Stories about: Health care rationing

Changing mammography guidelines and insights into health care reform

By Robert Troug, MD, executive director of Children’s Hospital Boston’s Institute for Professionalism and Ethical Practice and director of Clinical Ethics in the Division of Medical Ethics at Harvard Medical School. mammogram

Last week, I wrote a commentary in the New England Journal of Medicine on recent guidelines for routine mammography screening published by the U.S. Preventive Services Task Force. In it I described why the concept of rationing, which has been a dirty word in the American health care debate, is actually essential if we are to develop a health care care system that makes sense, is affordable and delivers the best possible health care to all of our citizens.

In their guidelines, the Taskforce recommended that routine mammography screening for women should begin at age 50 rather than the previously recommended age 40. As I read the report and reviewed the data, I was drawn toward what seemed to be contradictory conclusions.

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