Thursday, November 19, 2009

It's Harder Than It Looks

In regards to my last post, the last thing I want to do is belittle or downplay breast cancer. Because of the severity of the disease and how close to home it has hit for many, the recommendations of the Preventive Services Task Force provide an easy target for ridicule and outrage.

I think it's important to remember just how difficult their job is. How do you establish a break point where the cost of detecting or preventing a disease is excessive or unnecessary? How do you determine the number of lives that would statistically be saved and say it's worth the cost? Can we afford to save everyone by screening every woman every year from age 40-70? Can we do that for every disease? No, we can't. Unless it's my wife. Or my mother. Or my daughter. When it's personal it's an easy call. But when we look at the big picture, it's not so easy any more. For more discussion on that I invite you to read a post at Good Math, Bad Math as food for thought.

In the meantime, from the U.S. Preventive Services Task Force web site:

USPSTF recommendations have formed the basis of the clinical standards for many professional societies, health organizations, and medical quality review groups. Previous editions of the Guide to Clinical Preventive Services have been used widely in undergraduate and post-graduate medical and nursing education as a key reference for teaching preventive care.

The work of the USPSTF has helped establish the importance of including prevention in primary health care, ensuring insurance coverage for effective preventive services, and holding providers and health care systems accountable for delivering effective care.

USPSTF recommendations highlight the opportunities for improving delivery of effective services and have helped others in narrowing gaps in the provision of preventive care in different populations.

It's important to remember that this group's recommendations would have been released with or without the current health care reform bill in the works. And whether the health care reform bill is defeated or not, their recommendations could still be adopted by insurance companies who may then decide to only cover mammograms for women over 50. But that'll be easy for them. Someone else already did the hard part.

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