The breast exam scandal

On Monday of this week a federal task force reversed a recommendation that women between the ages of 40 and 50 get annual mammograms. This caused a furor in the media. The Diane Rehm Show on NPR had a discussion on the topic this Wednesday. Based on what I hear and read in the media, women are appalled for two reasons:

1. The new guidelines may make some women in their 40s feel that they are no longer at risk, and that these women, failing to subject themselves to annual exams and mammograms, would suffer or die from breast cancer that could have been caught in time.

2. Private health insurance companies may use these new guidelines as a pretext to drop coverage of annual mammograms for women in their 40s. The consequence, of course, is that a substantial group of women will no longer have health insurance coverage for mammograms.

The second issues seems to cause the biggest outrage, and merits asking 'why' at least once.

In the media discussions, the cost of a mammogram was mentioned as being approximately $100. If a health insurance company drops coverage for this procedure, the women, who would previously have the test paid by their insurance company, would now have to spend $100 a year for the test.

Would this additional expenditure be financially ruinous to these women? Considering that people who are covered by private health insurance tend to be in the middle and upper class, it is hard to fathom that spending the equivalent of one month's cell phone or cable bill in order to protect their lives would have any impact on their finances or would make them very upset.

But what would happen to women of any age, who are not covered by health insurance? These tend to be the working poor - not poor enough to qualify for government help, yet not earning high enough income to afford health coverage. If mammograms are no longer covered by health insurance, they are likely to go the way of breast implants - paid out of pocket. As I wrote in a previous post, the prices of medical procedures that were paid out of pocket tended to decrease over time because they were subjected to the same forces of competition that make computers ever better and ever cheaper.

The net result is that as prices of mammograms drop, they will become more affordable and more accessible to the working poor who don't have health coverage. An for those relatively wealthier women with health insurance (who still have to pay out of pocket for their exams) the price will also be somewhat less than the current $100, perhaps dropping to something closer to a pedicure...