Editorial: The economic case for immigration

Nov 20, 2009 at 07:00 PM

In the shallow, often misinformed rhetoric over immigration, we too seldom hear the case for reform made in economic terms.

That may be changing -- at least in Minnesota. A new report from the University of Minnesota's Humphrey Institute and the Minnesota Business Immigration Coalition pulls together compelling evidence that even in this mostly homogeneous state -- where the immigrant population is small but growing -- immigrants are playing an increasingly important role in the economy, and we will depend more on their contributions as boomers leave the workforce.

Consider these facts:

• Foreign-born workers make up the majority of growth in the labor force in the state, and immigrant workers are concentrated in both high- and low-skilled jobs.

• Immigrants represent 25 percent of the physicians and 40 percent of the engineers holding doctoral degrees in this country.

• There is a shortage of 126,000 nurses in the United States -- and rural Minnesota is projecting a shortage of 8,000 RNs in the next decade -- but the average wait for a nurse to get a green card is six years.

• If immigrants were removed from Minnesota's labor force, the state would lose more than 24,000 permanent jobs and $1.2 billion in personal income.

• Many immigrants start new businesses, pay taxes, revitalize neighborhoods and buy products and services, and there is convincing evidence that immigrant employment helps create job opportunities for all workers.

According to projections, there will be more retirees than children in elementary school in Minnesota by 2020. The Brookings Institution says Minnesota will lose more than 350,000 highly skilled workers to retirement in the next decade in a demographic wave some are calling a "silver tsunami.''

The vital importance of the immigrant workforce was made clear last week at the university, where a panel convened to discuss the economic impact report from the U's Prof. Katherine Fennelly and Anne Huart. Not lost on those in attendance was the irony that just one day earlier, the Star Tribune had reported that 1,200 workers with American Building Maintenance Co. in the Twin Cities had left their jobs after an audit found that they were working illegally. The crackdown highlighted the Obama administration's new focus on targeting employers rather than deportation. Instead of being taken into custody, the workers were allowed to go home. But they went home unemployed.

The Fennelly-Huart report should be required reading for members of Congress. And our elected officials should endorse the economic case for a reform package that would force illegal immigrants to come forward and earn legal status. Reform must include new border enforcement policies, and our visa programs should be overhauled to better reflect the need for low- and high-skilled workers.

To their credit, business leaders in Minnesota are stepping up the pressure on Washington by making the case that despite short-term costs, over the long run immigrants strengthen the economy as workers, consumers and employees. The evidence is overwhelming: We will need to replace today's workforce, and we can't afford to exclude immigrants from the solution.

Filed under: Editorial| 3 Comments

Gayle Kvenvold, Patti Cullen: Minnesota at forefront in care for the elderly

GAYLE KVENVOLD and PATTI CULLEN| Nov 20, 2009 at 06:56 PM

The recent three-part series in the Star Tribune highlighting falls in Minnesota's nursing homes fails to share the full story and provide readers with the appropriate context regarding nursing home care in Minnesota. Statistics clearly show that our population is aging, but there also are several relevant issues related to our aging population where data only tell part of the story.

Minnesota's providers continue to innovate for care environments and technologies for older adults. Today, we have an expansive array of care options for older adults to meet their individual needs in the right place and at the right time in their life's journey. As a community, we hold great pride in providing safe and personalized care while giving seniors freedom and autonomy as they age. However, at times freedom has risk, sometimes in the most basic activities of daily life.

Falling is one of those risks. We have abandoned the practice of controlling the risk of falling through the use of physical restraints or psychotropic drugs, and have led the nation in striking a balance between encouraging seniors to embrace personal freedoms as they age and providing the care that they need and deserve. Whether in a nursing home or at home, there is no perfect solution to prevent or eliminate falls in the elderly. Problems with gait, balance, muscle weakness, vision and hearing, as well as dementia, are common contributing factors, and a variety of chronic diseases and conditions, as well as age itself, also contribute to falls.

We continue to learn and improve our fall prevention programs for older adults as new products and services are developed -- there are a variety of solutions that may work for particular residents: gait training, the use of assistive devices like walkers, reviewing medications that may have adverse effects, using lifts to transfer residents from bed to chair, staff assistance while walking, and treating other problems like incontinence that can lead to falls.

Data from the Centers for Medicare & Medicaid Services (CMS) suggests that Minnesota is making progress on reducing the frequency of falls. Between 2000 and 2009, the proportion of residents with falls in the preceding 30 days was reduced by five percent. This is remarkable, given that over that same time period, Minnesota's use of physical restraints was cut by two-thirds. Minnesota's use of physical restraints is now less than half the national average -- striking the balance between safety while allowing for more autonomy and freedom for nursing home residents.

Nursing homes serve nearly 34,000 Minnesotans every day. During the period of time examined by the two reporters, there were more than 400,000 persons who received nursing home care, and the percentage of residents who died as a result of a fall was less than 0.3 percent. We continue to strive for improvement through new fall prevention measures, and to create an even safer living environment for those who need our services, and according to CMS, our facilities score among the top states on key overall quality measures.

As we look to the future and strive to deliver the best possible care for all of our residents we must, as a caring community, as sons and daughters and as a state prioritize the care of our older adults and invest in their future. We are indeed fortunate to have individuals who have already taken that pledge -- our committed and well-trained corps of excellent caregivers. However, years of underfunding by the state has hit this workforce hard -- in the form of reduced benefits, wage freezes and staff layoffs. With proper and responsible investment in older adult services now and in the future, more can be done, and additional progress can be made.

Gayle Kvenvold is president and CEO of Aging Services of Minnesota. Patti Cullen is president and CEO of Care Providers of Minnesota. More information about preventing falls is available at www.mnfallsprevention.org.

0 Comments

Barb Rode: 'Please, let me do it my way'

BARB RODE| Nov 20, 2009 at 06:57 PM

My heart goes out to the patients and their families whose pain was described in "Deadly Falls," the Star Tribune's series of articles on falls in Minnesota nursing homes.

As someone who has spent her entire career in nursing homes, I know the challenges of caring for our elderly. I also know the pain of losing a parent to a fall in a nursing home.

After suffering a stroke, my mother was admitted to a transitional care unit in a nursing home. Mom had some right-side weakness but could still stand and walk. But she had issues with balance, and her hands didn't work as well as they used to. She needed therapy to gain back some of her strength.

Mom had lived in a senior apartment for independent people -- she was a very independent woman. But even before the stroke, I could tell her health was starting to decline. She had fallen in her apartment several times, but without any apparent injury. I bought her the Lifeline service so that she could push a button on a pendant alarm that would call for an ambulance. When she had the stroke and fell, I found her pendant on her dresser. She told me she had just taken it off for a minute, and forgot to find it and push for help.

On her doctor's orders, she was admitted to a nursing home for rehabilitation. While she was there, she slept more, didn't eat as well and didn't want to participate in any activities. I often visited her and encouraged her to continue her therapy and join the activities. But she said she just wanted to go home, where she would be more comfortable and regain her strength.

One day, I got a call from her care manager. Mom was trying to get out of her wheelchair by herself, and the manager was concerned that she might fall because of her balance issues. I went to the home to remind Mom she must be sure to ring the nursing assistants for help if she needed to get out of her wheelchair. She said she would. I told her the consequences of falling and how she could fracture her hip, which could cause her pain and more time in the nursing home. I told her we could put an alarm on her wheelchair to alert the staff when she was getting up.

"What do you think I am -- a baby or a prisoner?" she said.

"I don't want you to get hurt," I said.

"Barb, this is my life and I need to make my own decisions, whatever the outcome. So please, let me do it my way."

Obviously, she was alert, she was an adult and she knew the consequences. Life is not risk-free. We all make decisions that carry risks, and as adults we have the right to make those decisions. I also knew, as a longtime nursing home worker, that restraints present their own risks, such as strangulation. So I asked the nurse not to use sensors or restraints. A few days later she fell and fractured her hip. Two weeks after her surgery, she passed away.

I cannot describe how terrible I felt -- not just that my Mom died, but that it could have been prevented.

I couldn't blame the nursing home -- I knew the challenges too well. Each patient is unique, with different cognitive states, bone density or reason for falling. No nursing home that I know of is staffed to watch every resident every minute 24 hours a day every day of the year.

Nor could I blame myself. She wouldn't have wanted a life under constant restraint or to be treated, as she said, "like a baby or prisoner." She wouldn't want to have someone else make her decisions for her.

But that doesn't mean we in senior care can simply ignore the problem of falls. At Saint Therese, the senior living center where I work, we teach seniors how to identify and strengthen themselves to offset their imbalance. We study the situations, such as time of day or environment, where seniors seem most vulnerable to falls.

We can do a better job of protecting elderly -- but not at the expense of their dignity and quality of life.

Barb Rode is president and chief executive officer at Saint Therese in New Hope.

0 Comments

Philadelphia Inquirer: Space: Do we still have the right stuff?

FROM AN EDITORIAL IN THE PHILADELPHIA INQUIRER| Nov 20, 2009 at 06:59 PM

Photo by NASA via Associated Press

This artist’s rendering depicts the recent mission to slam a probe into the moon in search of ice.

Having had his mind on his whirlwind trip to Tokyo, Singapore, Shanghai, Beijing and Seoul, Obama probably hasn't had time to appreciate the recent news that the presence of water on the moon has been confirmed. NASA purposely crashed two spacecraft into a crater at the moon's south pole and kicked up debris that included ice and water vapor.

The discovery ironically came only months after former astronauts in the old Apollo program, which first sent men to the moon 40 years ago, had urged Obama to give up on plans to go back there and instead concentrate on a manned mission to Mars.

In fact, Buzz Aldrin, who walked on the moon in 1969 with Neil Armstrong, said the water discovery doesn't justify going back. But in his zeal to get to Mars, he may be a bit myopic. Scientists say water on the moon makes it even more ideal as a low-gravity launching pad to deep-space points, including Mars.

But there's the cost. Perhaps seeking a better legacy, President George W. Bush began a program to return U.S. astronauts to the moon and to land a man on Mars by 2020. He didn't give NASA much more money, though. And while Obama lauded manned space flight on the campaign trail, he hasn't made a corresponding financial commitment.

Obama said that decision would be guided by a committee of experts he appointed. That panel reported in September that NASA would need at least $3 billion added to its annual budget of nearly $19 billion to achieve Bush's goals. It gave Obama other options, including extending the life of the space shuttle fleet, which is scheduled to be retired next year.

Of course, the shuttles can't travel out to deep space. And they're so old and patched-up that it's risky to keep sending them even to the low-orbit International Space Station, which is itself scheduled to be shut down in 2015. The Space Station, however, does provide another model for Obama that he should consider.

Although largely a U.S. enterprise, the Space Station has been an international effort, with various nations providing components, crew and scientists. If cost is the primary obstacle to moon and Mars missions that might provide scientific discoveries beneficial to all mankind, then why shouldn't that endeavor, like the Space Station, be international?

0 Comments

Los Angeles Times: D.C. council must take stand against Catholic Church

Nov 20, 2009 at 06:54 PM

CHURCH VS. STATE

D.C. council must take stand against Catholic Church

The Catholic Archdiocese of Washington is warning the District of Columbia Council that the church will stop contracting to provide social services if the city approves same-sex marriage as planned. To which the only valid response is, "OK."

The church hopes to change wording in the marriage legislation that could require its charitable arm, Catholic Charities, to facilitate adoptions to gay and lesbian couples and extend employee benefits to spouses in same-sex marriages. That, the church says, would require it to go against its religious teachings on homosexuality.

There are times when the aims of government and religious organizations are in sync: bringing food to the hungry, beds to the homeless and medical care to the sick. At other times, their aims veer apart. That's fine, but at such times, government must not be diverted from its own course.

The District of Columbia Council is expected to approve same-sex marriage next month. If it does, those marriages must receive the same recognition as all other marriages, at least in matters under the city's jurisdiction. The council cannot dictate how a religious organization spends its private money, but it has an obligation to set rules for the use of public funds.

This is a situation the Catholic Church has faced before, most notably after Massachusetts banned discrimination on the basis of sexual orientation. As a contractor with the state for adoption services, Catholic Charities placed hard-to-adopt children in gay and lesbian households until the church hierarchy pressured it to stop. It ended its contract with the state and closed its adoption service.

But Catholic Charities could have continued doing private adoptions with church money, as the Mormon Church does. No one was telling the nonprofit how to practice religion -- just how it could and could not use state funds.

So far, the District of Columbia Council is showing more backbone on this issue than the Obama administration. Barack Obama promised during his presidential campaign that he would end the practice of allowing faith-based groups receiving federal money to discriminate in hiring -- for example, by not employing people who hold other religious beliefs. But he has backed off from that vow.

In contrast, D.C. Council Chairman Vincent C. Gray said the city would find another contractor if the Catholic Church severed its ties. That was the right response, and we hope it rang loud enough for Obama to hear.

LOS ANGELES TIMES

2 Comments

Letter of the day: Commissioner Johnson's strong suit isn't architecture

Nov 20, 2009 at 06:53 PM

Photo by Star Tribune

The Walker Art Center’s Spoonbridge and Cherry sculpture: Would Commissioner Jeff Johnson find it too extravagant?

JOE KIMMEL, DAYTON

1 Comments

Readers Write for Saturday, Nov. 21

Nov 20, 2009 at 06:52 PM

WATCH VS. ALDRICH

Charges don't paint an accurate picture

I am dismayed by WATCH's call for Hennepin County Court Judge Stephen Aldrich to resign ("Judge's joke puts him in hot spot, again," Nov. 13).

WATCH says its purpose is to help women and children affected by domestic abuse. Thirty years ago, that was me. I hired Stephen Aldrich to help me start a better life for myself and my nine children.

Judge Aldrich represented me vigorously through the divorce and later issues. But he did much more than that. He supported and empowered me to defend my boundaries and deal with the damage done to my children. He introduced me to Chrysalis center for women, where he volunteered regularly.

Though I had rusty skills and a dated job history, he hired me. He mentored me as I became a legal secretary. After seven years, I moved on to work for a senior partner at Dorsey & Whitney. But to this day Judge Aldrich remains a personal friend, wise counselor and part of my extended family's support system.

Working beside him, I have seen Judge Aldrich help dozens of other women, men, children and families. Before WATCH existed, he was combating domestic violence. For example, together with a founder of Harriet Tubman Shelter and others, he planned and taught at one of the state's earliest seminars on the subject for the Minnesota Council on Family Relations.

WATCH may not like his personal style, but most people do. It is both caring and effective. Judge Stephen Aldrich should stay where he is.

HELEN PETERSON, NEW HOPE

GIVE TO THE MAX

A good day that could have been even better

Thanks to everybody who showed once again how much we Minnesotans value the quality of life for all citizens of our state by donating more than $14 million on Give to the Max Day. One of the reasons giving on that day was so attractive to donors was the promise of matching grants from a consortium of local foundations. Originally advertised as a 50 percent match, due to the unanticipated outpouring from Minnesotans, the matching funds will now provide only a 4 percent match, hardly enough to encourage donors again next year.

In order to establish this tradition of generosity, I call on the foundations to step forward and increase their commitment to the matching funding to provide at least a 10 percent increment. Otherwise, the match is basically meaningless.

SUSAN FREIVALDS, ST. LOUIS PARK

GAYS AND CATHOLIC CHURCH

It is welcoming of diversity but not sin

In the Nov. 17 article "Gays reject church's attempt to 'cure' them," Michael Bayly of the Catholic Pastoral Committee on Sexual Minorities says the Catholic Church "needs to be more accepting of diversity."

Isn't he really saying that the church needs to be more accepting of sin? After all, there is no more diverse grouping of human beings on the planet than the Catholic Church. It is arguably more diverse than the United States. It exists in every corner of the globe and includes the young and old, men and women, Eskimos, blacks, whites, gays, straights, Asians, Native Americans, Australians, little people, liars, thieves, etc.

What the church teaches is that some of these categories are physically descriptive and some are sinful. Bayly's problem isn't with the Catholic Church so much as with the Ten Commandments (as the church has interpreted them for 2,000 years).

BUTCH GRANDY, SEDONA, ARIZ.

GOPHERS END SEASON

Coach Brewster, stay home for the holidays

If the Minnesota Gophers football team doesn't win today against Iowa, it should reject any invitation to a bowl game.

I know it looks good on head coach Tim Brewster's résumé to have gone to two bowl games, but basically he's had a terrible year. His team lost games it should have won, and barely beat South Dakota State. So unless the Gophers win at Iowa, Brewster will be taking a team of losers to a losers' bowl.

Please, coach, don't embarrass the team and Minnesota by prolonging the agony.

FRANCIS TARANTO, MINNEAPOLIS

•••

We are now nearing the end of the Gophers football season, the first in their new stadium. During this run we have found several things to be true:

• By building a stadium with a locker room larger than those of NFL teams and with cherry wood lockers for the players, Athletic Director Joel Maturi and others find it very easy to spend other people's money.

• We have found that the Gophers truly do need more talent to be a winning team.

• We find that the Gophers really need more talent in the coaching ranks.

• Finally, we see that the Gophers are bowl-eligible, but not bowl-qualified. A major difference in definitions.

DALE PROBASCO, BACKUS

XCEL'S PRIVATE JETS

Are its customers picking up the tab?

Xcel Energy needs to answer whether its top executives who are flying around in private jets are paying for it by raising our rates (Star Tribune, Nov. 19). Are the executives turning off the heat for the poor this winter while at the same time jetting around the country?

JIM DAHLGREN, CRYSTAL

22 Comments

Editorial: A state tax to whack for growth's sake

Nov 20, 2009 at 10:26 AM

Organizers of last week's program at the TwinWest Chamber of Commerce may have been hoping for a tax policy fight. The lineup featured state Rep. Ann Lenczewski, DFL-Bloomington, head of the House Taxes Committee, and Mark Haveman, head of the business-oriented Minnesota Taxpayers Association.

But instead of an argument, chamber members heard considerable consensus around a key proposition: Minnesota's corporate income tax is too high, and it should be either reduced or scrapped. That would not be the universal view among DFLers at the Legislature. It might not be the first choice of Republicans or of most Minnesota businesses, since many small businesses don't pay corporate tax.

But it's an idea Minnesota policy leaders should seriously consider. State corporate income taxes generally top "worst tax" lists when economists and tax experts from around the country convene to dispense policy advice. State taxes on corporate profits are faulted for several reasons. They're highly volatile, rising and falling dramatically with the economic cycle. They're costly to collect, especially from big businesses that employ high-powered legal talent to dodge them. They're regressive -- invisibly so. They are paid by customers in the form of higher prices and by workers in the form of reduced wages and fewer jobs, all of which hits the poor disproportionately hard.

Minnesota's corporate income tax has one other defect -- its 9.8 percent rate. That's among the highest in the country. It's also deceiving because of adjustments that have been made through the years to the income base that's taxed. The effective rate most businesses pay is a good deal lower, particularly among those with foreign operations or those based in Minnesota with sales elsewhere. But the high rate creates a damaging impression among would-be out-of-state investors.

Filed under: Editorial| 13 Comments

Letter of the day: Resources are dwindling, and millionaires put hands out?

Nov 20, 2009 at 10:42 AM

Photo by Sl

Owners Zygi and Mark Wilf sent a strongly worded letter to the Metropolitan Sports Facilities Commission this week, saying they were questioning the future of the Minnesota Vikings franchise.

Nothing I've seen in the paper recently bespeaks the confused nature of our world more elegantly than Thursday's headlines, telling us that a) Hennepin County Medical Center is out of money and, b) the Minnesota Vikings want government to pay for a new stadium.

Are we so out of touch that we can't decide how to spend dwindling resources for true benefit? The owners of the Vikings should be told that they can build any stadium they want; all they have to do is charge ticket prices that reflect what it costs to build some glittering monument to beer-swilling and cheering for millionaires dancing badly and rolling around on plastic grass.

Either that, or the next time some unfortunate gets really sick, let him go to the home of football worshipers for health care.

GARY STEVENSEN, SHAKOPEE

•••

Why don't we just give TCF Bank Stadium to the Vikings? The Gophers have proven in less than a season that they can't draw a crowd, win a game, or recruit noncriminal players.

Let's kill two birds with one stone and move the Vikings into the Bank and the Gophers into the classroom where they belong.

DAVID CHALL, MINNEAPOLIS

34 Comments

Charles Lane: Over there, gays get less respect

CHARLES LANE| Nov 20, 2009 at 10:36 AM

If you had to guess, where would you say a gay couple has a better chance of legally adopting a child: France or the United States? The answer, of course, is here. We all learned a lesson about the social progressiveness of Europe, as opposed to the conservative United States, when a French court declared recently that a lesbian could legally adopt a child as an individual.

This breakthrough, which came in an appeal of a lower court's denial of the woman's petition, put French law on a par with Texas law. That state, like most others in the narrow-minded United States, already allowed gay individuals to petition to adopt. (This right exists on paper but may be subject to ideological variation among local courts.) In addition, several U.S. states allow same-sex couples to marry, which they still can't do in France. And some states -- California, Illinois and Oregon, for example -- do not license gay marriage but still permit gay couples to petition to adopt.

9 Comments

Four views on the new mammogram guidelines

Nov 20, 2009 at 12:03 PM

A new study advising women that there is little to be gained by having a mammogram before age 50 should spur politicians to address risk-reward and affordability in crafting a national health care bill, but it won't.

The report came from a government group called the U.S. Preventive Services Task Force, whose findings influence coverage of screening tests by Medicare and many insurance companies.

The task force concluded that most women don't need a mammogram in their 40s. The government panel of doctors and scientists said getting screened so early leads to too many false alarms and unneeded biopsies without substantially improving women's odds of survival.

This new information flies in the face of what women have been told for years. Spokespeople for the American Cancer Society immediately disputed the new advice.

Nobody wants to have this messy debate. Politicians prefer flowery speeches about the need for "health care for all." Confused consumers wonder what to believe, and many just bellow that health care should be "free," and we can get the multimillionaires among us to pay for it.

In Wisconsin, the WEA Trust health plan, which covers most public school teachers, reports it is billed an average of $142 per mammogram by providers in the Eau Claire/La Crosse region. There are roughly 7,500 women in their 40s living in the city of Eau Claire. The federal government says about 63 percent of women in their 40s get mammograms, or roughly 4,725 women in Eau Claire if we're near the average. So the cost if each of those 4,725 women is screened annually is $670,950 per year that somebody has to pay. And that's just Eau Claire. Imagine the cumulative cost nationwide for a procedure the Cancer Society says will positively impact just one of 1,900 women in that age group.

Cost-benefit analysis is crucial to crafting a sensible health care bill. We can't collectively afford everything everybody may wish to have. This study should ignite a much-needed conversation about affordable funding levels in any government-subsidized health plan. But politicians see no benefit in going down that path.

That's why they fritter while Medicare creeps ever closer to insolvency and budget deficits skyrocket.

DON HUEBSCHER, EDITOR, LEADER-TELEGRAM, EAU CLAIRE, WIS.

Breast cancer is the leading cause of cancer death in women ages 40 to 49, with more than 4,000 deaths expected in this age group this year. The task force says routine mammography would reduce deaths by about 15 percent. With its new recommendations, the task force is essentially telling women that mammography at ages 40 to 49 saves lives -- just not enough of them to recommend that all women get screened.

The panel concluded that the harms associated with mammography outweigh its benefits. When experts talk about the harms of screening, they mean things such as having additional tests to better identify what seems to be an abnormality. That usually means another mammogram and, for a small percentage of women, a biopsy to rule out breast cancer. Naturally, these false alarms can cause anxiety, but the data tell us that women know about these limitations and accept them.

Studying cancer deaths among women in their 40s reveals some important trends. Death rates were dropping slightly in the 1970s, thanks to better awareness and better treatments. In 1983, the American Cancer Society began recommending that all women get screened beginning at age 40. By 1990, death rates began a steep decline that continues today. While some of that drop is due to improvements in treatment, conservative estimates are that about half is due to mammography.

The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. The test is far from perfect, but it's the best way we have to find tumors early. How many lives are enough to make routine screening worth it? How many mothers, sisters, aunts, grandmothers, daughters and friends are we willing to lose to breast cancer while the debate goes on about the limitations of mammography?

OTIS W. BRAWLEY, CHIEF MEDICAL OFFICER, American Cancer Society

Science routinely second-guesses itself, and women have often been caught in the middle. But here's what galls me: Not enough lives are saved, the experts say, to justify mammography as a routine screener for breast cancer.

Of the lives saved by mammograms, which ones weren't worth the effort? Certainly my sister's life -- saved not only by a mammogram's detection of something amiss, but by subsequent biopsies, surgeries and rounds of chemotherapy -- was worth the effort and more.

But, says the panel of experts, mammograms' potential for harm outweigh their benefits. In about 10 percent of cases, they produce false-positive results. Women are not to blame for false-positive readings. The solution is not to take away a woman's choice to have a mammogram, but rather to work to reduce the rate of false readings.

I can only imagine that if men were experiencing abnormally high rates of false positives on tests for testicular cancer, heads would be rolling in radiology departments nationwide.

Under health care reform legislation in Congress, the new recommendations would help set standards for what preventive services insurance plans would be required to cover. Have insurance companies just been given a green light to refuse to cover mammograms for women under 50?

I know science must operate in large statistical terms but people are not numbers. If the life saved by a mammogram is my own, I am more than justified in wanting early and routine screenings.

LYNNE K. VARNER, SEATTLE TIMES

The reversal of the seven-year-old guidelines, and the resulting uproar, demonstrate why reducing medical costs will be challenging. Ideally, medical practice should follow the evidence. When drugs or procedures are proven to do more harm than good, or to do no more good than safer or less costly alternatives, incentives should be used to discourage them. In practice, though, as new studies overtake old research and new advice contradicts previous guidelines, the result can be confusion and even cynicism -- and political pressure to ignore the results.

WASHINGTON POST

5 Comments