ObamaCare Tax Increases Are Double Original Estimate


By zzyzzx   Follow   Wed, 13 Mar 2013, 7:31am   2,098 views   143 comments
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http://www.economicpolicyjournal.com/2013/03/tax-prof-obamacare-tax-increases-are.html

The Joint Committee on Taxation recently released a 96 page report on the tax provisions associated with Affordable Care Act. The report describes the 21 tax increases included in Obamacare, totaling $1.058 trillion – a steep increase from initial assessment, according to the Tax Prof Blog. The summer 2012 estimate is nearly twice the $569 billion estimate produced at the time of the passage of the law in March 2010.

Patrick's code won't let me paste in a table here.

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  1. Meccos


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    104   7:57pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    It comes back to what I said about intellectually dishonest debate tactics; you're in violation of the 'my resume is bigger than yours tactic.' Thanks for taking things out of context to the point that it misrepresents my original position.

    MMR the biggest problem to your argument is that I never tried to trump anyone's argument based on my resume. I never used the prestige of my schooling/education, job, etc as the basis for my arguments as you suggest.
    Rather it is you who boasts about your relatives in medicine, as if that has anything to do with you. You think having relatives in medicine gives you any credibility? Furthermore you try to overstate your position by saying "you are gunning for residency in 2015" rather than saying you are a second or third year medical student". Keep in mind, that I never stated what I did or what my background was, until curious asked me. So how could I possibly do what you accuse me of doing?

    BTW, you'll learn about projection soon enough (yes now I am talking down on you).

  2. Meccos


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    105   7:57pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    Curious provides links unlike you, usually high quality.

    If you think links to local newspapers with anecdotal evidence are high quality links , then you are a fool...

  3. MMR


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    106   7:59pm Sun 17 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    What does one need to diagnose for obesity at the primary care level? It makes up for 40% of patient load in most offices. What kind of treatments would you recommend for these people. What is the 'standard of care' for pre-diabetes, diabetes and CVD? Drug therapy? How brilliant! Not telling patients the truth about their situations makes for repeat customers and future referrals to others in your referral network. Yeah, yeah, diet and exercise. How do patients do that? Telling patients that is next to worthless but most doctors stop there, knowing damn well it doesnt make a difference. Since you like anecdotes, because you are 'too good' to provide evidence/links, failure to adequately address obesity increases referrals to cardiologists and oncologists and probably psychiatrists as well. What benefit is there for cardiologists and oncologists who make money to provide advice on diet and exercise when most live off of medicare? Generally speaking, most doctors I know (over 100) only have other doctors in their referral network. Since you are a doctor who has familiarity with the billing codes, maybe you can enlighten us all about the benefit financially for cardiologists to provide detailed diet and exercise advice. Oh, that's right, most cardiologists don't do that because that doesn't put more money in their pockets than doing procedures; When the arteries become blocked due to incompetence/failure to tell patients unvarnished truth at the primary care level, the cardiologist intervenes with a balloon angioplasty; prior to that, the radiologist might determine the level of blockage. So yeah, since nothing was done for the obese person at the primary care level, the radiologist got make a diagnosis which then leads to treatment.

    Not sure what kind of doctor you are, but based on your speaking style, your patients are most likely, unmitigated idiots if they put their trust in you.

    Again not saying that radiology doesn't add value, but it is often questionable. Certainly not 4.4 billion dollars. Certainly helps you to cover your ass, though it might not put money in your pocket.

    Meccos says

    f you feel that making a diagnosis adds no value, then I could see your argument. However, most if not all, patients and clinicians would argue that diagnosis is the first step in any treatment.

  4. Meccos


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    107   8:01pm Sun 17 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike (1)  

    MMR says

    I noticed that you make assertions without providing research, but use anecdotes to explain you position, but when others provide links, you just say they are wrong without providing alternate links.

    Perhaps you should review the links I made... Ill give you an example of my links versus curious' links.

    Mine:
    http://archinte.jamanetwork.com/article.aspx?articleid=416067

    Curious:
    http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande-the-cost-conundrum-redux.html

    Yes, this survey of hundreds of physician is anecdotal... yet the new yorker article surveying a couple physicians is not anecdotal.

  5. Meccos


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    108   8:04pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    Other than JAMA, Annals of Int Med, and Archives of Int Med and NEJM, what else do you read to stay up-to-date?

    What is the purpose of this question? MMR says

    By the way, on an unrelated topic, why do you whine about people deleting your links? Since you're a physician who uses this site often, why are you too cheap to donate 5 bucks for a premium account to Patrick, who is running this site at a loss?

    Again what is the purpose of this question? Whether I pay for a forum service or not, what is it to you? Perhaps I am cheap. so what? Regardless of whether I pay, do you think it is proper for any comment to be deleted?

  6. MMR


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    109   8:22pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Referencing the original quote, that's pretty much what you did. I've heard that a million times before so its possible that you weren't doing that, but based on experience, I'd say not likely

    Meccos says

    MMR the biggest problem to your argument is that I never tried to trump anyone's argument based on my resume. I never used the prestige of my schooling/education, job, etc as the basis for my arguments as you suggest.

    Meccos says

    Just so I know what your background is and where you get your info from, what do you do and where?

    There is a lot more to read that what makes it into political circle jerk that medicine has become. Pretty sure you're not much of a reader of current research unless it makes it into the only books you trust

    Meccos says

    MMR says

    Other than JAMA, Annals of Int Med, and Archives of Int Med and NEJM, what else do you read to stay up-to-date?

    What is the purpose of this question?

    That's not up to curious standards. He's done better in the past. I do agree that defensive medicine is real; it may well be that the fear of getting sued is greater than the actual reality and that some people use the confusion to game the system. On an anecdotal level, my cousin, a retired pediatrician, bills aggressively and 'sees what sticks'. He was never sued in his career of over 22 years.

    Meccos says

    Perhaps you should review the links I made... Ill give you an example of my links versus curious' links.

    Mine:

    http://archinte.jamanetwork.com/article.aspx?articleid=416067

    Curious:

    http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande-the-cost-conundrum-redux.html

    Yes, this survey of hundreds of physician is anecdotal... yet the new yorker article surveying a couple physicians is not anecdotal.

  7. Meccos


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    110   8:23pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    What does one need to diagnose for obesity at the primary care level? It makes up for 40% of patient load in most offices. What kind of treatments would you recommend for these people. What is the 'standard of care' for pre-diabetes, diabetes and CVD? Drug therapy? How brilliant! Not telling patients the truth about their situations makes for repeat customers and future referrals to others in your referral network. Yeah, yeah, diet and exercise. How do patients do that? Telling patients that is next to worthless but most doctors stop there, knowing damn well it doesnt make a difference.

    You have no idea what I do, yet you continue in this moronic fashion and accuse me of things to which you have no idea...

    MMR says

    Not sure what kind of doctor you are, but based on your speaking style, your patients are most likely, unmitigated idiots if they put their trust in you.

    Exactly you have no idea what I do.

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

    MMR says

    But radiologists sure do. It seems like they make the money they make not as a value-add, but just to help doctors practice CYA medicine. One estimate (can't remember where) was that it was about 4.4 billion dollars a year.

    BTW, I like how you deleted the part where you said that these tests are done to "cover" our butts. THis is exactly what I have been saying. Why did you delete that post??? haha

  8. Meccos


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    111   8:27pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    Referencing the original quote, that's pretty much what you did. I've heard that a million times before so its possible that you weren't doing that, but based on experience, I'd say not likely

    So cant prove I did that, but yeah I possibly did it? hahaah funny.

    MMR says

    There is a lot more to read that what makes it into political circle jerk that medicine has become. Pretty sure you're not much of a reader of current research unless it makes it into the only books you trust

    Again, you have no idea but make assumptions... You will go far my boy.

    MMR says

    That's not up to curious standards. He's done better in the past

    Perhaps he has done better in the past, but we arent talking about the past are we?

  9. MMR


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    112   8:30pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    I said it's overvalued. Not that it adds NO value. By the way

    Meccos says

    MMR says

    But radiologists sure do. It seems like they make the money they make not as a value-add, but just to help doctors practice CYA medicine. One estimate (can't remember where) was that it was about 4.4 billion dollars a year.

    BTW, I like how you deleted the part where you said that these tests are done to "cover" our butts. THis is exactly what I have been saying. Why did you delete that post??? haha

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

    Meccos says


    943053">

    When did I delete it. Pretty sure its still up there. I guess you're projecting again.

    MMR says

    But radiologists sure do. It seems like they make the money they make not as a value-add, but just to help doctors practice CYA medicine. One estimate (can't remember where) was that it was about 4.4 billion dollars a year.

    BTW, I like how you deleted the part where you said that these tests are done to "cover" our butts. THis is exactly what I have been saying. Why did you delete that post??? haha

  10. Meccos


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    113   8:35pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    I said it's overvalued. Not that it adds NO value.

    um.. no. you didnt say over valued.

    MMR says

    But radiologists sure do. It seems like they make the money they make not as a value-add, but just to help doctors practice CYA medicine. One estimate (can't remember where) was that it was about 4.4 billion dollars a year.

    BTW, you claimed that you didnt delete a comment after you posted it, but we both know its false. In fact, there is a comment that I quoted you on in the post just prior to this one that has been deleted as well.

  11. MMR


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    114   8:38pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Whatever you say dean ornish. I think you are using a dean ornish argument strategy. 'We both' don't "know" anything. Anyway, gotta go to bed so I can study. toodles. In closing I don't need your lousy 'advice' on how to 'make it far' in medicine. Lots of sucking up (strategically) and telling people what they want to hear until I have the freedom to practice what I see fit. Being good looking/fit helps as well, since most people(attendings,interns) in the wards judge people so superficially.

    In closing, you're patients are probably universally idiots if they think you could give them good advice on diet and lifestyle. I am not interested in YOUR focus, rather I'm giving you a perfect example of why Radiology is often of questionable value. At the same time, I'm telling you what I'm already good at. This is what most people really need help on since doing so would decrease incidence of diabetes and cardiovascular disease. Nope, I'm not going to be an insurance taking hack like you, even if it means I make 25K in my first year. I'm fortunate not to have loans. Truth be told, I'm not florence nightingale, I like to help but I'm no saint; money matters and if I had to take loans to do it, I wouldn't. Meccos says

    BTW, you claimed that you didnt delete a comment after you posted it, but we both know its false. In fact, if you look on the previous posts, I cant even find the post I quoted you there

  12. Meccos


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    115   8:41pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    MMR says

    Whatever you say dean ornish. I think you are using a dean ornish argument strategy. We both don't know shit. Anyway, gotta go to bed so I can study. toodles.

    I may not know a lot of shit, but you clearly do not know any shit. Good luck in medical school, I hope you do not turn out to be this guy:

    MMR says

    Telling patients that is next to worthless but most doctors stop there, knowing damn well it doesnt make a difference.

  13. MMR


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    116   8:49pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Clearly......as clear as a bowl of shit.Meccos says

    MMR says

    Whatever you say dean ornish. I think you are using a dean ornish argument strategy. We both don't know shit. Anyway, gotta go to bed so I can study. toodles.

    I may not know a lot of shit, but you clearly do not know any shit. Good luck in medical school, I hope you do not turn out to be this guy:

    MMR says

    Telling patients that is next to worthless but most doctors stop there, knowing damn well it doesnt make a difference.

  14. Rin


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    117   8:57pm Sun 17 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike (1)  

    BTW, to those reading this thread... Homeboy has accused me and MMR of being the same person in an earlier thread regarding doctor's salaries.

  15. Homeboy


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    118   11:31pm Sun 17 Mar 2013   Share   Quote   Permalink   Like   Dislike (1)  

    CaptainShuddup says

    Fuck... Who says I advocate some fantasy made up entity that no one has managed to put a face to, but several have gone on record, to say..."Gosh I'm not one of them, and why I wish they would tax me more..."

    YOU did, fucktard, to wit:

    "Why don't you Liberals just strong arm rob every rich republican in this country, then give all of their money to the IRS.
    Can you explain, how that will benefit people that are actually trying to earn a living? That would be "Oh happy days!" for the welfare class, but the rest of us, will be shit canned from our jobs because it is the RICH in this country that hires people. "

    You are saying you don't want the rich to pay more taxes, because they are the ones that "hire people". Look, dude - you fucking wrote it. It's right there. Don't try to slink away from it now like a pussy.

    CaptainShuddup says

    But nobody has explained how that top 1% managed to get everyone's money, but there's not one company that has been tied to this fictitious 1% entity pile of Bullshit. How in the fuck are the 1% getting so much goddamn money, if they aren't anyone that you can point at. How are they employing everyone, if there is one to point a finger at. How are they getting customers, to go to their businesses, to spend money, so they can pay their employees nothing, while they make piles of money and give everyone else the shaft.

    How is all of this even happening?

    All of the "1%" fear mongering, and not one Liberal will provide one fucking name of a company associated with this fictitious lot. So everyone can boycott them and drive them out of business if they are so bad.

    Are you kidding? You are so far in denial it's not even funny. Oh, I don't know, just for example... GOLDMAN FUCKING SACHS. Duh. Not one Liberal will provide the name of a company? That's ALL liberals ever do. Maybe you should turn off the Fox News for 5 minutes. What good would it do to boycott them? You are as naive as they come. They already would have gone out of business, but they were declared "too big to fail". Doesn't matter how bad their business model is, the government will keep handing over the middle class' wealth to them.

    You don't believe the distribution of wealth is skewed in the U.S. Well you're not the only one. Watch this video, and see the difference between people's perception and reality:

    http://www.youtube.com/watch?feature=player_embedded&v=QPKKQnijnsM

    Then look at this chart, to see how the distribution of income has CHANGED over the last few decades:

    Then awaken from your long slumber, my friend.

  16. MMR


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    119   7:30am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Well......one-third of cancers that were found via routine mammograms may not be life-threatening, raising once again the question about the value and benefits of traditional breast cancer screening. More than one million women could have been wrongly over-diagnosed with breast cancer, thereby exposing them needlessly to the angst that comes with the diagnosis, as well as the traditional healthcare treatments for the disease.

    http://www.ncbi.nlm.nih.gov/pubmed/12903848

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  17. MMR


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    120   7:34am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    We found that the introduction of screening has been associated with about 1.5 million additional women receiving a diagnosis of early stage breast cancer," writes study co-author Dr. Gilbert Welch.

    Now, at first, you might think that's a good thing. You might think, "Well, early detection saves lives, just like we've been told by Komen and the cancer non-profits."

    But you'd be wrong. As Dr. Welch's team discovered, there was virtually no reduction in late-stage breast cancer from all this "early" diagnosis, meaning that most women who were told they had breast cancer after a mammogram were being lied to.

    As he explains:

    We found that there were only around 0.1 million fewer women with a diagnosis of late-stage breast cancer. This discrepancy means there was a lot of overdiagnosis: more than a million women who were told they had early stage cancer -- most of whom underwent surgery, chemotherapy or radiation -- for a "cancer" that was never going to make them sick. Although it's impossible to know which women these are, that's some pretty serious harm.

    Yep, it is. In fact, if you do the math and calculate 0.1 million fewer women with advanced-stage cancer out of 1.5 million who were diagnosed, 93% of the "early detection" cancer cases studied were false positives, meaning that they would never have gone on to cause advanced-stage cancer anyway.

    http://www.nejm.org/doi/full/10.1056/NEJMoa1206809?query=featured_home&

    Dr. Welch, author of study in New York Times

    Six years ago, a long-term follow-up of a randomized trial showed that about one-quarter of cancers detected by screening were overdiagnosed. And this study reflected mammograms as used in the 1980s. Newer digital mammograms detect a lot more abnormalities, and the estimates of overdiagnosis have risen commensurately: now somewhere between a third and half of screen-detected cancers.

    Got that? Many cancer diagnoses from mammography are utterly false. But they are a great scare tactic for recruiting women into what can only be called a "cult of cancer" in which they are manipulated into poisoning themselves with chemicals. They are later called "cancer survivors" if the poison doesn't manage to kill them.

    http://www.nytimes.com/2012/11/22/opinion/cancer-survivor-or-victim-of-overdiagnosis.html?_r=1&

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  18. MMR


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    121   7:38am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Ultrasound better than mammography for detection of invasive breast cancer

    An analysis conducted by the Seattle Cancer Care Alliance (SCCA) reveals that, overall, ultrasounds have a 95.7 percent sensitivity rate in detecting malignant tumor cells while mammograms are only 60.9 percent sensitive, by comparison. Among 1,208 cases evaluated, ultrasounds also successfully detected about 57 percent more harmful breast cancers compared to mammograms.

    Dr. Constance Lehman, M.D., Ph.D., Director of Radiology at SCCA and her colleagues observed that, particularly among women aged 30 to 39, ultrasounds are a safer and more effective alternative to mammograms as a breast cancer screening tool. Based on her and her team's findings, it now appears prudent to switch gears and perhaps ditch mammography altogether.

    "In women under 40, ultrasound is better at evaluating breast lumps compared to mammography," said Lehman about the findings, which were published recently in the American Journal of Roentgenology. Though Lehman still recommends mammograms for women over age 40, her study's findings illustrate that they are an unnecessary risk.

    http://www.seattlecca.org/press-release/ultrasound-is-better-detecting-cancer-in-women-under-40.cfm

    http://www.ncbi.nlm.nih.gov/pubmed/15474430

    MMR says

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  19. MMR


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    122   7:42am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    When you really take an honest look at the data, it is clear that mammography is negligibly effective at reducing deaths from breast cancer, at best. The general, 10-year risk of a woman dying from breast cancer is about 0.53 percent, while the risk for a woman who gets mammograms is 0.46 percent. Mammograms, in other words, reduce this already low risk by a mere 0.07 percent, which could represent nothing more than a statistical margin of error.

    Put another way, 53 women out of 10,000 will die from breast cancer in the next 10 years, and mammograms may potentially lower this number to 46 women out of 10,000. But in the meantime, as many as 50 percent of all the women receiving mammograms to detect such cancers will have at least one false positive, which will in turn result in needless biopsies, surgery, radiation, or chemotherapy.

    Any potential benefit in terms of death reduction from breast cancer is essentially offset by the fact that regular mammography screenings are also linked to actually causing breast cancer. A study presented at the annual meeting of the Radiological Society of North America (RSNA) found that young, high-risk women who are screened using mammography are up to 250 percent more likely develop breast cancer as a result of the screening compared to those who are not screened.

    http://www.cnn.com/2012/08/02/health/komen-mammograms/index.html

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  20. MMR


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    123   7:47am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    More mammograms equals more mastectomies.......Due to overdiagnosis

    http://www.bidmc.org/YourHealth/HealthInTheNews.aspx?ChunkID=657310

    The study drew on data from Norway's national breast cancer screening program for 35,000 women aged 40 to 79 diagnosed with early or invasive breast cancers. Oslo researchers discovered a 31% increased risk of mastectomy among women invited to receive mammograms compared with a non-invited younger age group.

    The research team found, in comparing rates of mastectomy before and after the institution of the national screening program, mastectomies increased by 9% among women invited to screenings. However mastectomy rates decreased by 17 percent during the same time period among non-invited women aged 40 to 49 and by 13 percent in non-invited women aged 70 to 79.

    Study author Pal Suhrke observed that "these results are surprising and disappointing because one might suspect that due to earlier detection of tumors, the number of women needing mastectomies would decrease."

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  21. MMR


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    124   7:50am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Mammograms deliver overwhelmingly more false positive results than true positives in women under the age of 40, according to a new study conducted by researchers from the University of North Carolina-Chapel Hill and published in the Journal of the National Cancer Institute.

    In a false positive result, a mammogram detects signs of a tumor that turns out to be non-cancerous or otherwise not dangerous to a woman's health.

    "In a theoretical population of 10,000 women aged 35 to 39 years, 1,266 women who are screened will receive further workup, with 16 cancers detected and 1,250 women receiving a false-positive result," the researchers wrote.

    "Harms need to be considered, including radiation exposure, because such exposure is more harmful in young women; the anxiety associated with false-positive findings on the initial examination; and costs associated with additional imaging."

    The researchers examined the medical records of more than 117,000 U.S. women who got their first mammograms between the ages of 18 and 39. In the ensuing year, not a single woman under the age of 25 was diagnosed with breast cancer. For women between 35 and 39, 12.7 percent were called back for further tests but only 0.16 percent actually had cancer.

    Because breast cancer rates in young women are so low, screening them is like "looking for a needle in a haystack," lead researcher Bonnie Yankaskas said.

    http://thechart.blogs.cnn.com/2010/05/03/mammograms-in-your-30s-%E2%80%98a-needle-in-a-haystack%E2%80%99/

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  22. MMR


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    125   7:55am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    550
    0

    (NaturalNews) In my experience, it's not often that pro-mammogram literature or textbooks tell the truth about the limitations of mammography so imagine my surprise when I came across this section in the 1,100 page textbook I'm studying called Breast Imaging by Dr. Daniel B. Kopans.

    "Because screening does not detect all cancers and does not detect all cancers sufficiently early to permit cure, screening should not be thought of as a method to reassure someone she does not have cancer. Emphasis was added by the book's author.

    "Screening is purely a chance to detect some cancers early in their development, at a time when intervention may be able to alter the course of the disease. It should be understood that, given the present state of the art, screening does not detect all cancers or save all women, and there is still not a test or combination of tests that can guarantee a women does not have breast cancer. Screening is not the solution to the breast cancer problems, but until universal cure is developed or safe methods of prevention are discovered, screening with mammography can save many lives." (Kopans, pg. 146)

    This is a revelation all women should understand: A normal mammogram does not mean a storm is not just over the horizon. Most women who receive a report that their mammogram is normal breathe a sigh of relief. For some, they have been lulled into a false sense of security. It can take up to nine years for the fastest growing cancers to be detected by mammography. What if your scan is normal and it's year eight?

    I've heard women say, "I have to get my mammogram so I don't get cancer." They've said it with the same perky voice I've heard them announce, "I have to get my flu shot so I don't get sick!" Why is a flu shot viewed as something that provides health, like it's a shot of B12, instead of understanding a flu shot for what it is: an injection of a toxic substance? The same idea applies to a mammogram. It's not prevention. It's a dose of radiation, a toxic substance, promoted as something good for your health.

    Dr. Kopans clearly states that a mammogram is "simply a measuring tool to assess if you have cancer" - yet. But women have a different perception of their annual exams. In fact, a 1999 study revealed that 44 percent of women believe screening mammography had a sensitivity of 100 percent, meaning, they believe that mammograms find every breast cancer (http://jech.bmj.com/content/53/11/716.abstract). This is not only untrue, it is an unrealistic expectation of any medical test. In fact, the Breast Cancer Detection Demonstration Project, a large epidemiological study first done in the 1970s, found that a combination of mammography and clinical breast exam failed to detect at least 20 percent of cancers. (Kaplan, p148). This statistic has remained fairly constant to the present day.

    False positive and false negative mammograms

    While radiologists use a strict set of criteria for interpreting the films, the interpretation of a breast x-ray is challenging. A mammogram looks like white blobs and scratches across a black board. If you've never seen one, ask your doctor to see your films the next time you have a mammogram. It's an educational moment worth having and can explain why mammograms do not - and cannot - detect every cancer, especially at its smallest, earliest stage.

    A false-positive mammogram means that something appears abnormal on the film, but then turns out to be a false alarm. Over a 10-year period, approximately 24 percent of women who have an annual mammogram will have at least one false-positive mammogram

    Suspicious findings require a woman to be called back for "extra views" and more radiation exposure. An inconclusive mammogram can lead to an ultrasound, and most likely a biopsy, where eight of 10 are found to be normal.

    In 2006, the Cochrane Review published a meta-analysis of mammograms performed on 500,000 women throughout the US, Canada, Scotland and Sweden. The review concluded that for every 2,000 women who received mammograms over a 10-year period, 10 women have extra, unnecessary and potentially harmful treatments and the number of mastectomies increased by 20 percent

    http://www.ncbi.nlm.nih.gov/pubmed/17054145

    A false-negative x-ray, on the other hand, means cancer is present but not detected by the mammogram or is overlooked the radiologist who did the interpretation. In 1982, the false-negative rate for screening mammography was found to be eight to 10 percent

    (http://caonline.amcancersoc.org/cgi/content/abstract/32/4/194).

    A decade later, some authors have suggested the false-negative rate was as high as 25 percent

    http://radiology.rsna.org/content/184/3/613.short

    Dense breast tissue can compromise the ability of a mammogram to detect a mass, and lesions located near the sternum (breast bone) or near the chest wall can be difficult to visualize. A false-negative test can explain why one year the report is normal and the very next year, cancer is diagnosed.

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  23. MMR


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    126   7:58am Mon 18 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Radiologists vary in their ability to accurately interpret mammograms and the overall range of accuracy is troublesome. In 2005, a disturbing study published by U.S. Army Medical Research for its "Era of Hope Project," radiologists (on average) accurately identified only 77 percent of cancers. For individual radiologists, the detection rate ranged from 29 percent to 97 percent, meaning that some physicians only found about 30 percent of tumors on sample mammograms, an extraordinarily high false negative rate. Interestingly, this reference seems to be no longer available for review.

    At the other end of the scale, a meta-analysis of 117 studies published in Annals of Internal Medicine (2007) reported that false-positive results on mammograms range from 20 percent to 56 percent in women 40 to 49 years of age

    http://annals.org/article.aspx?articleid=733981

    In Radiology, researchers found that radiologists who interpret fewer scans generate more false positive reports. The minimum number of mammograms required of radiologists practicing in the U.S. is currently 960 mammograms every two years - or about 10 per week. The researchers estimate that increasing the number of required scan interpretations to 1,000 per year, or about 20 per week, would result in 43,629 fewer women being recalled for extra studies, reducing the cost of false-positive tests by $21.8 million per year. On average, for every cancer detected, 22.3 women were called back for more testing

    http://www.emaxhealth.com/1024/radiologist-who-read-more-diagnostic-mammograms-do-it-better

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

  24. MMR


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    127   8:05am Mon 18 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Radiology might add net value, but I doubt it. It's highest value is to help insurance mill owners/hospital employed MDs to practice CYA medicine. I'd venture to say that a significant driver for 'defensive medicine' is whether or not a patient is self-pay vs insured. Translation, self-pay patients are less likely to be overbilled since they are paying out of pocket. Of course that makes up a small percentage of people visiting insurance mills.

    One thing I am adamant about though: Radiologists should make a good living, but should not be the highest paid by any stretch, while Pathologists are near the bottom of the barrel. It's a lot harder for a pathologist to make a million dollars per year than for a radiologist. Based on value, that's unjust.

    I gotta study for step I so have a good one dude.

    MMR says

    MMR says

    Meccos says

    MMR says

    Again not saying that radiology doesn't add value

    No this is exactly what you said...

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    128   8:51am Mon 18 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike  

    As long as we are discussing breasts:

    Boobpedia - encyclopedia of big boobs
    http://www.boobpedia.com/boobs/Main_Page

    Note: I do not recommend viewing that webpage while you are at work (unless you work from home).

  26. curious2


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    129   3:57pm Mon 18 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike (1)  

    The bottom line with Obamacare is that it was written to require everyone to spend more on injurious products and "services" that no rational person would buy, e.g. "preventative" radiation "doing more harm than good" and Homefool's SSRIs. In the case of mammography, politicians seeking women's votes promote it as a "women's health" issue, since women are a majority of voters, even though the executives and sellers that get the real benefit are mostly men. Many women suffer from false positive diagnoses, and even the negatives (false or accurate) are getting irradiated. By far the most important factor reducing cancer deaths is fewer people are smoking, which caused all sorts of cancers including breast cancer. Of course Obamacare will generate more money and power for the people who wrote it, because that's why they wrote it, and you'd have to be popping Homefool's pills not to see that, or selling them like the wife of Toxo Bob.

    It's funny how the only two people who can't tell me apart from MMR and Rin are Homefool (SSRIs) and Bob (Rx opiates and opioids). Their comments have provided yet another warning of the cognitive side effects of those drugs.

    Bob & Homefool troll for fights for different but possibly related reasons. Like any addict, Homefool needs to secure his supply of the pills he can't afford, so he craves Obamacare. Toxo Bob seems to be suffering from Toxoplasma Gondii. Bob will misread these as fighting words, which he's always hoping to find, but seriously, he should get his wife to test him for T. Gondii. The endless trolling and the reckless driving are like a Toxo mouse desperately craving cats, maybe surfing among sharks in New Zealand too. I'm not always a fan of medical testing, but that one test and learning to cope with the infection might save Bob's life, really. And, a Czech study suggests a population with a high incidence of toxoplasmosis may shape local culture by causing "high levels of anxiety, insecurity or depression." It's conceivable that Homefool's original symptoms may have resulted from living in Oakland, surrounded by a fighting culture of toxic pugilists similar to Toxo Bob, causing Homefool to become anxious, insecure, and depressed.

  27. CaptainShuddup


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    130   8:22pm Mon 18 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike  

    Homeboy says

    You don't believe the distribution of wealth is skewed in the U.S.

    Then don't buy their product, who ever they may be, or where they hide. But stop giving them your money, if you have such a firm understanding of who the 1% are.

    You're just an unwilling participant in the system, expecting there's some evil clown throttling the wheely ride. But you keep
    getting back on man. You gotta simplify man, stop feeding the bears. Ride a bike and make a sandwich. Don't drink at Starbucks they are part of the problem. Pay more at the local super retail, boutique shops. Screw wall mart, don't give them any of your money. You can get the same thing for twice as much somewhere else
    But at least you wot be making those 1% bastards any richer. And Alice 47 year old shop owner's husband will thank you. The place is a money pit that is draining his retirement account dry.
    Quit using computers and the internet, because there's not one single technology that you could use, that isn't making some one, or a lot of someones more money.
    Quit buying gadgets, cars, electronics, designer labels and buying from name retailers, discount houses, and big box retailers.

    The 1 percenters... you're the one that gave em all your damn money, and now bitching about them. How about you?

  28. Homeboy


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    131   10:02pm Mon 18 Mar 2013   Share   Quote   Permalink   Like   Dislike (2)  

    CaptainShuddup says

    The 1 percenters... you're the one that gave em all your damn money, and now bitching about them. How about you?

    No I didn't. The government took my money and GAVE it to the 1% via bailouts, loans, and buying their toxic crap that they couldn't have GIVEN away. What part of that don't you understand?

  29. curious2


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    132   10:10pm Mon 18 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Homeboy says

    The government took my money and GAVE it to the 1% via bailouts, loans, and buying their toxic crap that they couldn't have GIVEN away. What part of that don't you understand?

    The part where you omitted Obamacare from your list.

  30. zzyzzx


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    133   6:15am Tue 19 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    Homeboy says

    No I didn't. The government took my money and GAVE it to the 1% via bailouts,

    They also gave it to millions too lazy to work.

  31. pdg


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    134   7:47am Tue 19 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike  

    This is pathetic. Are any of you actually discussing the linked-to article or just trashing each other personally. This has become what Patrick.net is all about now.

  32. CaptainShuddup


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    135   10:35am Tue 19 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Homeboy says

    No I didn't. The government took my money and GAVE it to the 1% via bailouts, loans, and buying their toxic crap that they couldn't have GIVEN away. What part of that don't you understand?

    You didn't? Didn't you... but Didn't you?

    Do you own or use...
    iPhone
    a car bought since 2006
    any social media that is publicly traded
    Corporate Restaurant(From starbucks to McDonald's to cheese cake factory)
    Shop at National grocery chains(From Wholefoods to WalMart to Target)
    Shop at a big box retailers(From Sams Club to Best Buy)
    tech gadgets
    home electronics(From televisions to stereo to Bluetooth speakers)

    Wait a minute, unless... could be... you're suspecting that the Bank bail out CEO's from 2007 are the only people that should be on the 1% list, and they make all the money in USA, and they are isolated from any of the products or companies mentioned above.
    Then you guys are more diluted than I even originally thought.
    Because I just don't see how making a hand few of people that have nothing to do with the dwindling jobs, and the corporate monopolies in this country that keep lowering the standard of living, in this country.
    Those bailouts were in the past, I didn't like them. I still feel like everyone involved should meet their demise though a firing squad.
    As well as the administration that came in behind them and continues that con job fuck over of the American people.

    But come on get your shit straight. Most Liberals still claim today, that had those bailouts never happened, then we would be in the "Great" "Great" "great" depression. Of course we all know that's a crock of bullshit. Any Idiot could have been in the Fed and we would have had the same result. Whether they bailed those banks and auto makers out or not.

    We just got fucked over in the name of a good crises. Then lets not forget, that it is also the current Libs that claim all of that bailout money got paid back.

    But they only say that in defense of Obama. But when they want to bitch about Bush's portion of that flimflam, then of course nothing got paid back, and Bush is a son of a bitch.

    You guys are so full of shit.

  33. Homeboy


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    136   12:33pm Tue 19 Mar 2013   Share   Quote   Permalink   Like   Dislike (2)  

    CaptainShuddup says

    But come on get your shit straight. Most Liberals still claim today, that had those bailouts never happened, then we would be in the "Great" "Great" "great" depression. Of course we all know that's a crock of bullshit. Any Idiot could have been in the Fed and we would have had the same result. Whether they bailed those banks and auto makers out or not.

    We just got fucked over in the name of a good crises. Then lets not forget, that it is also the current Libs that claim all of that bailout money got paid back.

    You're kidding, right? You pronounce me a "Lib", and then tell me what my opinion is? Your alzheimer's must really be kicking in. Did I EVER say any of those words you are now putting in my mouth? No. Did I ever say I wanted the bailouts to happen? Hell no. Here's the difference between you and me: I don't form opinions just because I think I'm "supposed" to, based on what "group" someone says I'm a part of. Whereas you just pretty much regurgitate whatever thought-rays Fox News has beamed into your brain.

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    137   12:37pm Tue 19 Mar 2013   Share   Quote   Permalink   Like   Dislike (3)  

    zzyzzx says

    They also gave it to millions too lazy to work.

    Math doesn't lie. Look at the chart. Is poor people's share of the pie increasing? Nope. Just the wealthy. You can have whatever delusion you choose, but it's not supported by any facts.

  35. Homeboy


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    138   12:41pm Tue 19 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike (1)  

    pdg says

    This is pathetic. Are any of you actually discussing the linked-to article or just trashing each other personally. This has become what Patrick.net is all about now.

    Originally we were, but Meccos and MMR carpet-bombed the thread into oblivion.

    No point anyway. I tried to actually discuss the topic, but just got verbally abused by the OP and had all my arguments deleted. Instead of trying to refute what I wrote, he just said they were "lies" and deleted them.

    And that pretty much is what Patrick.net is all about now.

  36. zzyzzx


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    139   2:17pm Mon 25 Mar 2013   Share   Quote   Permalink   Like   Dislike  

    http://obamacarefacts.com/obamacare-taxes.php

    ObamaCare Taxes That (may) Effect the 98%

    40% Excise Tax "Cadillac" on Premium Health Insurance Plans 2018 This will affect a lot of union thugs with their gold plated medical plans

    An annual $63 fee levied by ObamaCare on all plans (decreased each year until 2017 when pre-existing conditions are eliminated) to help pay for insurance companies covering the costs of high-risk pools.

    Medicine Cabinet Tax In Effect
    Over the counter medicines no longer qualified as medical expenses for flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs), and Archer Medical Saving accounts (MSAs).

    Additional Tax on HSA/MSA Distributions
    Health savings account or an Archer medical savings account, penalties for spending money on non-qualifed medical expenses. 10% to 20% in the case of a HSA and from 15% to 20% in the case of a MSA.

    Flexible Spending Account Cap 2013
    Contributions to FSAs are reduced to $2,500 from $5,000.

    Medical Deduction Threshold tax increase 2013
    Threshold to deduct medical expenses as an itemized deduction increases to 10% from 7.5%. This means that you are less likely to be able to use the medical expense tax deduction

    Individual Mandate (the tax for not purchasing insurance if you can afford it) 2014
    Starting in 2014, anyone not buying "qualifying" health insurance must pay an income tax surtax at a rate of 1% or $95 in 2014 to 2.5% in 2016 on profitable income above the tax threshold. The total penalty amount cannot exceed the national average of the annual premiums of a "bronze level" health insurance plan on ObamaCare exchanges.

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    140   2:25pm Mon 25 Mar 2013   Share   Quote   Permalink   Like (1)   Dislike  

    Homeboy says

    Look at the chart. Is poor people's share of the pie increasing?

    The chart shows income, not toxic disproved pills. Obamacare doesn't increase poor people's share of income, it merely opens them up as a market for PhRMA to make even more people physically dependent on Homefool's SSRIs. If you define "tax" more broadly, enduring Homefool's pills (and trying to survive in a community where even more people are similarly medicated out of their minds) will prove very taxing on the health of poor people.

  38. iwog


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    141   2:34pm Mon 25 Mar 2013   Share   Quote   Permalink   Like   Dislike (1)   Protected  

    zzyzzx says

    The Joint Committee on Taxation recently released a 96 page report on the tax provisions associated with Affordable Care Act. The report describes the 21 tax increases included in Obamacare, totaling $1.058 trillion – a steep increase from initial assessment, according to the Tax Prof Blog. The summer 2012 estimate is nearly twice the $569 billion estimate produced at the time of the passage of the law in March 2010.

    Good. I know what those taxes are and the huge majority will be on people making large sums of money on investment income.

    It's a great start but we need more.

    We fix the wealth disparity problem in this country and we force Republicans to accept it. This is the only long term fix. Everything else is just bullshit right wing propaganda.

  39. curious2


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    142   4:07pm Mon 25 Mar 2013   Share   Quote   Permalink   Like (2)   Dislike  

    iwog says

    We fix the wealth disparity problem in this country and we force Republicans to accept it. This is the only long term fix.

    By that logic, if you were simply to burn all the wealth of the top 10% in a bonfire, you would "fix the wealth disparity problem" more efficiently. You would save the trouble of irradiating and poisoning millions of people, increasing their medical costs for the rest of their lives. If burning trillions of dollars in a bonfire sounds like a bad idea, maybe you can see why Obamacare is worse.

  40. zzyzzx


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    143   5:19pm Mon 25 Mar 2013   Share   Quote   Permalink   Like (3)   Dislike  

    iwog says

    We fix the wealth disparity problem in this country and we force Republicans to accept it. This is the only long term fix. Everything else is just bullshit right wing propaganda.

    So when will you be writing a huge check to the government to redistribute your wealth?

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