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Old 12-08-2009, 10:03 PM
 
1,645 posts, read 4,567,372 times
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[quote=markg91359;11922465]
Quote:
Originally Posted by ionlife View Post
I have grown up in a socialized medicine country (Canada) and I have relatives in The Netherlands. Right now, if you are Dutch you receive NO anesthesia for colonoscopies or child birth. If you are Dutch, you must wait until you are 60 years old for a hip replacement because that is the minimum age regardless of your hip's problems. Right now, if you are Dutch, and your kid gets the swine flu and pops a 107 fever, you aren't going to convince a doctor or health care provider to give you a script for Tamiflu (my BF over there just went through that nightmare). Oh, and now, on top of huge taxes to pay for all this "care" they don't receive, they must PAY an additional payment themselves for their health insurance because it costs too much to run the health system.

If you are Canadian, you will receive excellent free care in the way of immunizations and well baby checks. You will receive excellent care if you stay healthy. However, don't get a heart condition. Good luck getting surgery for a busted valve. Good luck finding an open bed and good luck with scheduling and rescheduling surgery (happens all the time). And good luck to you if you are Canadian and you develop symptoms for a disease that you aren't in the "risk category" for and therefore you can't get any additional testing (like a colonoscopy if you are 29 and you have blood in your stool). Good luck. You'll be denied. And what if you are the one person in a zillion who DOES HAVE COLON cancer? Fortunately, the real person with this problem lived in the USA and although diagnosed at 29 with stage 4 colon cancer, IS STILL ALIVE TODAY 5 years later. Hmmm... she'd be in the ground in Canada (but they would have saved a TON of money on medical procedures).

Oh, and that brings me to a very scary thought: recently a panel of methodologists from universities and doctors and nurses NOT IN THE ONCOLOGICAL/GYNECOLOGICAL fields recommended that MAMMOGRAMS ARE NOT NECESSARY FOR WOMEN UNTIL THEY TURN 50. Hmmm. That SAME PANEL will be advising the UNIVERSAL HEALTH INSURANCE on coverage policies. So, how suspicious is this one?

WAKE UP! Please!!! I'd love free care for all, BUT IT ISN'T CARE. It's INSURANCE. And poorly managed, risk based insurance does NOT EQUAL CARE.
.................................................. ..............................................

Canada does not have a socialist healthcare system. All physicians and healthcare workers work for private entities and not the state. What Canada has is a "single payer insurance system". If you want to talk about "socialized medicine" a correct example would be Britain where medical care is run and dispensed by government employees who work through the National Health Service.

In a survey conducted by the World Health Organization, medical care in the USA was rated 37 among all the countries. We were rated behind Canada, behind the Netherlands (which actually rated very high), and behind every West European Country as well as Australia, Canada, Japan, and New Zealand. Not very impressive for a country that spends almost 16% of its entire GNP or income on healthcare. What is the difference? The USA is the one country among that entire group that does not offer universal healthcare.

WHO | World Health Organization Assesses the World's Health Systems

If medical care was so bad in other countries it would logically follow that life expectancy would be lower than in the USA. This is not true either. Of all the countries in the world, the the USA ranks 30th in life expectancy. This is behind the very same countries mentioned above. Canada, Australia, Japan, New Zealand, the Netherlands, and every other Western European Country including Great Britain have longer life expectancies for both men and women than in the USA.

List of countries by life expectancy - Wikipedia, the free encyclopedia

Objective surveys actually indicate that Canadian people have high satisfaction rates with their single payor healthcare system. The surveys indicate that 85% of Canadians are either satisfied or very satisfied with the healthcare system in their country. The median or average "wait time" to see a specialist physician in Canada is four weeks. Over 85% of patients see a specialist physician in under 3 months. Over 1/2 of Canadians needing MRI or CT scans get them in under four weeks. All those who need them as a result of an emergency get them at once.

medical care in the modern world. (Long Article, but its in their under the section on Canada)

Your anecdote about colonoscopies without anesthesia is a very humorous one. Anyone who has a colonoscopy understands the virtual impossibility of undergoing such a procedure without anesthesia. The anesthesia used is not "heavy duty" and not particularly difficult to administer. I challenge you to come up with a cite to support such at outlandish claim.

I wish that those attempting to defeat the Obama Healthcare Plan could debate facts and stop inventing garbage like this. The longer this debate goes on the more desperate opponents seem to get. Don't you people have any integrity?
This is not an invention about the colonoscopy. I have a colleague who went to the Netherlands and his wife had to have a colonoscopy while there... NO ANESTHESIA. That's my heavy duty REAL CLAIM. I'd be happy to provide you more info than that, but it is the truth as told by the person who underwent it. Also this same individual's wife was sent home with motrin and told it was "in her head" and not to worry. Fortunately, she came to the states during his knee replacement surgery and got properly diagnosed with CROHNS DISEASE. Give me a break. This is so typical. My facts are based on REAL CASES.

In addition, I have a friend from the Netherlands, as I was born there I still maintain contact, and she had her son denied tamiflu despite HIGH fevers kicking over 107 degrees. This is a true story. I'm not making this up.

citing Wikepedia doesn't equate REAL data. Sheesh. That is an unverified encyclopedia.

I will always, based on my personal and my friends' personal experience in both these countries, be against RISK BASED HEALTH MANAGEMENT OF OUR CARE IN THIS COUNTRY.

BTW, anyone who argues against my "anecdotes" ... I'd like to know if you have real experience with the health care/insurance in Canada or the Netherlands? Or do you know of people who are involved with them now?

 
Old 12-08-2009, 10:09 PM
 
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Quote:
Originally Posted by aneftp View Post
As a physician and someone who has practicing physician friends in countries such as Holland, the UK, Canada, and Australia.

Need to clear up some facts.

In Holland, much fewer women get epidurals for pregnancy as compared to the United States. The reason is because of it's "accepted culture" for most Holland women to bear through the pain of labor. Yes, that's the culture there. My friend in holland's best guess is less than 30-40% of women in Holland receive epidurals for standard labor. Obviously with C-sections, they will receive mainly spinal anesthesia. Had a woman from Holland a few years ago who had 2 "natural births" She moved to Washington DC and was deliverying there. OB nurses convinced her to have epidural because it's the "american way". Holland woman had her first epidural and loved it. She wishes it had been offered to her in Holland.

In terms of the US having the 37th best infant mortality rate. You need to consider how countries count "live births". In the US all babies are counted as live births as long as it appears to have a beating heart. Even if baby lives less than 24 hours, it's still counted as a live birth. It's like Goldman Sachs (GS) saying they had a great quarter in their earnings report. However, Goldman Sachs completely left out December 2008 in their earnings. Well December 2008 would have been the worst earning month in probably the history of that company. But since the Feds let Goldman Sachs be converted to a "bank" during that month, they felt like they did not need to include a horrible month in the overall earnings.

Other countries mislead facts. If that same baby born in the US were born in another country such as the UK, that government will count that birth as a miscarriage (thus not counting against infant mortality rate). My sister is an OB/GYN. She's done a ton of research during her residency on this matter plus she's still in academic medicine.

As for the colonscopy remarks. Again many in Holland do not receive any anesthesia for it. It's a culture thing. Many of those people just deal with the pain doing the procedure.
In the US, many people receive a combination of versed/fentayl/demerol for colonscopy. Some centers in the US contract out to anesthesiologists or nurse anesthetists who administer propofol sedation for colonscopy. While versed/fentyl work well for the majority of people, guess what type of anesthesia your favorite member of Congress gets when they get a colonscopy? They get the preferred propofol with the anesthesiologist or nurse anesthetist present because their recovery time it super quick.

Sure the US health system is needs work. There are better ways to reform it.

1. Raise taxes ON EVERYONE (yes that mean people making less than $30K need to pay a little extra and people earning more than $250K need to pay a lot more) in order to help everyone. Everyone needs to chip in.
2. Allow insurance companies to compete with each other across state lines
3. Heavily subsidize medical education costs. Most students these days graduate with $150-200K in debt. This will encourage more of them to go into primary care.
4. Go to a loser pays malpractice system (this way will still keep the malpractice attorneys in the game). If they want to sue, they can't claim their is a limit on how much they can sue for. Only the loser pays attorney costs. This prevents frivolous lawsuits. I am not proposing tort reform here. Patients will still have the opportunity to have their day in court.

But at the end of the day, ask yourself if you were to get sick. Which country would you want to get sick in? Canada where you have to wait up to 6 weeks for heart bypass surgery. President Clinton or even your average Joe America doesn't have to wait that long in the United States.

How about Italy? Even that personal injury young attorney, Andrew Speaker. Yeah you may have heard of him. He's the American who contracted a resisted form of TB. But decided to go on his honeymoon in Italy. He got sick over their and the Italians wanted to perform socialized medicine on him (IE there are better ways to spend our healthcare money and let this one American with TB suffered and die here). If the US health system is so bad, why did this American suck in Italty risk everything to fly to Canada and sneak back into the US to get treatment?

Our system is still the greatest in the world.
Thank you-- most of this is accurate and I truly appreciate a physician's input. But, if you are a foreign national in the Netherlands, you will NOT be offered anesthesia for a colonoscopy" even if you desire the meds. Let's face it, my friend's wife certainly wanted them.

Also, 6 weeks is a MINIMUM wait in Canada for heart surgery. My own father waited 2 years for heart surgery MORE THAN ONCE. Beds weren't available. Canada's heart related deaths are higher than our country.

I am curious, what is your take on the recent panel's findings regarding mammograms? Now women don't need them till they're fifty???
 
Old 12-08-2009, 10:37 PM
 
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Default The Latest... hopeful here

AP sources: Dems reach deal to drop gov't-run plan - Yahoo! News (http://news.yahoo.com/s/ap/20091209/ap_on_bi_ge/us_health_care_overhaul - broken link)
 
Old 12-09-2009, 03:12 AM
 
269 posts, read 467,003 times
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[quote=ionlife;11948621]
Quote:
Originally Posted by markg91359 View Post

This is not an invention about the colonoscopy. I have a colleague who went to the Netherlands and his wife had to have a colonoscopy while there... NO ANESTHESIA. That's my heavy duty REAL CLAIM. I'd be happy to provide you more info than that, but it is the truth as told by the person who underwent it. Also this same individual's wife was sent home with motrin and told it was "in her head" and not to worry. Fortunately, she came to the states during his knee replacement surgery and got properly diagnosed with CROHNS DISEASE. Give me a break. This is so typical. My facts are based on REAL CASES.

In addition, I have a friend from the Netherlands, as I was born there I still maintain contact, and she had her son denied tamiflu despite HIGH fevers kicking over 107 degrees. This is a true story. I'm not making this up.

citing Wikepedia doesn't equate REAL data. Sheesh. That is an unverified encyclopedia.

I will always, based on my personal and my friends' personal experience in both these countries, be against RISK BASED HEALTH MANAGEMENT OF OUR CARE IN THIS COUNTRY.

BTW, anyone who argues against my "anecdotes" ... I'd like to know if you have real experience with the health care/insurance in Canada or the Netherlands? Or do you know of people who are involved with them now?
Any real experience? I am Dutch, and I live here. Enough for you?

So you have your story of one friend who did not receive sedatives for her colonoscopy? I have an entire family of grandparents/aunts/uncles who have gone through their first colonoscopy, and every single one of them (except my grandfather who opted for the "gas") was in la-la land. Here is a link to the sheet given to patients at a Rotterdam hospital (I assume you can read it, since you seem to know so much about this country?):

http://www.sfg.nl/Docs/DCR/colonoscopie%20internetversie.pdf (broken link)

I suggest you focus on the part "Uitvoering," which explains in detail what kind of sedation you will get and how it will be administered. Do Dutch patients sometimes forego the sedation? Sure, the Dutch are crazy like that. But to be denied sedation? Please.

As for giving birth here, yes most Dutch women choose to do it without an epidural. That is just "the norm" here. But, will you be denied one if you ask? Of course not. My sister-in-law just gave birth last month with her 3rd child, and she received her third epidural. Here is another link to a women's forum talking about natural vs. "ruggeprik" (epideral):

bevalling met of zonder ruggenprik...., pagina 1 - Kinderen - Viva.nl

Seems a good number of women on there choose to go for the epidural. Again, this is a relatively new thing - Dutch women choosing pain killers, but it would never be denied to anyone unless there was a medical reason. Here, a news article about guidelines that every hospital must have someone on staff, day and night, to administer an epidural.

nrc.nl - Voorpagina - Ruggeprik voor alle barende vrouwen

As for being denied tamiflu? I've never been denied a necessary drug here, so I'm not sure what to tell you. I work with at least 10 people who have gotten the flu, and they all received tamiflu. There are tons of news stories out there about tamiflu being given to any school age child that has even come in contact with someone who has the swine flu. My doctor has even been holding open hours every day for people who have it to come in quickly and get a prescription.

I love my health insurance, and I thank God I know I will always be taken care of, no matter what my situation. There is a reason why the Dutch come out ranked on top in almost every health care study.
 
Old 12-09-2009, 03:16 AM
 
269 posts, read 467,003 times
Reputation: 220
Quote:
Originally Posted by ionlife View Post
How would you know about the facts? You're not even based in Canada or Europe. Do you have any FACTS of your own to refute your allegation?

BTW, true stories aren't anecdotes. They are based in REALITY. Reality is, UNIVERSAL HEALTH INSURANCE does NOT equal CARE. Period. The. End.
Just saw this doozy.

FACT: I am DUTCH and I LIVE in the NETHERLANDS.

FACT: Stories about your "friends" or "they told me this" are anecdotes. Come back to me when you are in the Dutch healthcare system, and then we can chat.

The End.
 
Old 12-09-2009, 06:28 AM
 
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Quote:
Originally Posted by Annie28 View Post
Just saw this doozy.

FACT: I am DUTCH and I LIVE in the NETHERLANDS.

FACT: Stories about your "friends" or "they told me this" are anecdotes. Come back to me when you are in the Dutch healthcare system, and then we can chat.

The End.
I know several people right now who are dutch and who live in the Netherlands. I am in constant communication with them. I know of several people living and working the Netherlands who I am in contact with personally. Perhaps the one person who posted is having a bang up experience, but that is one person's experience. And much depends upon where one lives in Holland. In addition, that ONE Dutch person's experience doesn't negate the 10 Dutch people's experience (number just given to round things out as I know many) who have not had good experiences. One person's experience is "one person."

In addition, that one person's experience is, by poster definition, anecdotal.

In the Netherlands everyone must purchase Health Insurance under gov't law (FACT). And there are different levels of insurance offered at different payments. So perhaps the ONE poster living in the Netherlands who has had a quality experience has PAID for that experience ON TOP OF PAYING super high taxes.

I'd also like to see a discussion about the number of people in lower paying jobs who are "out sick" all the time and then the upper management has to pick up the slack. Another big tax on the system is "burnout." People go on leave there all the time, at the taxpayer's cost, due to "burnout." If that becomes the case here, cause, HEY IT'S FREE, who will carry the burden? Those who still believe that a day's work is worth a day's pay, not lollygaggling around collecting benefits.

For every ONE person who has a positive experience, I am pretty sure I can find TEN who don't. I also have very good friend who is dutch and lives in the USA. She moderates many Dutch forums. And she is contact with HUNDREDS of Dutch people via her forums (they are for travel). And she can trot a whole lot more "anecdotes" than me about the travesty of the system and how it fails people who must wait endlessly for appointments and for help when they are truly sick with a life threatening disease (eg cancer).

This is a debate, and I am by no means a final authority on the subject. But by my experience and experiences of many people I know in the Dutch and Canadian systems of health care (which I have personally experienced), I cannot ever support a gov't sponsored health insurance plan. And, by the looks of it, neither can those in the positions to make it happen. To close the door on the discussion, based on ONE person's experience, is not conducive to proper discussion or debate about the subject.

Also, one must also remember that the Netherlands has about a TENTH of the USA's population. Try applying their system here... I doubt it will work.

I already have experienced how the gov't runs RISK BASED INSURANCE and care via the Veteran's Admin and Military medicine. Ask a person who serves today, or who has served and been honorably discharged, how great that system is and you'll know why the majority of those with experience in dealing with the VA and military institutions CRINGE at the idea of having the gov't takeover the country's health INSURANCE system.

Insurance does not equate care. I've seen it fail time and time again FIRST HAND.
 
Old 12-09-2009, 06:35 AM
 
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washingtonpost.com

The latest in the Senate...

BTW, I am not against reform, I am against the gov't running the show and the costs that will generate. Also, whatever our elected officials bring into play, I expect them to be forced to use that system as well. I'll bet the Dutch Royals are treated much better than the common citizen when they are sick.
 
Old 12-09-2009, 07:03 AM
 
269 posts, read 467,003 times
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Quote:
Originally Posted by ionlife View Post
I know several people right now who are dutch and who live in the Netherlands. I am in constant communication with them. I know of several people living and working the Netherlands who I am in contact with personally. Perhaps the one person who posted is having a bang up experience, but that is one person's experience. And much depends upon where one lives in Holland. In addition, that ONE Dutch person's experience doesn't negate the 10 Dutch people's experience (number just given to round things out as I know many) who have not had good experiences. One person's experience is "one person."

Are you seriously arguing with someone who lives here? Do you really think you "know" more people than I do who have experience with the Dutch healthcare system? ....Seriously?
In addition, that one person's experience is, by poster definition, anecdotal.

How are links to articles/forums that dispute what you are saying anecdotal? A link to the procedures of a colonoscopy at a hospital in Rotterdam - anectodal? Really?
In the Netherlands everyone must purchase Health Insurance under gov't law (FACT). And there are different levels of insurance offered at different payments. So perhaps the ONE poster living in the Netherlands who has had a quality experience has PAID for that experience ON TOP OF PAYING super high taxes.
Yes, we all have to have health insurance. What a shame that all of our citizens are covered if they get sick. And me? I have basic health insurance. As does almost everyone I know, and they all have no complaints about the level of care they receive.

I'd also like to see a discussion about the number of people in lower paying jobs who are "out sick" all the time and then the upper management has to pick up the slack. Another big tax on the system is "burnout." People go on leave there all the time, at the taxpayer's cost, due to "burnout." If that becomes the case here, cause, HEY IT'S FREE, who will carry the burden? Those who still believe that a day's work is worth a day's pay, not lollygaggling around collecting benefits.

What is your point? Yes, like many European countries, we do have stress leave. It is highly regulated and you must be diagnosed by a doctor. I'm sure there is some abuse in the system, but I have seen it first hand prevent a complete downward spiral into depression.

For every ONE person who has a positive experience, I am pretty sure I can find TEN who don't. I also have very good friend who is dutch and lives in the USA. She moderates many Dutch forums. And she is contact with HUNDREDS of Dutch people via her forums (they are for travel). And she can trot a whole lot more "anecdotes" than me about the travesty of the system and how it fails people who must wait endlessly for appointments and for help when they are truly sick with a life threatening disease (eg cancer).

Huh? The Netherlands has pretty good cancer survival rates, and the cancer care here is fantastic. Tell me more about your first hand experience with cancer care here. Oh, wait....

This is a debate, and I am by no means a final authority on the subject. But by my experience and experiences of many people I know in the Dutch and Canadian systems of health care (which I have personally experienced), I cannot ever support a gov't sponsored health insurance plan. And, by the looks of it, neither can those in the positions to make it happen. To close the door on the discussion, based on ONE person's experience, is not conducive to proper discussion or debate about the subject.
You are not an authority at all on the subject. I know a lot of people in a lot of countries, but I would never be so foolish to launch an attack against their health care system.

Also, one must also remember that the Netherlands has about a TENTH of the USA's population. Try applying their system here... I doubt it will work.

Who is advocating that?

I already have experienced how the gov't runs RISK BASED INSURANCE and care via the Veteran's Admin and Military medicine. Ask a person who serves today, or who has served and been honorably discharged, how great that system is and you'll know why the majority of those with experience in dealing with the VA and military institutions CRINGE at the idea of having the gov't takeover the country's health INSURANCE system.

Insurance does not equate care. I've seen it fail time and time again FIRST HAND.
Go ahead and read the links I posted, that refutes your ridiculous claims. I mean, I am assuming you can read Dutch since you have so much to say about our society?
 
Old 12-09-2009, 08:09 AM
 
1,645 posts, read 4,567,372 times
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Quote:
Originally Posted by Annie28 View Post
Go ahead and read the links I posted, that refutes your ridiculous claims. I mean, I am assuming you can read Dutch since you have so much to say about our society?
I can speak it, but no, not read it well. Your links don't negate my DUTCH friends' experiences. I don't think I've said anything insulting to the Dutch system other than sharing what has NOT worked for people I KNOW. Of course, a Dutch citizen with TIER ONE health care will have a much better experience in the health system than a Dutch person in a TIER 3 system.

Really, I know the Dutch system isn't horrible, but it isn't perfect either. Again, easier to manage if you are in a country a tenth the size of this one. This is why I don't believe a single gov't option is the way to go here. Therefore I don't think my points are invalidated by your experiences or your forums. They are merely my points based on what I know to be other Dutch citizens' experiences. Thus, they are not moot by your point.

However, to take this out of the Dutch arena (as it was used as an EXAMPLE of when things CAN GO WRONG in a system such as the Canadian and Dutch systems) and put the debate back into the USA.

It appears that the US Gov't is backtracking on the National Health Insurance Bill and that will benefit our country. If we go to that way of helping people afford insurance, then that will be good for the country as a whole. However a primary concern for me is that we will go to RISK BASED MANAGEMENT of our care based on PANEL FINDINGS in which certain EXPENSIVE tests are negated by doctors, nurses and university methodologists. Most recently, this panel recommended that MAMMOGRAMS are NOT necessary for women until they are 50 years old. This PANEL will advise the policy for NATIONAL HEALTH INSURANCE and this will make RECEIVING CARE in the form of TESTING FOR CANCER and DISCOVERING IT EARLY very difficult for women under the age of 50.

Now, interesting that this panel came out with this finding during the health insurance push for the national gov't. Hmmm. Another interesting fact, NOT ONE PERSON on the panel was an oncologist or gynecologist. These professionals in our nation's health care system strenuously opposed the findings by this panel (who will advise the system and set policy for our nation's health insurance--remember insurance does not equate care).

This is my largest concern based on how I've seen RISK BASED HEALTH MANAGEMENT FAIL people in other countries with the gov't fully in charge of dictating the course of health insurance and possible testing/care/treatment.

This is not the health care system I want for my child's future.
 
Old 12-09-2009, 08:21 AM
 
3,599 posts, read 6,761,459 times
Reputation: 1461
Quote:
Originally Posted by ionlife View Post
Thank you-- most of this is accurate and I truly appreciate a physician's input. But, if you are a foreign national in the Netherlands, you will NOT be offered anesthesia for a colonoscopy" even if you desire the meds. Let's face it, my friend's wife certainly wanted them.

Also, 6 weeks is a MINIMUM wait in Canada for heart surgery. My own father waited 2 years for heart surgery MORE THAN ONCE. Beds weren't available. Canada's heart related deaths are higher than our country.

I am curious, what is your take on the recent panel's findings regarding mammograms? Now women don't need them till they're fifty???
With regards to mammograms, that's going to be a political suicide topic. When I started medical school, 1 in 10 women would be diagnose with breast cancer in their lifetime. Now I believe it's either 1 in 6 or 1 in 7 women will be diagnosed with breast cancer.

I've seen women as young as in their mid 20s been diagnosed with breast cancer.

Bad medical luck happens in life. But US residents have come to expect the absolute best care possible. So you have to ask yourself, if the recommendation is 50 years old. And you get diagnosed with breast cancer when you are in your 40s. What if that happens to you?

Frankly I've be incredibly upset that a regular screening mammogram would not be routinely offer to women at earlier ages.

All these screening tests cost money. I believe the data shows (don't quote me on the exact costs here) but the data shows that it costs the US health system around $10-50K to diagnose one colon cancer. But it costs $100-200K to diagnose one breast cancer (because there are a lot of false positives with breast cancer tests).

So its a sticky situation. Do you want to be that one person the US health system diagnoses and saves early? Or do you want to have healthcare rationing of costs. And the government says bad luck to you that you got cancer earlier than they expected. That's why every politician is backing away from the newer 50 year old mammogram recommendation. It's a political battle they do not want to touch. That's why they included new legislation to still pay for test for women for routine screening in their 40s.
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