Is there anybody who believes that America is about competition? If you believe that America and business love competition, please email me because I have some swamp land ocean front property to sell you out in Idaho. Think about that period in American history after World War II. The big companies got bigger because of competition? No. Of course, there are a few exceptions but as a rule big companies split up the marketplace. Whether it was General Motors, Ford and Chrysler or, in steel, United States Steel, Republic and Bethlehem, these big companies split up the marketplace and made profits. There was no competition. None.
Now, it looks like we have more information on the pharmaceutical companies. They paid generic drug companies to keep their generics off the market. Is anyone really surprised? There is so much money in pharmaceuticals that drug companies are able to pay off these generic companies so that everybody makes money but, and this is important, the pharmaceutical companies make a ton more money and the consumers pay a ton more money. Everybody wins except the consumers.
I talked about mammograms and the controversy surrounding them a couple of weeks ago. It seems that several of the folks who made the recommendations were brought in front of a congressional committee in which they yelled that it was all just some sort of misunderstanding. It was a problem in communication. Horse hockey. I hate when people kind of weasel out of things. Say what you mean and mean what you say. In the formal paper which was published in the Annals of Internal Medicine, this committee stated that it recommended "against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 should be an individual one and take into account the patient's context, including the patient's values regarding specific benefits and harms."
The recommendations weren't a mistake. They were not something that they just dreamed up out of the air. The panel should've stood firm and said that, in their interpretation of the literature, these were their recommendations. Then, they should've added a caveat, the same warning in the paper, that treatment should be individualized in these patients.
Again, as I said before, this is a minor task force which has no bearing on the American Cancer Society, really the main medical body to which physicians look for recommendations on cancer, including breast cancer. I believe in screening more women and not fewer. I believe that women need to be informed about their choices. They need to be told that the earlier you start screening the more likely it is that you're going to have something found on mammography, which will lead to a biopsy, which most likely will be negative. Once women understand this and want to accept this risk then there should be no argument.