Michelle D. Bernard is president and CEO of the Independent Women's Forum and an MSNBC political analyst.
I am black. I am a woman. And, with all due respect, I think Harry Reid has lost his mind.
Yesterday, on the Senate floor, Majority Leader Reid compared those who oppose his healthcare reform package to those who opposed ending slavery, fought against women's suffrage, and thwarted civil rights. What's next, Holocaust comparisons?
Many assume that given my race and gender, I would support the Senate health reform bill as a savior of the masses. I do not. And thousands, if not millions, of blacks, Hispanics, women, low-income, and at-risk communities feel the same.
There are many reasons why I don't support the proposed healthcare legislation. I worry about how Congress's regulations will drive up insurance premiums, a "public" option might strangle private health insurance, employer mandates might exacerbate the job crisis, and that ultimately this program will add to our already exploding debt.
Yet my reasons to oppose this bill are also personal: In 2005, I found a mass in one of my breasts. I was four months pregnant. I've never forgotten my doctor telling me that "cancer starts small." I had a biopsy and my doctor found a second mass. Two years later, I found a mass and my doctor found another. Thankfully, all four masses were benign. But I know I have an elevated risk for breast cancer, so I'm taking many precautions. Following the advice of my doctor, I do a monthly breast exam; I have a breast MRI every six months, and an annual mammogram.
I firmly believe that decisions about my care should be left between me and doctor. I worry that for millions of American women, these kinds of personal choices will increasingly become influenced by government bureaucrats.
We recently got a glimpse into the role that the government could play in making healthcare decisions. A federal task force recommended against annual mammogram exams and regular breast self-exams for women under age 50. They calculated that the costs of all of the false-positives that are created by screening women (like me) in their forties aren't worth the number of lives saved. The calculation goes like this: Every 2,000 mammograms for women between 39 and 49 prevent one cancer death. It takes only 1,300 for women between 50 and 59 to save a life, and just 337 for those between 60 and 69. From the government's standpoint, it's worth reducing the number of false-positive and unnecessary tests of women in their 40s even if that means sacrificing the lives of some women.
Many doctors were alarmed by the recommendations. An impassioned Dr. Daniel Kopans at Harvard Medical School said: "Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it. It's crazy—unethical, really." And beyond the effects of the change in policy, doctors worry about the confusing messages that recommendations like these send. Robert M. Goldberg at the Center for Medicine in the Public Interest warns of "the impact of telling women to simply go away. It took years to build up screening rates to where new drugs could have an impact on mortality. Now all that could be undone."
This is particularly true for minority communities. African-American women are nearly 40 percent more likely than white women to die of the disease. The mortality rate for black women under 50 is 77 percent higher than for white women. Shockingly, breast cancer deaths of African-American women are up 13 percent since 1974, even though the deaths of white women dropped 11 percent over the same period.
They are many reasons for these differences in mortality, but a primary cause is that African-American women are more likely to be diagnosed later. The single most important way to save more lives is earlier detection. Studies suggest that when black women follow the same preventive practices, most notably regular mammograms, as white women, their death rates are similar.
There was a public outcry about the mammogram recommendations, and the Senate has amended its legislation specifically to protect and encourage the use of women's preventative services. Yet this should be little comfort to those concerned about the potential consequences of more government involvement in healthcare. The government will have to limit services as it assumes responsibility for providing healthcare to a larger and larger segment of the population. Less politically popular diseases and treatments are sure to be on the chopping block.
Reader Comments Read all comments (42)
Frank of VA 3:20PM December 31, 2009
allen of MS 12:49PM December 20, 2009
Jeff of WI 9:22PM December 15, 2009