17 November 2009

Just Take the Blue Pill, Lady

The newspaper headlines today declared the new recommendation. A typical woman should start breast cancer screening only at fifty years of age instead of forty. This new guideline, issued by the federal government’s Agency for Healthcare Research and Quality, is ostensibly intended to prevent harm from “overtreatment.”

Not for an instant do I trust this recommendation.

My mistrust has nothing to do with the medical evidence, of which I have no opinion, one way or the other. The guidance might be correct, or it might not be. I have no specialized knowledge in that field, so I cannot judge the matter directly.

The reason I do not trust the recommendation is that it comes from the federal government. No specialized knowledge is required to observe that Congress and the Obama administration are taking over the American health care industry, one piece at a time. It is currently dismantling what remained of private medical insurance, and in doing so, will essentially control the purse strings of what is already a heavily regulated medical industry. With the fathomless complexity typical of a mammoth bureaucracy (particular one that wishes to conceal the nature of its intentions), the federal government will in the end fix the prices that doctors, hospitals, and drug companies may charge for products and services, and will control the distribution of those medical services.

History and logic indicate that such freedom-suffocating activities have a one hundred per cent chance of driving American medical care into the ground, and the Obama administration seems to be at least dimly aware that it must anticipate some drastic cost cutting. After all, one cannot stride so confidently and blindly in the dark like Barack Obama has without bumping one’s shins into reality from time to time. We have already seen Mr. Obama qua medical dictator blithely prescribing the blue pill instead of the red pill.[Note 1.] It is not hard to imagine this Chicago political boss “persuading” his government panel to significantly reduce the recommended number of mammograms required by American women; all the panel had to do was change one little number. The next step will be to use this recommendation to set the maximum number of mammograms that will be paid for by Obama’s national health insurance plan, which in turn will make it impossible or illegal for an ordinary woman to get a yearly mammogram. Such services, considered basic in relatively free countries, will thus become luxuries in America, available only to those who have an “in” with a politician or to those wealthy enough to travel to another country for the service.

It has always amazed me how much trust the general public puts in government recommendations of this sort. The group in this case, the United States Preventive Services Task Force, is characterized as an “independent panel of experts in prevention and private care appointed by the federal Department of Health and Human Services.”[Note 2.] But what exactly is this group independent of? The implication is that they are independent of individuals and corporations that have a vested interest in the guidelines. However, what the panel is entirely dependent upon for its existence is the federal government, an institution that has absolutely no incentive to meet consumer demands. The panel is independent of responsibility and accountability.

This naive trust in government is equalled only by the distrust in private individuals and corporations. Considering the incalculable life-advancing benefits that freedom has made possible, I would find the suspicion of unfettered men and the general anti-corporate sentiment of the public to be completely incomprehensible but for one fact: Americans obviously spend far more time watching movies and television than they spend studying history and economics. In a free market, the very existence of a business requires it to exert every effort to please its customers. Companies cannot, with impunity, make promises or recommendations that are not consonant with reality.[Note 3.]

If Americans want to stop the hemorrhaging of liberty in this country, we will do well to stop demonizing the businessmen who treat us like customers and start questioning the motives of the politicians who treat us like serfs.


1. In an ABC News interview with Dr. Timothy Johnson, Mr. Obama said, “What I've proposed is that we have a panel of medical experts that are making determinations about what protocols are appropriate for what diseases. There's going to be some disagreement, but if there's broad agreement that, in this situation the blue pill works better than the red pill, and it turns out the blue pills are half as expensive as the red pill, then we want to make sure that doctors and patients have that information available to them.”

The sheer dishonesty of this short passage is manifest. Obviously, if an individual deems a particular pill to be both better and cheaper than an alternative, he does not need the government to jam it down his throat. Mr. Obama’s obvious intention is to soften resistance to the prospect of government panels making these decisions.

2. “Panel Urges Mammograms at 50, Not 40,” The New York Times, 16 Nov 2009.

3. Of course, when companies in a mixed economy like our own mingle or collude with the government, the free market is surrendered, along with its prosperity and justice.


I fixed a minor typographical error: The phrase "number of mammograms" was supposed to be "recommended number of mammograms."


Beth said...

Thank you for this post. It is ironic that I should come across it today (via Gus Van Horn) as I have a noon appointment for my annual mammogram. I now intend to ask my radiologist her opinion of the govmt's announcement.(She personally reviews the mammogram results with each patient immediately following the test.)I also plan to give her a printout of your post. I had already intended to ask her about whether or not mammograms truly need to be performed annually, anticipating the government may start claiming less frequent tests are necessary, esp. for women over 65!!
I will let you know her answers.

Stephen Bourque said...

Good luck with your exam, Beth, and yes, I am curious to know what your radiologist has to say about the issue.

Amy said...

I had the same reaction when I read this news story. Thank you for this post!

Beth said...

My exam went great! I hope I have time to write a post specifically on my experience with the exam itself, but I spent every spare moment of three days (shame when life keeps interrupting my blogging) researching for and writing a post on the breast cancer screening announcement. The short story is I asked my radiologist what she thought of the USPSTF recommendations, and she handed me a printout of the response from the American College of Radiologists. I thanked her, and then gave her a copy of your post saying that she may find it of interest as well. She seemed interested so chances are good that she will read it.

Any way, I hope you will take the time to check out my analysis of the task force's announcement. I am pretty pleased with it.

Mammograohy: The Road to rationing?