American Elephants

Aawwk! Now They Want to Redefine the Word “Cancer” by The Elephant's Child

“The federal government wants to reduce the number of Americans diagnosed each year with cancer.  But not by better preventive care or healthier living. Instead the government wants to redefine the term “cancer” so that fewer conditions qualify as a true cancer. What does this mean for ordinary Americans — and should we be concerned?”

This is from an article in Forbes by Paul Hsieu, who is a physician and who did his residency in diagnostic radiology. The federal government wants to reserve the term “cancer” for lesions with a reasonable likelihood of killing the patient if left untreated.

Tumors that are slower growing would be called by a different name such as “indolent lesions of epithelial origin” (IDLE). ( this has echoes of Janet Napolitano’s redefinition of the global war on terror to “an overseas contingency operation.”)

The justification for the change is that modern technology allows doctors to detect small  tumors that are slow-growing and not likely to be fatal. Yet once patients are told that they have cancer, many become frightened and demand unnecessary tests, chemotherapy, radiation or even surgery. By redefining the term “cancer” the National Cancer Institute hopes to reduce over-diagnosis, and over-treatment, and reduce patient’s anxiety — and governments costs.

Some patients do panic at the word “cancer” just when they most need sound judgment about medical decisions. But can redefinition be used for inappropriate political purposes? With a vast bureaucratic organization increasingly controlling American healthcare, how the government defines medical terms can have real implications for economic and policy decisions.

The definition of a “live birth” has played a huge part in the passage of the Affordable Care Act. The supposedly high infant mortality rate in the US relative to European countries was heavily emphasized by the Left as one of the failures of the US medical system that had to be fixed right now.

Dr. Bernadine Healy (former director of the National Institute of Health explained:

The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don’t reliably register babies who die within the first 24 hours of birth.

Thus the U.S. is sure to report higher infant mortality rates. But comparisons are faulty. The definition of the beginning of “pregnancy” has major implications for the abortion debate, and whether a drug is considered a form of birth control or a chemical abortion.

The AMA recently voted to declare obesity a “disease.”This is an interesting way for members to get more federal dollars by getting obesity treatment covered on federal health plans.

Redefining “cancer” will be used to justify reducing “unnecessary” screening tests. Mammograms can detect “ductal carcinoma in situ” which would no longer be called cancer under redefinition, yet a certain percentage of such lesions can and will progress to clear-cut cancers. Cutting back on tests will save money.

There aren’t any easy answers, medicine is not a cut-and-dried, one-size-fits-all deal. It’s an art,  and doctors can’t always tell what will progress to really serious.

ObamaCare — the government as insurance company — is based on the idea that they can make health care cost less by having a faceless government bureaucracy decide what treatments actually make people healthier by examining nationwide statistics. President Obama has frequently used the idea that we’re paying for treatments that don’t actually make people healthier as one of his ACA promotion points.

Unspoken in the debate about redefinition is insurance coverage. If a patient has an “indolent lesion of epithelial origin” will subsequent mammograms be covered? The government is already trying to reduce the frequency of mammograms. Is this a money-saving scheme? Dr. Hsieh doesn’t think so.

This is the basic fundamental problem with government-run health insurance. Their drive is to make health care cost less. Physicians struggle to be paid enough to cover their expenses. Federal programs always cost far more than the original estimates. The incentives are no longer patient health and care.

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