NBC on the Curve-Bending Team

Mickey Kaus Columnist
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Journalistic, if not medical, malpractice: NBC’s Dr. Nancy Snyderman goes to bat for the health care cost-curve-benders, taking sides against a new study suggesting that mammograms for women under 50 have a significant payoff:

 Brian Williams: …Our chief medical editor Dr. Nancy Snyderman is with us tonight on assignment at the Mayo Clinic in Minnesota with guidance on all of this, and Nancy, good evening.

Nancy Snyderman: Today’s report increases the confusion about women as to how early and how often to get screened. It would be great to think that the more often women get screened the more  we’re going to cure cancer but that’s just not the fact. Not all breast cancers are the same. Some cancers in younger women are more aggressive. Some cancers will just go away on their own. And there’s a downside about screening everybody. It means more radiation for women who aren’t at risk. It means more false positives and biopsies. And there’s an economic downside too. So as of right now, the recommendations to start routinely screening at 50, those stay, Brian. [Emphasis added]**

1) Snyderman’s sermonette quickly veers into condescension. Women are confused and don’t want to hear the truth! 2) Snyderman muddles the conventional argument for earlier mammography–which is not just that “some” cancers “are more aggressive” and some aren’t, but that the breast cancers found in younger women tend to be more aggressive than the cancers found in older women.  Snyderman even makes it seem as if this variation in aggressiveness is an argument against expanded screening (“that’s just not the fact. Not all breast cancers are the same”) when really it’s a big argument in favor;*** 3) The Center for Disease Control hasn’t changed its recommendations. But, as Snyderman doesn’t mention, the American Cancer Society still recommends annual mammograms for women over 40, not 50.

The elite/MSM campaign against overtesting would be more convincing if cost-saving–i.e. the “curve bending” promised by Obamacare–wasn’t involved along with patient health. Snyderman basically admits cost considerations (“economic downside”) have influenced her reporting. She even implies they’ve influenced the government’s recommendations.

Am I suggesting that the CDC may have been politicized as part of the Obamacare cost-saving push? Don’t be silly. That would be like suggesting … I dunno, that the IRS had been politicized. …


About time: First Philip Klein and now the L.A. Times focus on a huge potential Obamacare problem that Ezra Klein and his popularizer, Paul Krugman, tend to overlook: Not that the health insurance plans offered on Obamacare’s exchanges will be too expensive, but that they won’t offer access to a wide array of doctors. That certainly seems to be the case for the cheapest California plans. Maybe the problem will work itself out–people will just pay more to see the doctors they want, and the lower-cost plans will be forced to expand their networks. Or maybe the problem won’t work itself out, if all the best doctors bail out of all the plans.

Re “best doctors”: Even the L.A. Times article studiously avoids admitting the obvious: that some doctors are good and some are not so good, a difference that is not inconsequential (since the better doctors tend to save you and the bad doctors can kill you). After all, it’s much easier to just talk about the “number of doctors and hospitals available” and “wait times” and “capacity … to accept new patients”–as if all doctors were functionally equal. But if everyone gets a doctor, yet only the richer Obamacare participants get the good doctors, that’s in important respects a bad outcome–one way Obamacare could contribute to social inequality rather than social equality. We’ll see. (I’m not for defunding or repealing Obamacare.  I’m for trying to implement it, trying to fix the problems that crop up, and then deciding whether to keep it. But first its reflexive defenders have to be ready to admit what the potential problems are.)


**–I originally posted NBC’s transcript, available here, which was more condescending (“women are continually confused and the reality is nobody likes to hear the answer”). I’ve now substituted the text of the video as actually delivered, which is worse in implying that a major reason for early screening (“some cancers in younger women are more aggressive”) is a reason against it.

***–“That’s just not the fact.” It isn’t? I thought Snyderman was arguing mainly that while we may cure cancer more often it’s not worth it due to the various downsides.

Mickey Kaus