Let me first say that my Mother died of metastasized breast cancer at age 66, after a 7 year battle. It was a far too early death, so I do not lack sympathy.
I would agree that this might be considered rationing, but it could also be considered good use of available resources. Many women develop breast cancer after menopause, some where after the age of 40 and most commonly in late 40's or early 50's and on up. Some women, unfortunately, develop it very early, in their 20's and early 30's. This early (young) breast cancer victim, often has an extremely aggressive form, requiring aggressive treatment.
Although I know that some breast cancers are discovered during a routine mammo, most still follow the route of a woman discovering a lump, going to the doctor, and having it confirmed by a mammogram.
What we are talking about, is the routine irradiating of breast tissue, not a diagnostic procedure, just an added cost to everyone's premium. I, personally, with a maternal family history of breast cancer was told not to have mammograms prior to 50, since there may be some connection to routine irradiation and BC development, and was also told to avoid routine chest Xrays for the same reason. I have mammograms now, but only every 3 years.
At some point we have to face, that routine testing for numerous possibilities is costly, and maybe we can't afford it, particularly if the taxpayer starts to pay for universal health care.
The type of rationing that I find more disturbing is the rationing of treatment options. As some of you may know, there are 3 common treatments for prostrate cancer, low, mid, and high cost. The "success" rate for each is about the same. Most MD's discuss the options, and the patient makes the choice, often initially going for the lower cost treatment, and then moving up if he is one of "non-success" patients. Rationing by statistics would/could limit treatment to the lower cost option only. If you happen to not respond to "A", since it's statistical success is the same as "B" and "C", why authorize those treatments? What's left out, is the individual factor. If you don't respond to "A", that doesn't mean that you as an individual won't respond to "B" or "C". But if "A" is the standard treatment, it's going to take a heck of a lot of paperwork (by doctors treating a huge increase in patients) to get "B" and "C" authorized by your friendly Government Health Bureaucrat. Same thing goes for many other conditions, and treatments. Just my opinion.
Years ago, one of my physicians who was doing a study on fibrocystic breast disease, told me pretty much the same thing, Strokey. I have a mammogram once every three years and a breast exam every six months (only because of the study - I continue to be monitored).
I think it's more the insurance lobby getting their way in cutting their costs. A year or two ago prostate cancer testing for men over 70 was cut. That was a different administration, so it's not just Obama. You're going to see the insurance companies running with this and only those with money will be able to afford yearly mammograms during the 40 - 50 age group or during the alternating years thereafter. No new data was made available for this move. Just like there wasn't for the prostate cancer testing change.
I know a few women who were diagnosed with breast cancer in their 30's and 40's and they'd be dead with currently proposed standards. By the time a lump is sizable enough to be felt or seen it's often too late. In the ways that really matter we are not a "pro life" country.
Strokey, the medical center I used to work for was one of 2 facilities in the country that offered Proton beam therapy for prostate and brain cancer. The success rate of Proton therapy was higher than standard radiation and had far fewer side effects and no good tissue destroyed like with standard radiation, but it was much more expensive. For years patients generally had to fight to get their insurance companies to cover it. Many took out loans and/or had families pooling savings to pay cash when insurance denied the treatment. Those I spoke with didn't regret doing whatever they had to to get treatment. By the time I left we had contracts with all the major companies so it was less of a fight. I'm hoping we don't go back to the cheapest way out as it's the most destructive to the patient.
