"My Two Cents Are Free" - Mammogram & Pap Studies

Having begun a blog for breast cancer patients, survivors, family and friends, it's rather difficult not to weigh in on the recent announcements regarding mammograms and pap smears.  Until now, I've abstained from political commentary on this blog and especially on Facebook.  But I hear Eminem in my head.  To loosely paraphrase, "Here's 10 cents, my 2 cents are free."

My initial instinct was to exclaim in print.  Instead, I chose to watch it unravel a bit first.  My sense quickly became, the bullshit will bubble to the top.

Some of it did.  So instead of recanting the events and studies, I welcome you to consider a few things, particularly when it comes to breast cancer and mammogram screening.

1. Mammograms are not the only means of detecting breast cancer, each with a particular strength and limitation:  ultrasound, thermography, self exam, MRI, PET, etc.
2. Mammograms save lives, even for women under 50.
3. Mammograms don't read dense tissue well, so for those of us with perkier breasts (this is usually considered a good thing), a combination is optimal.  
4. There is no single effective screening tool for women under 40.
5. The cost of care dramatically increases when caught later.  
6. Under 40, breast cancer tends to be much more aggressive with lower survival rates.  Since it is often caught later, earlier detection and prevention are key.
7. 9 out of 10 breast cancer patients have no family history.
8. The BRCA gene blood test tends only to be covered by health insurance if:
   a)  one has family history
   b)  one has already been diagnosed with breast cancer.
9. I have excellent health insurance, the premium choice PPO bentley, but still faced the possibility of having to pay out of pocket to get the BRCA test.  My oncologist said it might be over a $1K should insurance not cover.  I took the chance given the gravity and risk a positive result would incur on my treatment protocol.  I was also fortunate in that I could scrape the money together, if needed.  How many Americans, particularly in this economy, have $1K for a blood test?
10. Although there is a lot of insisting about them being unrelated, both announcements were made the same week, both transparently emphasizing cost savings rather than improving health services or saving lives, and last but most interestingly not least, both groups are in some part funded by the government which is currently undergoing serious debate on health care cost reduction.

Go figure.

Personally, I'm all for cost reduction and improved operations.  I've helped many organizations implement technologies to achieve these goals.  Once again, however, it seems folks have conveniently lost the plot on both sides of the debate.  'Tis a shame really.  We're the ones always left with the mess to sort through.