This Week in Conservative Media: Health Rationing and Mammograms

The U.S. Preventive Services Task Force on Monday said women in their 40s should stop routinely having yearly mammograms, and older women should have them only every other year, recommendations that have divided the medical community (“It’s crazy—unethical, really,” Harvard radiologist Daniel B. Kopans told The Washington Post), left a whole lot of women confused, and riled conservative commentators, as well as just about everyone else.  

What happened? As Hot Air’s Ed Morrissey writes, “What a difference six months—and a health-care overhaul proposal—can make!” Just a few months ago there was a concern over a slight dip in the number of mammograms, and alarm bells were sounded. Why the about-face? Money, writes Morrissey. “If the administration gets its way, the government will be paying for a lot more of these exams when ObamaCare passes. That will put a serious strain on resources, especially since many of the providers will look to avoid dealing with government-managed care and its poor compensation rates.” The motivation, in short, will be to cut costs, not save lives. Morrissey raises a question likely to come up more in the future as health care continues to be debated: “Barack Obama predicated his ObamaCare vision on the notion that increased prevention would save costs. Suddenly, his administration is for decreased screening and prevention.”

Clarifying that point Wednesday afternoon, Health and Human Services Secretary Kathleen Sebelius confirmed in a statement that federal policy on mammograms remains unchanged and that the Preventive Services Task Force, whose advisory on mammograms originally broke the news, is "an outside independent panel of doctors and scientists who make recommendations." In other words, the decision on revised mammogram guidance was not a political one made by the White House.

Iain Murray at National Review’s The Corner says the policy change “is something to be pleased about,” since many women go through unnecessary and painful procedures because of the recommendations. “So it is possible that this decision is actually a victory for science over the precautionary principle, with a decision having been based on a proper consideration of the risk trade-offs involved. Even if cost was involved in the decision, as Captain Ed suggests, it's still the right decision.”

Fox News health blogger Dr. Manny Alvarez isn’t so sanguine, especially with the panel’s surprising advice against teaching women to do self-exams and assertion that there is insufficient evidence to recommend that doctors do them too. If it doesn’t cost much (other than a few minutes of a doctor’s time during an already scheduled appointment), doesn’t hurt, and might catch something, why not? “Finally, I really want to express my discontent with the advice being given to younger women not to bother doing self exams," Alvarez wrote. "We teach women about the importance of becoming familiar with their bodies. Self examination can yield lesions in a woman’s breast that if recognized and worked-up could prevent death and disease. It does not cost anything, and it can only provide vital information that is important to health care professionals.”

Alvarez is more measured than’s staff, which, taking a post from Americans for Prosperity, asks why the phrase "unnecessary tests" sounds so familiar. “That’s probably because it’s the same rationale for many of the decisions made by the government rationing boards in Britain and Canada."

The post continues: “And the results speak for themselves. Where mammograms are used much more infrequently than the U.S., breast cancer mortality rates are 9 percent higher in Canada and 88 percent higher in the United Kingdom!

“Is this what we are to expect once we have government-run health care as well?”

We do know what to expect in the coming weeks: that the recommendations will play a key role in the current health-care debate.

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