Monday, March 16, 2009

Mammography Bailout is Coming

"A Very Expensive Program"

In 1993 the United States government seized control of the mammography "industry" with the Mammography Quality Standards Act. Over the past week I have blogged about this catastrophic government takeover here and here and here.

MQSA was purportedly designed to "improve" quality in mammography; however, as we have seen, the people involved in enacting the law really did not have a good grasp on the medical issues involved; rather, they were fixated on a political and social agenda that would send a bigger message to the United States health care system, and the world.

As one analyst described The Act:

"the adoption of the MQSA...was a highly political decision that reflected the efforts of numerous advocates and legislators to remedy the historical failure of the medical establishment and regulatory structure to pay the proper amount of attention to issues affecting the health of the nation’s women."

Because the aim of the act was social and political, the unintended consequences included the possibility of actually harming the practice of mammography -- something which has come to pass. As previously noted by Kennedy's Tumor:

*The sensitivity and specificity of mammography remain unchanged 1993 vs 2009.

*Mammography today is no better at finding cancer than it was in 1993 ...AND

*STILL...a mammogram is an insensitive test for many women
*STILL...mammography remains the second most dangerous thing a doctor can do in all of medicine
*STILL...jury awards for missed cancers on mammograms represent the largest liability awards in all of medical practice.

And what changes has MSQA actually catalyzed?

*massive closing of women's centers
*physicians fleeing the field
*millions of dollars in costs
*destruction of business initiative
*blunting of technology that might actually produce better methods of finding and diagnosing cancer

The Economy of Failure

MQSA has devastated the practice of mammography. But what are the real dollar costs?
A lot of money. As quoted above, a Harvard law school analysis in 2003 listed the government appropriation for operation of MQSA its first year of full operation, 1994, at $10,000,000 followed by an additional $1,000,000 that were transferred from the Center for Disease Control for MQSA implementation.

The Congressional Budget Office has estimated that reauthorization of the MQSA program, in 2003, cost $12,000,000 that year and an additional $77,000,000 over the 2003-2007 period.

Of that amount, $52,000,000 is for program services not covered by user fees.

"User Fees" are the fees/taxes levied each year on the mammogram facilities which, for 2008, were $18,398,000.00. These fees do not reflect the cost each center incurs hiring personnel to assist with compliance; buying software to track, publish and compile the data requested; and pursuing ongoing continued medical education training courses as required by this onerous law.

And those user fees are plummeting (think credit default swaps), as centers close at the rate of 20 per month; meaning more government bailout money will be needed, only this time to support the continued depreciation of the practice of screening women for breast cancer-- caused directly by government intervention in health care.

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