Save the boobies under attack

[Malthus]

What we ought to have is some sort of rigourous metric. Problem is, it will always sound cold-hearted.

What we ought to do is to decide how much money we (as a society) are willing to spend, in total, on all screening type tests, then divy that money up based on some calculus of efficacy of test and risk of harm from what you are testing for.

Instead, we have a calculus based purely on emotion, with various disease interest groups lobbying for attention.

[Malthus]

I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

Once you start reasoning like this, euthanasia of the undesirables becomes a valid option.

After all, if you believe it's sensible to save money on prevention, why not save on the actual treatment? A child born with a debilitating disease that requires a life-time life support is unlikely to be worth it in financial terms - he or she will never get contribute to the society in a way that will exceed the costs of keeping such treatment going. Likewise, treating pensioners for any diseases really doesn't make sense either.

The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.

[KRonn]

Yeah Meri, this is confusing now and opens up new concerns and questions. Seems they're looking to change the whole process, and have some good reasons for doing so, but still it leaves concerns and worries, and rightly so.

[Berkut]

I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

Once you start reasoning like this, euthanasia of the undesirables becomes a valid option.

No, actually it doesn't. There is no such slippery slope.

Rather, when you "reason like this" you are simply replacing one choice about who you let die, with another - since it is certianly the case that there is not an infinite amount of resources to spend on preventitive care, therefore there will always be some set of people out there who are going to die because they did not get tested early or often enough. Ideally, that choice ought to be based on science and reason, rather than your kind of "death panel" crap.

This is reality. The study in question is a scientific and presumably objective attempt to evaluate the costs and risks involved in early screening for breast cancer. Your response is EXACTLY the problem I am talking about - based completely on emotion and "OMG you are an asshole who wants to euthanize people!" rather than any kind of actual rebuttal of the point. You are right up there with the "death panel" folks. In fact, that is exactly the same response.

[Berkut]

What we ought to have is some sort of rigourous metric. Problem is, it will always sound cold-hearted.

What we ought to do is to decide how much money we (as a society) are willing to spend, in total, on all screening type tests, then divy that money up based on some calculus of efficacy of test and risk of harm from what you are testing for.

Instead, we have a calculus based purely on emotion, with various disease interest groups lobbying for attention.

You sir, are a callous prick who wants to euthanize people.

Welcome to the club.

[Martinus]

I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

Once you start reasoning like this, euthanasia of the undesirables becomes a valid option.

After all, if you believe it's sensible to save money on prevention, why not save on the actual treatment? A child born with a debilitating disease that requires a life-time life support is unlikely to be worth it in financial terms - he or she will never get contribute to the society in a way that will exceed the costs of keeping such treatment going. Likewise, treating pensioners for any diseases really doesn't make sense either.

The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.

Ok but are you saying that a disease that has a chance of killing 1% of the total population is insignificant? I don't think many diseases can top that.

[Berkut]

Ok but are you saying that a disease that has a chance of killing 1% of the total population is insignificant? I don't think many diseases can top that.

WTF?

Who said anything about this disease being insignificant? Nobody has - not even the article made any such claim.

Jesus Marty, you are building strawmen faster than even you can burn them. First it is that people want to euthanize people, and not that breast cancer is insignificant???

[Martinus]

Ok sorry I thought your point was that we should stop spending money on breast cancer screening.

[Berkut]

Ok sorry I thought your point was that we should stop spending money on breast cancer screening.

Not at all - my point is simply that we should make these kinds of decisions based on presumably objective and scientific studies (like this one), but for the most part we do not.

[DontSayBanana]

If the science says that the risk of breast cancer in women in their 40s does not justify the costs and risks associated with mammograms at some particular rate, then the insurance companies should most certainly not cover those exams.

Of course, this will never happen, because everyone will wear their pink bows or whatever, but it is what SHOULD happen.

The findings of one group don't constitute "the science says."  The only hard number given in support is a 60-percent increase in false positives of women in their 40s over women in their 50s.  Of those, the description is of "cancerous lesions that would never become life-threatening."  That's assuming nothing changes; benign tumors can become malignant ones.  They're also poo-pooing self-exams, and saying only to bring it up when day-to-day life changes- in other words, no early detection.  If self-exams aren't taught, a tumor could get pretty far by the time you notice it in day-to-day life.

Once you strip away the attempt to override eight "gold-star" studies with one shaky set of results, it reads like the kind of homeopathic quackery you'd find at a local chiropractor's office.

[DGuller]

I think results like this are rather amusing.

It is funny how impossible it is to have a rational discourse about any of this. If you ever suggest that maybe a course of action that will cost less, but result in some number of deaths is the right course of action, you are getting to get roasted for being such a callous prick.

The only acceptable answer is "ZOMG WE MUST HAVE EXAMS FOR EVERYONE NO MATTER THE COST!!!" So much of what is "important" in medicine is based on completely emotive responses, rather than simple and dispassionate evaluations of risks and costs.

Kind of funny Meri that you would champion this, while at the same time you laugh off vaccinations. A bit inconsistent there in your decisions about what preventative measures should be taken. Vaccinations are a lot cheaper, and prevent a illness that is MUCH more likely than breast cancer in women in their 40s.

That was pretty predictable response.  And a right one too, I might add.

[DGuller]

Ok sorry I thought your point was that we should stop spending money on breast cancer screening.

I thought his, and the researchers' point, was to spend the money on screening more efficiently.  Such as screening only when there is a significant enough chance of finding anything.

[DGuller]

The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.

Another way to look at it is that if your budget for saving lives is fixed, then doing away with inefficient expenditures actually saves lives.  Sure, some people who'd previously live will die, but many more people who would've previously died would live.

[Berkut]

If the science says that the risk of breast cancer in women in their 40s does not justify the costs and risks associated with mammograms at some particular rate, then the insurance companies should most certainly not cover those exams.

Of course, this will never happen, because everyone will wear their pink bows or whatever, but it is what SHOULD happen.

The findings of one group don't constitute "the science says." 

...hence the inclusion of the word "if", right there at the beginning of the sentence.

[alfred russel]

The problem at the other end is that there is no limit on what you could spend to achieve 100% safety for everyone.

Another way to look at it is that if your budget for saving lives is fixed, then doing away with inefficient expenditures actually saves lives.  Sure, some people who'd previously live will die, but many more people who would've previously died would live.

I buy a lot of crap I don't need, and lord knows the wife does too. If we are going to fix a budget for saving lives, that number should be high. I'm willing to tolerate some "inefficiency" to avoid dying of cancer.