Thursday, November 24, 2011

Death Panels and breast cancer

The Canadian Task Force on Preventative Health Care recommends that women aged 40 to 49 NEED NOT bother getting a routine mammogram. For women aged 50 to 74 they recommend routine screening with mammography every 2 to 3 years.
The Task Force study relied on data from mammograms, some of it 30 years old. Things have changed in 30 years. The pictures (left) show mammograms of the same normal breast, taken two different ways using modern digital (left-sde) and 20 to 30 year old film-based (right-side) mammography. You don't need to be an expert to see that the modern digital picture provides a much clearer image where an expert is more likely to find a suspicious area. Much of the Task force data is based older, less accurate, film-based technology. Don't believe me? Listen to Dr. Martin J. Yaffe interviewed on CBC Radio's The Current here. Click the "Listen Pop-up" where Dr. Yaffe can be heard from 2:12 to 12:39. He is fairly adamant that this recommendation by the Task Force is flawed, and he does not shirk from the question that this may be related to cost considerations rather than the best interests of women.
An article (The Department of Health and Human Services' Death Panel) in an American publication, Forbes Magazine, says it best for the United States:
"If the government succeeds in dominating health care, as it’s now on its way to doing, we can expect more of these weird and lethal findings. The focus will be on rationing and saving money. What we need in health care is more free enterprise, not Soviet-style controls."
Of course here in Canada, and Ontario in particular, the government already dominates the health care system, and rationing and triage are the way things are done. So imagine having a discussion with a physician that has read and accepted this Task Force report, which, as Dr. Yaffe suggests is flawed. The physician will reassure her 40 to 49 year old female patients, that there is nothing to be concerned about, and of course the patients may accept that assurance.
There is an element of coercion here on the part of the physician. Implicit to the physician's advice is the incentive to ration care and save costs which may be a motivation of the Task Force. Rather, the incentive should to offer patients the best choices available so they may act in their own best interests. Choice is imperative.
The simple question I have, is why is it illegal in Ontario to have a supplementary private health care system that patients may use, or not, to allay their particular health concerns? Why not give people the choice?

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.