Barack Obama Criticism Health care Politics Videos

NBC’s Dr. Nancy Defends Doctors in Breast Cancer Debate: “We are on the verge of becoming a scientifically illiterate country”

[digg-reddit-me]One of the main competitions in our politics, aside from the liberal versus right-wing, and the establishment versus anti-establishment, is the the competition between technocrats and idiocrats. While technocrats may be ascendant in Obama’s Washington, as policy wonks and experts attempt to solve intractable problems with technical solutions and brainpower and science, the idiocrats, who try to get their agenda through by fooling enough of the people enough of the time, still have a solid hold on the political discussion.

Idiocrats take advantage of that old adage, “Where there’s smoke, there’s fire,” and make sure smoke obscures any issue in which they want to get their way. Rather than respond to their opponents on the merits, they simply describe their opponents and their agenda as the fulfillment of the idiocrat’s worst fears: “Nazi!” “Socialist!” “Communist!” Terrorist!” “America-hater!” “Death panels!” “Government-mandated abortion!” “Reparations!” “Secret Muslim!” “Radical!” For those who are not paying enough attention to the issue to sort through all the competing claims, this extremist rhetoric, while not convincing them, causes them to assume something bad is going on, even if it isn’t as bad as is being claimed.

For example, even as the health care plan Obama has proposed is largely based on previous Republican proposals, and seems to take into account conservative critiques of big government while still making progress towards liberal goals, idiocrats have condemned it in the harshest terms possible, raising every possible fear – from government kidnapping your children and indoctrinating them into socialism, to rationing by death panels, to runaway spending bankrupting the country, to abortion mandates, to the destruction of the employer-based health care system, to the destruction of Medicare. It makes little difference that it is hard to imagine a plan that both rations care brutally and leads to runaway spending, or that everyone acknowledges our current system is on an unsustainable course, or that the measures included in the bills under consideration represent the most significant attempt at cost control in a generation.

Last week, as part of a continuing effort to generate smoke to obscure real issues, the Wall Street Journal editorial board started a deliberate lie to undermine the health care reforms in Congress by claiming (without evidence and contrary to news reports as well as the the recommendation itself) that the U.S. Preventive Services Task Force – a independent, technocratic organization of doctors started by Ronald Reagan – had changed its recommendations regarding breast cancer prevention as part of Obama’s push to reduce the health care costs. This explosive claim became the focus of the public debate, instead of the recommendations of the report itself and their rationale.

On Sunday, Meet the Press had a typically “even-handed” debate between their own Dr. Nancy Snyderman and Ambassador Nancy Brinker, founder of an organization dedicated to fighting breast cancer. The whole 12 minute segment is worth watching (transcript), as you can see Brinker acknowledging that the task force might be right on the science, but at the same time suggesting that we shouldn’t show any weakness in our war against cancer by suggesting mammograms might not always be a good thing. She made a few valid points, giving certain circumstances in which mammograms would be better than alternatives, but she couldn’t and didn’t dispute the task force’s medical conclusions.

But the piece is truly worth watching for “Dr. Nancy” took on the idiocrats who were muddying the issue and defended the scientific conclusions of the doctors:

DR. SNYDERMAN: [O]ver 1900 women screened over a 10-year period of annual mammograms, one life is saved and there are a thousand false positives, which means ongoing, unnecessary tests.  Now remember, the scientists who did these numbers, their role is, as scientists, to take the anecdotes and the passion and the emotion out of it.  And I recognize that’s hard as part of the message.  But they’re to look at the public health issues of how we screen. And we’ve always known that mammography for women in their 40s has been fraught with problems.  It is not as precise for older women [She meant younger here].  On that Nancy and I have great agreement.  So what their consensus was is that there are a lot of unnecessary screenings for that one life.  Now, if you’re that one life, it’s 100 percent.  I get that.  But their charge as an independent body was to look at the cumulative research as scientists.

Later, as Ambassador Brinker tried to simultaneously politicize the issue while claiming not to be, Dr. Nancy interjected with a righteous defense of science:

The key line that got me:

I would argue that we are on the verge of becoming a scientifically illiterate country if we don’t at times separate [science and politics]…

In a large measure, the promise of Obama, the hope he held out, was to break the hold that idiocrats have over our political debate. Thus far, this is a battle he does not seem to be winning.

Criticism Health care Politics The Opinionsphere

That’s What You Get For Trusting a WSJ Editorial

[digg-reddit-me]Yesterday, the Wall Street Journal had an editorial that got passed around as if it were a news story, insisting that the decision of a board of doctors and scientists to recommend that biannual breast cancer screening only for those between the ages of 50 and 75 “is a sign of cost control to come.” The editorial cited this fact:

But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

Yet this isn’t what news articles are reporting:

Panel members said politics and questions of cost were never part of their discussions of the risks and benefits of mammograms — in fact they are prohibited from considering costs when they make guidelines.

Or this:

In reaching its recommendations, the task force of doctors and scientists determined that early and frequent mammograms often lead to false-positive readings and unnecessary biopsies, without substantially improving the odds of survival for women under 50.

And it is not the rationale given by the report itself:

The harms resulting from screening for breast cancer include psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results. Furthermore, one must also consider the harms associated with treatment of cancer that would not become clinically apparent during a woman’s lifetime (overdiagnosis), as well as the harms of unnecessary earlier treatment of breast cancer that would have become clinically apparent but would not have shortened a woman’s life. Radiation exposure (from radiologic tests), although a minor concern, is also a consideration.

Adequate evidence suggests that the overall harms associated with mammography are moderate for every age group considered, although the main components of the harms shift over time. Although false-positive test results, overdiagnosis, and unnecessary earlier treatment are problems for all age groups, false-positive results are more common for women aged 40 to 49 years, whereas overdiagnosis is a greater concern for women in the older age groups.

There is adequate evidence that teaching BSE is associated with harms that are at least small. There is inadequate evidence concerning harms of CBE.

That hasn’t stopped this from becoming a right wing talking point nor from causing concerns among independents uncertain about whom to believe – the statements of the board itself, claiming they focused on science, or the speculating opinions of right wingers, playing into people’s worst fears.

I have some advice for those people on the fence: Read the damn report if you don’t trust the media. Don’t put your blind faith in the often discredited Wall Street Journal editorial page.