Word: health
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Dates: during 2000-2009
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...rumblings over the mammography message provide a useful window into why U.S. health policy does not always dovetail with the best available medical evidence, and certainly not with the best available data on costs. By and large, American patients (not to mention politicians and cancer advocacy groups) still subscribe to the view that every life is worth saving, no matter the cost, and that when it comes to prevention, screening is always good and more is always better. For decades, patients have been steeped in the notion that frequent screening is not just beneficial but also essential to the early...
...frequency of testing in older women. Doctors are also questioning the usefulness of prostate-cancer screening among otherwise healthy middle-aged men, as studies begin to show that the test, which has many risks, may not necessarily lead to fewer deaths from the usually slow-growing cancer. The Senate health reform bill currently being debated would also rely on the task-force guidelines to determine what preventive medical services private insurers would be required to cover at no cost to patients. In a sign of how contentious evidence-based approaches may become, Secretary of Health and Human Services (HHS) Kathleen...
That calculus is precisely what drives comparative-effectiveness research, a strategy embraced by both the House and Senate health care reform bills: figuring out which tests and treatments work best--instead of using every available treatment just because it's there--while saving money without adversely affecting health. Using magnetic resonance imaging (MRI) to screen for breast cancer, for example, isn't necessary for the vast majority of women who are at low risk of the disease; because most tumors are not aggressive, most women will not benefit from finding the first signs of tiny tumors that...
Both bills in Congress would set up new institutes to organize and fund more comparative-effectiveness research, ostensibly to help guide health care policy. (The $787 billion American Recovery and Reinvestment Act of 2009 has already authorized $1.1 billion for the field.) And yet as Diana Buist, a researcher at Group Health in Seattle who received some of the stimulus funding, says, "[Comparative-effectiveness research is] a hard sell. It always has been." According to a 2007 Congressional Budget Office (CBO) report on the topic, "Some experts believed that less than half of all medical care is based...
...personal understanding of risk. It's intuitively difficult for a woman in her 40s to stop getting annual mammograms when she is fully aware that they could save her life. Feeding this instinct is the relentless effort on the part of doctors and disease advocacy groups to promote preventive-health behaviors. Many feel the push may have done the public a disservice by instilling the belief that screenings are purely beneficial. "We have not rounded out that discussion with the American public about the harms," says Dr. Therese Bevers, a professor of clinical cancer prevention at M.D. Anderson Cancer Center...