OUR VIEW: Early detection of health rationing

Health care reform should be on every American’s list of things to consider, even if the answers are undetermined and the eventual outcome unknown. Whatever decision Congress makes will impact us all in some way.

A recent Gallup poll indicated the biggest concern Americans have is the cost. The government’s involvement in health care presents major concerns regarding cost and availability. The latest recommendation on screening for breast cancer, for example, flies in the face of everything women have been told for the past 20 years. More screening and early detection were the goals, and now we are told to seek less screening, out of concern for false positives.

The statement by the U.S. Preventative Services Task Force, an independent panel of health care professionals that evaluates scientific evidence and develops recommendations for clinical preventative services, has raised a great deal of controversy and questions.

The new recommendations contradict the American Cancer Society’s previous guidelines which say women starting at age 40 should have a screening mammogram every year and breast self-exams should start in their 20s. The task force completely discounts self-examinations and recommends women forego mammograms until age 50. Adding to the confusion, the American Cancer Society stands by its earlier guidelines. Health and Human Services Secretary Kathleen Sebelius heads the agency that appoints the task force. Sebelius has been one of the administration’s biggest health care reform advocates. Although Sebelius issued a statement Nov. 18, basically telling women to ignore what the task force said, it remains disturbing that the agency responsible for these new guidelines is closely linked to the administration.

The American College of Obstetricians and Gynecologists released new guidelines Nov. 20, saying women don’t need their first cervical cancer screening — or Pap test — until they’re 21 years old. The guidelines said follow-up exams can be every other year, instead of annual exams.

All these new recommendations are supposedly not reflected in insurance coverage guidelines yet. But with health care reform still looming, it is hard to believe the changes won’t affect women’s health in a negative and regressive way. Minority women already lag in preventative health care, and this could intensify the problem. Studies and reports, including the Institute of Medicine’s “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” document that racial and ethnic minorities often have less access to health care, receive lower-quality health care, less preventative care and have higher rates of illness, injury, and premature death.

The reasons are varied: lack of insurance coverage, poor communication with physicians and cultural barriers. Stress, embarrassment, and false beliefs about cancer risks are some of the other reasons minority women continue to fall behind in getting health screening and testing. With these latest guidelines, will women of color lead the increase in women who postpone or ignore preventative health care measures? If so, these task force guidelines will only exacerbate a serious problem.

Equally troubling is the statistical evidence from the Health and Human Services fact book that say Latina women with lung or breast cancer are diagnosed in later stages and thus have a lower survival rate than white women with similar cancers. What will the latest mammogram guidelines mean for those numbers?

These latest developments appear to conflict with President Obama’s goal to extend health care to all Americans. It is hard to imagine expanding health care while simultaneously undermining early detection measures.

Some health care experts think this rewriting of recommendations is an early sign of government rationing. As government becomes more entwined in health care, it seems obvious government officials will make life and death decisions for us. Government, not private physicians and insurance companies, will tell us how often we should screen for problems. That’s because government must ration in order to provide equal access. Whether you are a minority, an older American or anyone struggling with health issues, the government’s less-is-better attitude about screening for cancer should send up red flags. — Pula Davis, for the editorial board

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Our View editorials uphold a proud tradition at The Gazette of advocating individual freedom, constitutional law, faith, and limited government. Editorial opinions have no connection with The Gazette’s news division, and do not express the views of all Gazette associates.