All you women, stop worrying. Actually, you're fearmongering, and you all know how your beloved president doesn't like fearmongers. So stop it.
You'll be able to get your routine mammograms whenever you want after the feds take over health care. Health and Human Services Secretary Kathleen Sebelius said so, on National Public Radio and other news outlets. You can relax and ignore the recommendations of the HHS's Preventive Services Task Force, which is advising women to ditch decades of advice from doctors, the National Cancer Society and just about every women's health expert out there regarding screening for breast cancer.
They have always recommended an annual mammogram starting at age 40 and encouraged self-examination. The task force recommends against routine mammograms for women until they are 50 or older, and then only every other year. And it found no statistical health benefit to self-examination.
But, those are just recommendations, you see. Sebelius said on NPR — after a very long pause — that she won't follow them.
And remember, these recommendations have nothing to do with cost.
That is the other reassuring refrain from the task force, which insists that this is all about good science. All this additional screening doesn't save very many lives — maybe one out of 1,900. Mammograms carry risks of their own. Women can get stressed out by false positives that then lead to biopsies and other unnecessary procedures that aren't making women live any longer.
It's purely a coincidence that this report is coming out in the heat of the debate over a government takeover of health care. It is most unfortunate that some right-wing groups are stirring up "unfounded" fears of rationing. The research was done long before any of the health care bills were filed.
This is just about delivering better care.
If you believe that, you're probably still believing all the hopey changey hypnotic sloganeering of President Barack Obama's campaign. You probably believe Gitmo is really going to close in a couple of months. You probably believe unemployment is still less than 8 percent, thanks to the stunning success of the $780 billion stimulus package. You probably believe it "saved or created" millions of jobs.
I'm sure the task force did do its work some time ago. But unless its members were in a hermetically sealed pod for the past two years, they had to know that if the Democrats won, a government takeover of health care was going to be a top priority on the legislative menu.
And how interesting — no? — that the talking points of the defenders of the new report match those of the president. This is all about better, smarter medicine, they say. Just what Obamacare is promising America.
Of course it is smarter, at the broad population level. According to some members of the task force, who have been out on radio and television trying to make sure nobody misinterprets or exaggerates their recommendations, doing mammograms on women between ages 40 and 50 would save relatively few lives.
That's not worth it, is it? Especially when we could save so much money. Except, maybe, if it's your life that is one of the relatively few that could be saved.
And that is what this is all about. I don't think there will be any immediate big change in breast cancer screening or other moves toward rationing, especially since it is more than right-wing women who are complaining about it. This is the kind of thing that will take years — maybe decades.
But, the idea is out there. This task force exists to "help" government decide what services health insurers will cover.
So, a generation from now, if you look back for a defining moment when we crossed that line in health care from the individual being the focus to the state being supreme, this might be it.
See, you have to think about it differently. It's not about individuals. It's about what's best for the population as a whole. If there's not a broad benefit to everybody from a certain treatment or screening, well then, those few of you who would benefit are going to have to do without — you know, for the greater good. It will all be based on good science.
You won't mind, will you? Just keep thinking about hope and change.
It takes me back to a conversation I had at least 20 years ago with the CEO of a major regional hospital corporation. We were discussing the rapidly rising cost of health care, and he mentioned that the vast majority of the money spent on people for medical care came in the last six months of their lives.
There was a pause.
"So, what are you saying?" I asked.
"Nothing more than what I said," he replied. "It's just something to think about."
Our government leaders are obviously thinking about it.
Rationing won't happen now. But the groundwork is being put in place. And it won't be just about mammograms. So, don't worry about yourselves. Worry about your daughters.
Taylor Armerding is a staff columnist. He may be reached at 978-946-2213 or at firstname.lastname@example.org.