example of absurdity of current state of US healthcare

[the argus]

I'm generally not an anti-government dude, and there's certainly much bigger issues to deal with when it comes to the US healthcare apparatus, but just encountered an small example of how ridiculous and poorly run US healthcare is becoming.

the USPSTF, a panel funded and appointed by the US Department of Health and Human Services, a cabinet level department level of the federal government, recommends low dose CT for lung cancer screening for ages 50-80.

Medicare, a government national health insurance program, administered by the Centers for Medicare and Medicaid Services, an agency within (the god damn same) US Department of Health and Human Services, will only cover low dose CT for lung cancer screening for ages 50-77.

Unbelievable...

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[VA Hopeful Dr]

I'm generally not an anti-government dude, and there's certainly much bigger issues to deal with when it comes to the US healthcare apparatus, but just encountered an small example of how ridiculous and poorly run US healthcare is becoming.

the USPSTF, a panel funded and appointed by the US Department of Health and Human Services, a cabinet level department level of the federal government, recommends low dose CT for lung cancer screening for ages 50-80.

Medicare, a government national health insurance program, administered by the Centers for Medicare and Medicaid Services, an agency within (the god damn same) US Department of Health and Human Services, will only cover low dose CT for lung cancer screening for ages 50-77.

Unbelievable...

That is odd as most cancer screenings stop at 75.

 

[NewYorkDoctors]

The update from the original 2013 guidelines to the latest guidelines reducing to ages 50-80 and only 20 pack years was based off of the NELSON trial which took place in the Netherlands and Belgium and these were ALL MALES. Already you can see how this trial somewhat lacks generalizability to the US population. The USPSTF made the decision to proceed anyway with the newest guidelines somewhat out of necessity given the high needs lung cancer screening and prevention in the US.

https://www.nejm.org/doi/full/10.1056/nejmoa1911793

USPSTF Report: Screening for Lung Cancer With Low-Dose Computed Tomography

This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on screening for lung cancer summarizes published evidence about the relative benefits and harms of low-dose computed tomography to identify lung cancer in persons at high risk.

jamanetwork.com

Anyway yeah. The government sure is frustrating. hey look a balloon! don't look at that train wreck in Ohio. hey look UFOs! Don't pay any attention to laptops or secret island guest lists.

 

[the argus]

I honestly haven't looked deeply into the data that drives the age cutoffs, and wasn't trying to comment on the appropriateness of those cutoffs.

Was just pointing out that if the Department of Health and Human Services can't even follow their own screening guidelines that they publish, how in the hell do they expect anyone else to.

"You really need to do this screening for a 30 year period, but we're only gonna pay for 27 of those years"

 

[NewYorkDoctors]

point taken. i concur. inefficiency and lack of consistent / communication is a hallmark of (corrupt) governments.

maybe if you put on a Zelensky mask, you will your patient the screening CT instantly approved.

at the end of the day, Medicare and Medicaid are the hand that feed us doctors. so... it's all one big futile cycle in a sense. i figure I would not waste the ATP and just find ways of working around it.

Edit: i must throw in another (lame) medical joke... the reason I don't want to deal with this futile cycle is because I can't handle all the heat!

*distant sound of a pin dropping is heard amidst the silence*