The recommendations by USPSTF, a private independent scientific panel, which counter traditional, widely used breast cancer pre-screening measures, were followed a few days later by other contradictory guidelines from another private agency, the American College of Obstetricians and Gynecologists.

The ACOG guidelines stipulate that women do not need to have their first pap test (a screening test for cervical cancer) earlier than age 21, and unless a woman is at high risk, she should do a pap test every two years, instead of annually.

The unending healthcare debate reveals that America’s healthcare system includes a plethora of agencies, groups, associations, foundations, etc., that make the system awfully complicated, and difficult to operate autonomously. This diversity is a definite impediment to consensus, and underscores the decades-long difficulties that have blocked attempts to reform the healthcare system. The reforms needed go beyond just changing healthcare insurance; they should also apply to the structure of the system, and most importantly, communication and the flow of information.

One assumes that the Department of Health and Human Services would be the national agency responsible for evaluating and disseminating important healthcare information. Thus, most of the controversy arising from the new guidelines on breast cancer screenings would have been averted. Admittedly, the nation has need for the findings of entities like the USPSTF and the ACOG. It is always worthwhile to get new and developing research findings that lead to the general improvement of the nation’s health. The problem is, when these private entities announce the findings of their respective research, they are made a kind of authority, contradicting the status quo, not representing the views of the government.

These research entities should be required to make their research findings and recommendations to DHHS, who then evaluates the findings and their implications on norms in implementation of healthcare. After the findings are evaluated the DHHS would make the appropriate public announcement with its own recommendation. The current situation with every health research entity appearing to be an authority in their respective area of study is becoming chaotic.

Government spokespersons, including DHHS Secretary Kathleen Sebelius, spent significant time and energy ensuring the public that the guidelines on breast screening were not official government guidelines. Many people assumed the new guidelines were the government’s position, and callers to talk shows, and Internet bloggers were quick to accuse the government of confusing the screening issues related to breast cancer.

However, conservatives, who argue relentlessly against government’s involvement in the healthcare system, would most likely oppose private research findings first going to the DHHS for evaluation. But, why is there need for a federal department responsible for the nation’s healthcare system, if private entities are allowed to make announcements on healthcare policies, outside the responsibilities of that department.

Another important reason for an evaluation by a central government unit is that, ironically, there could be value in the new breast and cervix cancer screening guidelines. The respective panels conducted extended research to ensure the validity of their findings, but because they are private panels, making recommendations not backed by the government, the accuracy and worth of their recommendations are being questioned. This can be potentially dangerous, for although it has been a long standing tradition for women to get early and frequent breast and cervix screenings, there could be real justifications for less screening. Maybe we’ll never know, since the new guidelines are now seen as just opinions of private panels, regardless of the impressive background of the members on the panels. Coming straight from the government, with comprehensive explanations for the basis of the recommendations, the public would be more confident in accepting the new guidelines.
Until there is a structure in the healthcare system that clearly underscores the validity of new, developing healthcare guidelines, especially radically different ones, the public needs to keep very close relationships with their doctors to ensure they get the best medical guidance. But, there is still a problem if doctors themselves are confused by the contradictory guidelines coming from private sources that have the national stage. This is yet another reason for government evaluation and endorsement of these new, critical guidelines.

---

Add this article to your favorite Social Bookmarking websites