Saturday, November 21, 2009

Who is in Charge?

New guidelines for old problems are usually good things. After all we are always trying to improve and move forward, right?

I mean when you see an advertisement on television it doesn't say, "Old and unimproved" does it?

So why should we not be embracing the new medical guidelines coming down from high concerning mammograms or cervical cancer screening? These edicts say that women don't need to be screened for possible life threatening diseases as often as they have in the past.

Going to a doctor is an inconvenience, right?

So women should be happy to skip their yearly trek to have their breasts uncomfortably squashed and examined or push back that embarrassing position in the stirrups for the pap smear.

This is a good thing, right?

NO, it's not.

Why?

Because we should not be naive anymore!

In this day and age and certainly in this country big business controls our lives. Insurance companies already tell us what doctor to see when we are sick and limit our intake of necessary drugs to those they get kickbacks on.

The ulterior motive here is not so ulterior! The fewer times women go to the doctor the fewer bills the insurance companies have to reject! Rejection takes time and clerks!

If the number of claims submitted to the scum of the Earth, I'm sorry I mean insurance companies were reduced to a bare few they could lay off thousands and just have a stay at home house wife in India rubber stamp every claim, "Rejected."

And what better way to reduce the number of claims than to push off the expense on the coroners?

The time has come for women to rise up and join the fight against the scourge of life known as big insurance. It is clear that Congress does not have the balls to do so.

But luckily it does not take balls to put these inhuman bastards in their place, only common sense and solidarity. Lech licked the odds in Poland and women should be able to do so in America.

If all the women were to get together and JUST SAY NO to the health insurance companies and their puppets in congress maybe we could get true reform. Even Nancy Reagan would like that slogan!

America was once the greatest nation in the world. Don't allow greedy corporations and special interest groups to continue our current path into third world status.

2 comments:

pharmjock1 said...

Dear mugguy:
What you are saying may be true, but I just don't know. Well meaning clinicians wrestle with the public health questions:
to screen or not to screen
to vaccinate or not to vaccinate
to treat or not to treat
With vaccinations and treatments, clinicians daily have to weigh the risks and benefits for things that reimbursers readily pay for. Do more people get sick from smallpox or polio vaccine than will get the disease? Should we anticoaguate a patient for life that has had an event. The sensitivity of screenings (the rate at which a positive screening shows a positive disease state) differs from screen to screen. For example it is thought to be high in PSA's. Other tests may be lower. Once a screening is done, the clinician is obligated to treat which may expose the patients to many risks. The specificity of a screening (the rate at which a negative screen shows actual absence of disease) varies from screening to screening. Therefore, if the screening is done and shows a negative, how sure can the clinician be that there is no disease without delving into more invasive and risky diagnostic tests? Physicians rely on the clinical evidence to make these decisions, and evidence is dynamic. Yes, costs do come into play, because if a screening is done with a low sensivity, there will be an obligation to undertake the risks and costs of treatment for patients that are in actuality disease free. The ability for the clinician to watch and wait will be lost because of fear of litigation. In practice, I hear clinicians debating with themselves and colleagues whether to screen or not to screen, to treat or not to treat, without insurance involved. So I don't know if these decisions are being made by insurers, or by the path of science.

mug guy said...

Thank you for your well thought out comment.
The path has been muddied and while the medical community sorts out better ways to screen and read results I do not believe the insurance companies should be the deciders. They hold most of our money in their pockets (and by hold I mean keep) must they also hold our fate in their hands?