Capitalism Turns Cure into Racist Killer, Cutting Back on Mammography

It isn’t bad enough that capitalism ruins our health through overwork, unemployment, on-the-job accidents, air and water pollution, toxins in food, and sending young working-class men and women to war to kill other workers or be killed. Nor is it bad enough that it provides a kind of health care that gives us one of the worst overall outcomes for the working class in the entire industrialized part of the world, in terms of life expectancy, infant mortality, and other measures of health. 

Now the U.S. Preventive Services Task Force, a so-called panel of “experts” appointed by the U.S. Government, calls for wrecking even what little preventive care we get. In the middle of November they revised their previous recommendations for screening mammography, which happens today to be the best way to detect breast cancer while it is still curable. This panel of “experts” consists of 16 doctors, nurses, and scientists who study statistics, but contains not a single expert in breast care. That is, not a single cancer specialist, radiologist (particularly one specializing in mammography), or breast surgeon.

The Task Force recommended that women from 40 to 49 years of age, or older than 75 years, not receive screening mammography and that women between 50 and 74 be screened only every other year rather than every year, as it now stands. They claim that screening mammography does women more harm than good by emphasizing the number of times women are called back for additional mammographic views or for an ultrasound, or for a biopsy (usually involving use of a needle to take a small piece of tissue to be examined under a microscope). Many more women are called back than actually have cancer, approximately 30 times as many on average. But most of these women are cleared at the first stage, many more at the second stage, and only about one in six of these gets a biopsy.

The Task Force, however, has decided the “stress” for women being called back is worse than the cancer being found after it has reached such a size that it is no longer curable. They have been supported by various doctors and others on the grounds that they are basing their conclusions on science. But science only provides numbers. Weighing the numbers is a political value judgment. And their value judgment is that saving money for the imperialist ruling class to use for more wars is more important than the women’s lives that could be saved.

Besides, the number of women who are called back or who undergo biopsy varies tremendously with the experience of the mammographer (radiologist who interprets the x-rays). So rather than call for improving their skill and experience by more training and by requiring that only specialists in mammography be allowed to interpret mammograms, the Task Force calls for allowing fewer women to receive mammography. 

Three weeks following these recommendations, the state of California put part of them into practice, despite the fact that most doctors are refusing to follow them. California has now stated that they will no longer provide Medicare and Medicaid funding for screening mammography for women in their 40s — a racist death sentence for far too many of the overwhelmingly black and Latina working-class women recipients of those programs. Capitalism truly kills, in more ways than we can count. J

Mammography done on an annual basis, along with improved treatment of breast cancer, has been shown to save about 30-40% of lives from this particular disease, with mammography contributing most of that improvement.  Doing it every other year will allow many more cancers to escape detection until they are no longer curable, just as the racist differences in the availability of medical care causes a higher death rate from breast cancer for black women (28%) than for white women (18%).