• The Perversions of Politics

    Speaking of the perversions of politics, here’s another one (Wall Street Journal):

    The final health-care bill is likely to require coverage for more mammograms than the new guidelines recommend after women’s groups, doctors and imaging-equipment makers stepped up pressure on lawmakers — one of many threads of the bill negotiated behind the scenes.

    Many doctors and patient groups have long supported early, frequent screening for breast cancer. In recent years, they joined forces with mammography companies — striking sponsorship deals, for example, and holding joint events to promote breast-cancer awareness, as well as to tout company products.

    They swung into action in November after the federally funded U.S. Preventive Services Task Force said routine mammograms weren’t necessary for women in their 40s who have normal cancer risk.

    The panel said the downsides of mammograms, including the risk of false positive results, could outweigh the benefits for many women in their 40s. Other potential harms cited were unnecessary treatment and exposure to low-level radiation.

    Please don’t interpret this post as anti-women’s health. It is not. It is pro-science. But more than that, it is an example of what happens to science when it meets politics. It isn’t pretty. If we took every dollar saved on scientifically demonstrated unnecessary mammograms and pumped it back into health care for women with a higher health payoff, that would be fine with me.

    • This post brings up a very important question. Namely, does government provided insurance respond more or less than privately provided insurance to evidence based incentives?

      • @Cody Custis – That’s a great question. I think it depends where you look. The VA does a great job at responding to evidence (or lack thereof). As a result, sometimes it is accused of being slow to adapt, but what it really is is deliberate in its reliance on scientific evidence.

        Medicare is different and much more prone to political pressure.

        I would imagine that private insurers respond to financial pressure and the necessities of marketing. That would suggest they don’t follow the evidence so much as the perception of it and what it means for their business. But they’re also under the thumb of (state-varying) regulation which could force them into certain responses to certain evidence. So it is political as well.

        So different kinds of responses from different types of systems.