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  • Rotten Food and the VA Hospital October 20, 2014
    by G. Keith Smith, MD Imagine for a moment that you own and operate a restaurant knowing that if you provide spoiled food and rotten service, you will subsequently make more money.  You openly employ strong-arm and intimidation tactics to …
  • Hospitals want patients to pay in advance October 17, 2014
    Hospitals are asking for payments from patients before they leave the facility so they don’t end up with unpaid bills. Knowing the costs before the procedure is important because insurance deductibles are increasing and so are procedure costs. Obamacare policies …
  • State Highlights: Mass. First To Require Health Care Price Tags; Health Disparities In Wis. October 15, 2014
    A selection of health policy stories from Massachusetts, Wisconsin, Illinois, Connecticut, California, Texas, South Dakota and Pennsylvania. WBUR: Massachusetts Becomes First State To Require Price Tags For Health Care Massachusetts has launched a new era of shopping. It began last …
  • Physicians Remove Government from Medical Equation October 13, 2014
    by Gerard Gianoli, MD Doctors in Nevada and across the country are protesting against the government’s intrusion into health care, but we aren’t voicing our concerns using bullhorns and pickets. Instead, many of the state’s 5,400 physicians are protesting silently …
  • Revolutionary Idea Could Change Medicine October 10, 2014
    For those of us who get woozy when having blood drawn for routine testing, a simple pin prick may be the blood test of the future. Elizabeth Holmes, the CEO and founder of Theranos, says that her company can run …
  • Why Accountable Care Organizations Are Failing October 8, 2014
    by Richard Amerling, MD Accountable Care Organizations (ACOs), a key piece of the Affordable Care Act (“ObamaCare”) “reform” plan, are failing because they must fail. ACOs are based on faulty assumptions, poor economics, and junk science. They would not exist …
  • Common Sense Travel Restrictions to Stop Ebola: Dr. Jane Orient October 7, 2014
    Dr. Orient appears on Cavuto – October 6, 2014
  • What Employers Can Do To Reduce The Cost Of Obamacare October 6, 2014
    The Obamacare mandate will be enforced on large employers in 2015 and small employers in 2016. Large companies who self-insure can have a plan that does not cover hospitalization, mental health care, or emergency room visits.  Small companies have to …
  • Ralph Weber Talks About Fixed Pricing – Video October 3, 2014
    You can ask the price of a procedure at a hospital, but may ask several different people before finally getting an answer. Listing set prices for procedures has lead to medical tourism. People will travel to get the price they …
  • Here’s The Thing #5 Fixed Pricing HD October 3, 2014
  • Economists Say Third-Party Payment Key to Increases in Medical Cost October 1, 2014
    The rapid increase in medical costs starting in the 1970s is commonly ascribed be market imperfections. However, federal and state governments have long suppressed the functioning of the market system in the medical industry, write Maureen Buff and Timothy Terrell, …
  • Health Insurance Exchanges Waste Taxpayer Money September 29, 2014
    Obamacare may surpass Cash for Clunkers to become the prime example of federal taxpayer resource mismanagement. For every dollar in premiums for exchange coverage, taxpayers paid 94 cents in subsidies to either enroll people or encourage them to do so. …
  • Mesothelioma: An avoidable cancer? September 26, 2014
    by Sue Redmond Did you know? Mesothelioma is an aggressive cancer that attacks the lining of the body cavity called the mesothelium (80% of which occur within the lining of the lungs). The only known cause to mesothelioma is exposure …
  • Government Healthcare is Breech of Contract September 24, 2014
    by G. Keith Smith, MD One of the smartest people I have ever met is a property and contracts lawyer, someone from whom I have gleaned countless and valuable insights over the years.  He has advised me, among other things, …
  • Dr. Alieta Eck Campaign Update September 24, 2014
    Dr. Eck http://EckForCongress.com speaks to colleagues at AAPS 71st annual meeting on September 5, 2014.
  • Is There A Provider In The House? September 22, 2014
    by Marilyn Singleton, MD, JD Physicians have a proud heritage. We can boast Dr. Benjamin Rush, a founding father, signer of the Declaration of Independence, Surgeon General of the Continental Army, and opponent of slavery. And Dr. James Derham, born …
  • From EBM to Guidelines September 20, 2014
    Richard Amerling, MD presents at the 71st Annual Meeting of the Association of American Physicians and Surgeons, September 5, 2014.
  • Flaw In Federal Software Lets Employers Offer Plans Without Hospital Benefits September 19, 2014
    A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants. The calculator …
  • Ralph Weber Talks About Cost Shifting – Video September 17, 2014
    How do hospitals come up with their prices? Medicare patients cause them to lose money. They have to make up the difference by charging the self-insured more. Non-profit hospitals keep beds vacant or build other facilities so as not to …
  • Here’s The Thing #4 Cost Shifting HD September 17, 2014

Cancer screening delayed by Obamacare

by Constance Uribe, MD

shacklesIt is common knowledge that over 500,000 Americans die from cancer every year. Americans have become increasingly conscientious about the concept of early detection as it pertains to breast and prostate cancer. One in six men will develop prostate cancer, and about one in eight women will be diagnosed with some form of breast cancer. Eighty-five percent will have no family history.

We have improved the survival of breast cancer patients, especially in those who are diagnosed before the age of 50. While it is true much of this success can be attributed to improved treatment regimens, early detection through screening mammograms has played a major role.

Many elderly men have undiagnosed prostate cancer. It has been estimated 70 to 90 percent will have malignant cellular changes in their prostates by the age of 80. The prostate-specific antigen blood test can save an estimated 17,000 men every year from presenting with the disease in an advanced stage.

The federal government has once again driven a wedge between patients and physicians by creating its own criteria for the screening of these two prevalent malignancies. Instead of trying to improve on something that was working pretty well, Washington decided to scrap the idea because it did not fit the current agenda.

Our own government is avoiding early diagnosis and treatment of these two known killers, turning a blind eye as these malignant terrorists invade our bodies. Only Washington could take something as straight forward as cancer screening and turn it into a complicated quagmire, and a deadly one at that.

These bureaucrats recruited members of my own profession to fall back on the Hippocratic doctrine of “first, do no harm.” To use simple examples: A physician should not order a mammogram, even if he can pick up an early cancer, because the mammogram is radiation and that is dangerous. Also, he should not order a prostate-specific antigen test on a patient because it might turn out “positive,” and the patient might have a side effect from the treatment. That would be bad.

This idiocy began with the United States Preventative Services Task Force, an organization created by the U.S. Department of Health and Human Services. The task force is composed of primary care physicians and epidemiologists to make recommendations regarding clinical preventative tests. It would seem their assignment was to come up with reasons to deny clinical preventative tests, such as mammograms and the prostate-specific antigen.

The panel members came to the conclusion physicians would “overdiagnose” and “overtreat” early, indolent breast and prostate cancers. If left alone, these tumors may not develop into more aggressive forms until much later. They also suggest we work on finding genetic testing to discover which of these tumors fit this indolent category, yet there is no recommendation to continue early screening until then.

According to our government, only women above the age of 50 are to have screening mammograms, and then only every other year. A younger woman would qualify for a mammogram if she had a mass that was large enough to be palpable. By then, her stage and treatment options would be different, and the same task force concerned about “overtreatment” would be subjecting this patient to modalities fraught with more
possible complications.

Likewise, the task force reports the prostate-specific antigen shows no benefit for diagnosing prostate cancer and claims the risks outweigh the benefits. The American Urological Association has an entirely different opinion. This organization, made up of specialists, believes ordering the prostate-specific antigen test results in a reduction of the number of men presenting with the advanced form of the disease.

According to Dr. Edward Messing at the University of Rochester Medical Center in New York, many more men will present with far advanced prostate cancer if physicians stop doing the prostate-specific antigen test. “Almost all men with clinically apparent metastases (spread) at initial diagnoses will die from prostate cancer,” Dr. Messing explained.

How does Obamacare come into play here? Under the Affordable Care Act, the same medically challenged agency which created this task force will be the one overseeing the healthcare of this nation. The Secretary of Health and Human Services will have the final word on all the rules and regulations regarding the distribution of health services, and those will include the ones related to preventative care.

I foresee the day when physicians will not only have difficulty ordering screening exams on their patients, but they will be penalized if they do. Health and Human Services will take the screening recommendations from this task force very seriously, and the agency will enforce them. Even if Congress attempts to pass legislation overriding any of the regulations, Health and Human Services will still have the final word.

President Obama, the Secretary of Health and Human Services and Congress have no major investment in the new cancer screening guidelines. They will be getting mammograms and prostate-specific antigen tests whenever their doctors recommend. It’s not about them and their husbands and wives and sons and daughters. It’s about you and yours.

Dr. Constance Uribe is a general surgeon and author of “The Health Care Provider’s Guide to Facing the Malpractice Deposition” (CRC Press, 1999).



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