that has nothing to do with what we're talking about. This company ADMITTED what they do on a routine basis, whether you've ever seen it in practice or not. You really think the agents of these women would have made any difference whatsoever? No offense,but I doubt it. They don't WANT to keep these customers. This is a conspiracy to avoid covering life-saving treatment for people who have actually paid for it. I still have not heard you justify it.
  10. #10  
    Quote Originally Posted by Bujin View Post
    No, they recommended fewer routine exams for younger women, because the potential harm outweighed the potential benefits:




    That's an issue that people can have reasonable disagreements about, but those disagreements don't happen if you simply respond to right-wing spin to miscategorize the issue.
    BS, I suggest you stick to topics you have a clue about. It was about saving money PERIOD! more of same to come count on it.
  11.    #11  
    Quote Originally Posted by cjgem View Post
    BS, I suggest you stick to topics you have a clue about. It was about saving money PERIOD! more of same to come count on it.

    I would suggest the same to you. AHRQ is composed not of government doctors but specialists in their field. If you would like to have an extended discussion about the role of evidence-based clinical guidelines, the use of prevalence and pre-test likelihood in the determination of positive predictive value, issues of sensitivity and specificity in cost-benefit analyses, I'm here to talk to you about it, because that's what I do. Issues of the relative non-utility of mammographic screening were present in a textbook I helped write in the '70s. The Cochrane Collaboration, a group affiliated with no government at all, found the value of mammograms to be very unclear in terms of saving lives, especially in younger women.

    Authors' conclusions

    Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomised trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% overdiagnosis and overtreatment, or an absolute risk increase of 0.5%. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm. To help ensure that the women are fully informed of both benefits and harms before they decide whether or not to attend screening, we have written an evidence-based leaflet for lay people that is available in several languages on www.cochrane.dk.
    I can provide you many more references about using unproven tests and their harm. Why don't you provide me with ANYTHING that suggests that you "have a clue about" anything in this field?
  12.    #12  
    Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative

    Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman

    International Journal of Health Services, 31(3):605-615, 2001.

    Mammography screening is a profit-driven technology posing risks compounded by unreliability. In striking contrast, annual clinical breast examination (CBE) by a trained health professional, together with monthly breast self-examination (BSE), is safe, at least as effective, and low in cost. International programs for training nurses how to perform CBE and teach BSE are critical and overdue.

    Contrary to popular belief and assurances by the U. S. media and the cancer establishment- the National Cancer Institute (NCI) and American Cancer Society (ACS)- mammography is not a technique for early diagnosis. In fact, a breast cancer has usually been present for about eight years before it can finally be detected. Furthermore, screening should be recognized as damage control, rather than misleadingly as "secondary prevention."
    Link


    mammographyThe mammography screening for the diagnosis of breast cancer might not help to reduce mortality, according to the study from the British Medical Journal.

    Danish and Norwegian investigators suggested that of each 2,000 women submitted to such a diagnosis test by images, only one could have overcome the disease, while unnecessary diagnosis possibilities are higher.

    The investigations main author, Doctor Karsten Jorgensen, from the Cochrane Nordic Medical Center, said these results support studies made before in countries with national organized programs.

    "This is the moment to wonder if the tests had the effect desired in breast cancer mortality," Jorgensen said.

    The study shows that in women between 55 and 74 years of age, living in regions where mammography programs are made, mortality by breast neoplasias was reduced in 1 percent, and in regions where the programs are not carried out, it was reduced in 2 percent a year.

    In women between 35 and 54 years of age, mortality by breast cancer went down 5 percent a year in areas with detection programs, and 6 percent a year in others, during the same period.
    Link

    I've got a lot more. What do you have?
  13. #13  
    Quote Originally Posted by davidra View Post
    This is a conspiracy to avoid covering life-saving treatment for people who have actually paid for it. I still have not heard you justify it.
    Nor will you hear me justify it....if you scroll up to Post # 2, I said: "But, I do agree if all is how it was explained....what they did was very wrong. Did the article say they were later reinstated? Because if not, I gotta think they have a pretty darn good law suit." I went back and read the article and couldn't find if the women were put back on the plans? I would have to think yes.

    By the way, the article did go on and say:

    "Victoria Veltri, the general counsel of Connecticut's Office of Healthcare Advocate, a state agency that investigates complaints by policyholders, says she has seen the success of such a process in her home state. One company, Aetna, has voluntarily agreed to engage in the third party review, with what she described as favorable results.

    "I haven't seen an Aetna case in our office since they went to the third party review process," she said. "It's a powerful tool to have a third set of eyes required before someone is rescinded."

    For its part, WellPoint said it began offering third-party reviews in 2008."


    It still doesn't make it right what they did, but at least it appears the issue has been addressed.
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  14.    #14  
    Quote Originally Posted by clemgrad85 View Post
    Nor will you hear me justify it....if you scroll up to Post # 2, I said: "But, I do agree if all is how it was explained....what they did was very wrong. Did the article say they were later reinstated? Because if not, I gotta think they have a pretty darn good law suit." I went back and read the article and couldn't find if the women were put back on the plans? I would have to think yes.

    By the way, the article did go on and say:

    "Victoria Veltri, the general counsel of Connecticut's Office of Healthcare Advocate, a state agency that investigates complaints by policyholders, says she has seen the success of such a process in her home state. One company, Aetna, has voluntarily agreed to engage in the third party review, with what she described as favorable results.

    "I haven't seen an Aetna case in our office since they went to the third party review process," she said. "It's a powerful tool to have a third set of eyes required before someone is rescinded."

    For its part, WellPoint said it began offering third-party reviews in 2008."


    It still doesn't make it right what they did, but at least it appears the issue has been addressed.
    No, I was well aware you weren't justifying it, because I know you wouldn't do that. But it sets the stage for putting more teeth into the oversight of insurance activities...since they have shown they are capable of such horrifying and heartless behavior. As many "problems" as people have with Medicare, worrying about them denying care for a profit motive is not one of them.
  15. #15  
    Quote Originally Posted by cjgem View Post
    BS, I suggest you stick to topics you have a clue about. It was about saving money PERIOD! more of same to come count on it.
    Well, I wouldn't want to confuse your right-wing talking points with facts, would I? It's a much better strategy to simply say "BS...blah blah blah" and back up with nothing. Nice work.
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  16. #16  
    Quote Originally Posted by davidra View Post
    No, I was well aware you weren't justifying it, because I know you wouldn't do that. But it sets the stage for putting more teeth into the oversight of insurance activities...since they have shown they are capable of such horrifying and heartless behavior. As many "problems" as people have with Medicare, worrying about them denying care for a profit motive is not one of them.
    Placing patients at further risk is the issue, I feel, which is central to Wellpoint's culpability. These patients may not have the ability to bring their case to trial or settlement. In fact, it may be their estates which have to defend them against such egregious corporate behavior. Obviously, being in the professional gambling business, Wellpoint has been willing to accept that risk.

    Without responsive government action to investigate Wellpoint's practice, this may have never come to light and their 3rd-party review system may not have been implemented 1 year after that investigation.
  17. #17  
    Quote Originally Posted by davidra View Post
    I would suggest the same to you. AHRQ is composed not of government doctors but specialists in their field. If you would like to have an extended discussion about the role of evidence-based clinical guidelines, the use of prevalence and pre-test likelihood in the determination of positive predictive value, issues of sensitivity and specificity in cost-benefit analyses, I'm here to talk to you about it, because that's what I do. Issues of the relative non-utility of mammographic screening were present in a textbook I helped write in the '70s. The Cochrane Collaboration, a group affiliated with no government at all, found the value of mammograms to be very unclear in terms of saving lives, especially in younger women.



    I can provide you many more references about using unproven tests and their harm. Why don't you provide me with ANYTHING that suggests that you "have a clue about" anything in this field?
    70's huh, my experience with Mammography is a bit more current.

    Unproven tests? So Mamm's Don't show anything useful? Self breast exams are worthless? Young Women? If your 40 or over I think I would have to go with ACR/ACS guidelines especially if there is history in your family. Are there going to be false positives? Sure, but consider the alternative. My Mother In-law was 46 when she was diagnosed by a self exam and confirmed with a Mamm and Biopsy. I'm going to hold firm that the current system works.

    For someone that went to great ends to argue for preventive care and better access I find you take on this very interesting.

    ETA, My Mother In-law is doing fine today, because of our "wasteful current system"
    Last edited by cjgem; 04/23/2010 at 09:35 AM.
  18. #18  
    Quote Originally Posted by Bujin View Post
    Well, I wouldn't want to confuse your right-wing talking points with facts, would I? It's a much better strategy to simply say "BS...blah blah blah" and back up with nothing. Nice work.
    Linking an article from the WP, nice try. Right wing, whatever. The system works, but if in your mind rationing is the way to go because of cost then so be it.
  19.    #19  
    Quote Originally Posted by cjgem View Post
    70's huh, my experience with Mammography is a bit more current.

    Unproven tests? So Mamm's Don't show anything useful? Self breast exams are worthless? Young Women? If your 40 or over I think I would have to go with ACR/ACS guidelines especially if there is history in your family. Are there going to be false positives? Sure, but consider the alternative. My Mother In-law was 46 when she was diagnosed by a self exam and confirmed with a Mamm and Biopsy. I'm going to hold firm that the current system works.

    For someone that went to great ends to argue for preventive care and better access I find you take on this very interesting.

    Your "experience" with mammograms is anecdotal. It's never a good idea to determine policy based on anecdotes. That's why EVIDENCE is important. Believe me, my experience with mammograms is very recent as well, as were the references I posted. I was just pointing out that mammograms have been suspect for a long long time by people that understand screening and diagnostic testing issues. The recommendations by AHRQ did not deny anyone screening. They simply pointed out the facts, and suggested that physicians discuss these with their patients and then make a joint decision. If someone has a first-order relative, their pretest likelihood goes up and it might be more reasonable to screen those women. That's what clinical judgment is about. Your comments suggest that there was some limitation put on whether or not women could get mammograms. And you feel free to rely on anyone's guidelines you want, whether they make sense or not. The American College of Ob-GYN recommends getting pap smears much more frequently than AHRQ. Not that I would suggest there is bias involved as their specialists get paid for doing pap smears, but it is an interesting observation. The ACS in general has always been more aggressive in their recommendations. That doesn't mean they are any better than AHRQ/Preventive Services Task Force recommendation. I'll stick to my guns, too, when I say you don't really provide any evidence that what you are saying is correct.

    Oh...and with regard to the one case you seem to know something about, your mother-in-law was not diagnosed by screening mammography, and you have no idea if she would have been either. You also have no idea if her outcome would have been any different if she hadn't done self exam. But you're not interested in thinking about alternatives, are you?
    Last edited by davidra; 04/23/2010 at 09:45 AM.
  20.    #20  
    Quote Originally Posted by cjgem View Post
    Linking an article from the WP, nice try. Right wing, whatever. The system works, but if in your mind rationing is the way to go because of cost then so be it.

    Such a joke. Rationing, right? Tell me, at what age would you begin mammograms? Twelve? Would you do them annually? Twice a year? How do you think these things are determined? I had an 18 year old patient that died of colon cancer. Do you think all 18 year olds should get colonoscopy?

    Please. You're much better off not weighing in. But by all means, feel free, and I will be more than happy to provide you with evidence....not opinion.
    Last edited by davidra; 04/23/2010 at 10:06 AM.
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