Tag Archives: health reform bills


The new breast cancer screening guidelines released last week, along with the supporting study, are among the most disputatious medical recommendations in recent memory. Critics on the right charge government rationing, while those on the left suspect an insurance company conspiracy to cut essential coverage. Adding gasoline to the fire is the even more heated health reform debate that has led its combatants to hijack the mammography issue to bolster their own particular views, pro and con.

To get past the politics, I read the study. It is hardly a page turner, but it’s a credible scientific analysis of the available data on breast cancer screening. A key question it addresses is how effective mammography is for women under age 50—an issue that has ping-ponged back and forth across the medical policy community for four decades. In this latest volley, the U.S. Preventive Services Task Force (USPSTF), citing the study, recommends “…against routine screening mammography in women aged 40 to 49 years.” But then it equivocates with, “The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.”

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The raging health reform debate has completely obscured recent disclosures by some medical providers of shocking information that has long been held among their most closely guarded secrets: their prices. These innovators are responding to the rapid four-year growth of high-deductible health plans that incentivize consumers to demand cost-effective solutions for their medical problems. Stated simply, a lot more patients want to know the prices of medical services before they buy them.

I recently discovered one striking example of this trend that promises an entirely different and brighter future for American health care than the one currently fermenting its way through the legislative bowels of our nation’s capital. It is the website for The Surgery Center of Oklahoma in Oklahoma City. Click on the link and see something extraordinary: a leading-edge medical facility that actually tells you its prices up front—but only for patients who pay them in full and in advance. Otherwise, if you want the Center to bill your insurance company and fight through its bureaucratic layers for uncertain payment at some distant time, the price will be higher.

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