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More Mammography Brouhaha

Posted Sep 28 2010 4:05am
The question of the value of screening mammography is in the news again.

Here is one typical article from the 9/22/2010 New York Times, " Mammograms' Value in Cancer Fight at Issue ".

The abstract of the original paper at the New England Journal of Medicine is here at, " Effect of Screening Mammography on Breast-Cancer Mortality in Norway ".

Of the various commentary I've seen, one of the best has been from the 9/23/2010 Wall Street Journal Health Blog, " Study: Mammograms Save Lives — Just Not As Many As Expected ".

As NEJM co-author Marvin Zelen notes in the WSJ piece:
Zelen says women need to weigh the benefits of screening (a lower chance of dying from breast cancer, at least in this age group) against possible risks. As an accompanying editorial notes, those include false alarms and unnecessary biopsies, as well as the "less frequent but more worrisome" problem of needlessly treating cancer found via mammogram that never would have amounted to anything if it went undetected. If you take the approach of "minimizing the maximum risk," as Zelen says, that suggests being screened.

But "we have to make decisions about our health on the basis of what's important to us," he says.
That last point deserves highlighting.

Patients must have the freedom to decide for themselves (in consultation with their doctors) whether they wish to undergo certain tests and procedures -- or if the risk aren't worth it (in their opinion). Those decisions are intensely personal and no government agency can or should make those decisions for us.

Hence, people should be left free to spend their own health care dollars according to their own best judgment for their benefit based on their priorities and values.

This precious freedom will evaporate as ObamaCare is implemented. Instead of patients and doctors making these decisions according to the patient's values, they will be made by central committees enforcing "practice guidelines" dictated from above to doctors working in government-sanctioned "Accountable Care Organizations" and "Medical Homes". These decisions will be based on the government's values, not the patients'.

Do Americans really want the government making these decisions for them?
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