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November 19, 2009
A ‘Death Panel’ Surfaces
This week, the U.S. Preventative Services Task Force announced its recommendation that women between the ages of 40 and 50 no longer receive routine mammograms to detect breast cancer at its earliest and most curable stage. This was a near-total reversal of the same Task Force’s earlier recommendations, and contrary to the advice of the American Cancer Society and other authorities.
The Task Force did, of course, state its reasons for this radically different recommendation. They used computer modeling of three large studies of breast cancer, in Sweden, Britain, and the United States. According to that work, "For every 1,000 women screened beginning at age 40, the modeling suggested that just 0.7 deaths from breast cancer would be prevented while 480 women would get a false-positive result and 33 more would undergo unnecessary biopsies."
The total cost of all mammograms of women of all ages is estimated as $5 billion per year, though the Task Force claimed that cost was not a factor in its decision-making. However, the very way they stated the basis of their recommendation suggests that claim is false. It is also one more example of the fact that the American media can totally miss a story which is right under their noses. There has been ample discussion of whether this recommendation makes sense. There is no discussion of how many preventable deaths will occur.
Notice that the women who are inconvenienced by the early exams are numbered. The report says that 480 false positives will result in additional tests, and 33 more will have unnecessary biopsies. What about the women who will die without the tests? That number is concealed behind a seemingly-small number of 0.7 deaths per 1,000. No one in the press apparently thought to open a copy of the last official Census in 2000, and figure out the number of extra deaths.
The Census data divides its results in the middle of every 10 years, rather than at the end of each decade. There are slightly less than 83 million Americans between the ages of 35 and 55. Cut out slightly more than half, because the number of Americans at each individual age, declines as age goes up. So, count 40 million Americans between 40 and 50.
The older we get, the more women there are in each age category. So it is conservative to count half of that group, 20 million, as women. Now, apply that seemingly small 0.7 percent to those Americans. The result is, 140,000 women will die every year if the 40-50 mammograms are eliminated. That is not a misprint. The Task Forces own figure of additional deaths at 0.7 percent does work out to 140,000 additional deaths of women.
Now, this Task Force does not have the power of compulsion. No private or public health programs have changed their policies as a result of this Task Force’s recommendation. However, the government health plan will have a review board which will have compulsion behind it. That board is in the Stimulus Act which has already passed and is in force.
It is that which Sarah Palin and other critics have called a "death panel." When it has the power to reduce insurance coverage for individuals because some medical efforts are not "cost effective," the deaths will begin.
No woman in my family "likes" to get a mammogram. But all of them who are older than 40, routinely submit to this life-saving indignity. What will happen when the board with real power cuts out procedures as "inefficient," as not "cost effective"? People with money to spare may pay for their own mammograms. All the women who depend on insurance will be the first to die of undetected cancers that could have been prevented.
We know this from statistics that are right in front of us, this week. No one else has noticed and reported on the extra deaths. How telling. How sad.
FamilySecurityMatters.org Contributing Editor John Armor practiced law in the Supreme Court for 33 years. John Armor practiced in the US Supreme Court for 33 years. John_Armor@aya.yale.edu His latest book about Thomas Paine is available at www.TheseAreTheTimes.us. Contact him at John_Armor@aya.yale.edu.
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