Healthcare reform has now become entangled in the latest controversy over whether affordable healthcare for all translates to healthcare rationing.
This week, the U.S. Preventive Services Task Force (USPSTF) issued its latest recommendations on screening for breast cancer, published in the November 17 issue of Annals of Internal Medicine.
New guidelines advise routine mammography screening for women starting at age 50 and repeated every two years until the age of 74, presuming there is no history of breast cancer in themselves or family.
No longer is the advisory panel recommending routine screening for women between the ages of 40-49.
According to the U.S. Census Bureauâ€™s Population Division, its figures which were released on 5/14/09 reflects 10,761,793 women in this country between the ages of 40 and 44 with another 11,565,799 women between 45 and 49. So we are affecting quite a number of people.
The most startling is that the task force dissuades physicians from teaching women to do breast self-examinations because â€œ it leads to worry and stressâ€.
This is a drastic 180-degree turn from 2002 when the Task Force suggested mammography is performed every one to two years on women over 40 years. It is also in direct contradiction to guidelines issued from the American Cancer Society.
In the last several years, media along with the healthcare system had been very successful in promoting this message along with instruction on breast self-examinations with accompanying instructional literature and illustrated brochures.
Women are up in arms that with the government trying to reduce healthcare spending, that this step represents rationing of healthcare and that should individuals decide to have a mammography done, that insurance would no longer cover the procedure.
According to the USPSTF, the advice of the Task Force is not official or meant as Public Health Service guidelines or the basis for the U.S. Department of Health and Human Services. Kathleen Sebelius, the secretary of health and human services, confirmed this.
Statements issued from this panel have not only aided in stressing the importance of prevention in health care, but also have formed the foundation of the clinical standards for many professional societies, medical organizations and quality review groups.
Indeed, the White House insists that Task Force recommendations have no immediate bearing.
Insurance companies contacted by USA TODAY denied that annual mammograms would not be reimbursed and that despite new guidelines, will continue to cover the test for their insured.
Susan Pisano, a spokeswoman for Americaâ€™s Health Insurance Plans, which include 1,300 companies, protecting 200 million Americans, stated that insurance plans have not proposed amending the coverage.
Representatives of the Society of Breast Imaging and the American College of Radiology also expressed concern that the new recommendations appeared to be issued for cost-saving measures.
Both the American Cancer Society and the American College of Obstetrics and Gynecology are still advising annual screenings beginning at age 40.
Yet despite protestations to the contrary, the National Cancer Institute stated that it would include the new recommendations to physicians and the public at large.