If you’re at risk of prostate cancer — in other words, if you’re male — the best place to be is the United States, where survival rates are highest in the world. But not for long, if the Obama administration gets its way in curtailing a test that flags prostate cancer before it spreads.
The administration wants to penalize doctors who routinely order the PSA blood test. Under a proposed policy, those doctors will get demerits for being considered over-spenders, while doctors who skip the test will be rewarded with a high “quality” rating from the government — and be paid more.
The Obama administration claims less care is better. That’s double-talk. An editorial in the current issue of the Journal of the American Medical Association points to a sudden, disturbing drop in prostate-cancer detection since 2011, when the United States Preventive Services Task Force recommended against using this simple test.
Worse, the journal predicts more prostate-cancer deaths due to the drop.
The task force — 16 government appointees — tried to argue that the test does more harm than good. Some men with high PSA scores undergo retests and biopsies only to find out they don’t have cancer. Or they endure the side effects of radiation and surgery even though their cancer is slow-growing and not life-threatening.
The task force claims the test’s “harms” outweigh the “benefits.” Not so fast. Of course it’s distressing to get a call that you need to get retested because of a high PSA score, but that “harm” is nothing compared to being told you have cancer that could’ve been caught and stopped years earlier.
Women go back to their doctors all the time for repeat mammograms. It beats dying of breast cancer.
Male patients aren’t pushed into biopsies or treatment on the basis of a single abnormal PSA score anyway, explains Dr. John Williams, a New York urologist. Doctors also consider a patient’s age, his prostate’s size and other factors.
In truth, the Obama administration is more concerned with cutting care than preventing cancer deaths. Guided by that warped philosophy, the task force told women in their 40s not to get mammograms, and advised women 50 and over to settle for a mammogram every two years, instead of annually.
The task force’s crass calculation was that 1,900 women in their 40s have to be screened to save one life. Not worth it, they said.
Fortunately, cancer physicians and patient-advocacy groups rebelled against that nickel-and-diming. That was in 2009. They need to mobilize again to defeat the assault on prostate-cancer screening.
Even without these new proposed penalties on doctors, the task force’s misguided opposition to PSA tests already has caused thousands of avoidable deaths, according to David Penson, a urological surgeon at Vanderbilt University. Many doctors stopped the test, allowing cancer to spread undetected.
“This is a warning,” says Dr. Anthony D’Amico of the Dana Farber Cancer Institute in Boston. “It is likely that men will develop more advanced prostate cancer before it is diagnosed and be less likely to be cured.”
Similarly, the JAMA editorial warns of advanced prostate-cancer deaths “associated with the decline in PSA screening that has occurred following the USPSTF recommendation.” That’s proof the task force is dead wrong.
Who in their right mind would consider skipping this test to be a sign of “quality” care?
But it’s part of a pattern. Obama’s signature health law awards “quality” points to the hospitals that spend the least per senior, even though these are the hospitals where seniors are least apt to survive an illness.
Dr. Ezekiel Emanuel, the Obama administration’s health-policy architect, says he has no desire to live beyond 75, so he’s forgoing all treatment, including PSA tests. He’s entitled.
But the rest of us who value life, including our own, need to know the facts. The Obama administration’s war on PSA tests is, in Williams’ opinion, “a cold-hearted decision based on cost.” It’s a war on men.
Betsy McCaughey is author of “Beating Obamacare” and a senior fellow at the London Center for Policy Research.