11/20/09

Why Instructions for Mammograms is Statism

Would an individual woman decide differently than a group of insurers or the federal government as it pertains to screening for breast cancer?

That indeed is the question. Read this Washington Post article or NY Times editorial to get up to speed. The issue at it's core involves the fact that women in their 40's shouldn't get every year mammograms because the risks outweigh the benefits.

It is a "recommendation by United States Preventive Services Task Force, a government-appointed group of 16 outside experts created 25 years ago to advise the Department of Health and Human Services... That recommendation was based on an analysis showing that every-other-year screenings could provide 80 percent of the benefits of annual screening while cutting the risks almost in half." From NY Times.
A quote from the Post article has a different angle:

"The only conclusion I can come to is it's economically motivated," said Carol H. Lee, who chairs the American College of Radiology's breast-imaging commission. "In this climate, when we are all paying attention to how we can decrease the cost of health care, in my opinion that's the primary motivation." From Washington Post.
The NY Times editorial claims that this issue has nothing to do with healthcare and thus should stay out of the debate. And yet, no matter how much anybody scours any article on this issue, the only risks discussed are unnecessary biopsies, radiation and stress. Now the first one isn't a risk for the patient, really. Exposure to radiation only happens if somebody actually finds real cancer (Admittedly, some of the articles parse the different between more harmless cancers and more dangerous cancers. Even still, this doesn't seem like an important distinction as it relates to radiation exposure. If somebody has cancer, they want it gone). So the only real risk is stress. And so the real question becomes: why does the government care about our levels of stress?

The answer is because the government doesn't care about our stress. Insurers care about reducing costs, and so does the government. But if you were a women in your 40's, do the risks outweigh the benefits? Of course not. You're getting that mammogram done.

And herein lies the danger. When the government starts to tell its people what to do on a collective level regarding our health (or our right to exist, or what role religion is supposed to play- just to name a few examples), we run the dangerous risk of statism: the idea that the state is the answer to all human problems. And the state isn't. It's run by imperfect people in an imperfect system and cannot answer deep questions on human existence.

The further we continue to go down this road, beware. While this issue isn't directly related to the healthcare bill currently in the Senate, they both have the same statist aims in common. The more the government runs things, the more it will have a stake in wanting to reduce costs, and thus have a significant say in the role of a human life, and ultimately whether we live or die. Death will be couched (and often already is) in compassionate terms, either for the unborn infant or the elderly. Beware, and fight back with the power of ideas.

5 comments:

Ben said...

Disagree. These are recommendations only. No one is forcing anyone to do anything. Statism would be making a law that a 45-year-old woman can't get a mammogram without special permission.

Another issue is that mammograms (and self-exams) are not the world's best diagnostic tools. The breast cancer community knows this. Ideally, cheaper and more effective diagnostic tools are the goal.

Kristina E said...

I heard about this whole mammogram debate earlier this week. I would like to point out that someone like me will have to start getting mammograms in my 30's because my mother had one of the most aggressive kinds of breast cancers there is. I do not want to follow in her footsteps, hence the prevention starting in my 30's. A routine mammogram saved my mom's life, praise the LORD! The more the government wants to control health care, the worse things will get. If anyone thinks I'm wrong, I'd like them to tell that to my 90 year old uncle in Norway (who has socialized medicine) who is STILL waiting on a hip replacement!

Ben said...

Amen to your mom's life-saving mammogram, Kristina. I think the new recommendations would agree with you - their advice is for women who have no particular risk factors. With your family history, they would still tell you to get examined in your 30s like you mentioned. Also, to the best of my knowledge, the recommendations are entirely independent of the health care reform debate. Out of curiosity, how long has your uncle been waiting?

David Strunk said...

Ben,
It isn't direct statism, so in essence I agree with you. It is a "recommendation," but it's source is very important. This is a governmental panel. So, if I were being more clear, as you suggest, I should have said that this kind of government oversight leads to statism. It isn't statism, prima facie, but it's still something we should beware of. At the very least, I tried to show that this kind of thinking leads down a dangerous road. It isn't a sufficient condition, but it is a necessary one for statism.

Thanks as always for clearing up my thinking.

Kristina, thanks for commenting! I didn't know you read up on my blog.

Kristina E said...

He has been waiting 2-3 years that I know of, possibly more. My mom is better at keeping track of these things.
Hehe, I don't always read your blog Dave, but you're welcome anyway. If you facebook posts end up on my feed I see it. I truly hate politics, but I'm not gonna lie...the word "mammogram" caught my eye. Personal interest, you see. :) Oh, and about 1/4 of it didn't make much sense to me, but keep in mind my brain stays on a first grade level these days. Ah, the joys of teaching.