MSNBC’s Dr. Nancy Snyderman appeared on Wednesday’s Morning Joe and justified reducing the number of women in their 40s who get mammograms. "No, it is rationing. Let's be clear," she admitted.
Confusing private actions by American citizens and the government, the Dr. Nancy host compared, "But, you ration what food you eat. You ration how much sleep you get. And this is saying we should question about how we spend our health care dollars." Of course, the government doesn’t control how much food and sleep Americans get.
Host Joe Scarborough made the same point, though he didn’t seem so cheery about rationing: "You talk about the death panels. Forget the death panels. This is rationing, saying, 'Okay, we could do this. We could save some lives. It's just not worth the money.'"
There’s obviously a big difference between a woman in her early 40s opting to forgo a breast exam and not having that option under government-run health care. Snyderman didn't seem to consider the implications.
(The Morning Joe discussion grew out of a government panel's recommendation that women begin getting mammograms at age 50, not 40.)
Snyderman continued, “And if it isn't prudent to irradiate that many women in their 40s and you take that money and you say – okay, let's finds something better than mammography, which is isn't great anyway.” Who takes the money and finds something “better” to spend it on? The anchor didn’t say.
Snyderman, who appeared so blase about the prospect of rationing, is the same MSNBC host who fumed on her November 9 program that she found pro-life Democrats to be "infuriating." She complained to correspondent Kelly O’Donnell about legislation in the health care bill that would restrict some private insurance plans from paying for abortion:
NANCY SNYDERMAN: Kelly, you know what I find so infuriating about this? I mean, absolutely infuriating. And this isn't about being pro-choice or pro-abortion, or any of the hot-butto lingo. We know women pay more for insurance than men. We know women are restricted in many states...I'm surprised that frankly, that there isn't more outrage over fact that, this isn't fair!
On November 12, Snyderman railed against Catholic Bishops opposing abortion funding in the health care bill: "This is going to be a Pollyannaish statement. The Catholic bishops appearing and having a political voice seems to be a most fundamental violation of church and state." She also lobbied for the IRS to investigate them.
[Thanks to MRC intern Mike Sargent for noticing the exchange and the transcript.]
A partial transcript of the November 18 segment, which aired at 7:33am EST, follows:
MIKA BRZEZINSKI: One of the big headlines this morning, women across the country trying to sort through new conflicting advice about when to begin breast cancer screening. Now according to "The New York Times," many doctors say they are not ready to embrace a government panel's recommendation that women begin mammograms at the age of 50 instead of at the age of 40. The task force says screening women in their 40s only saved one life out of roughly 2,000 and led to unnecessary testing and anxiety. I see Nancy at the edge of her seat ready to talk about this. With us now, NBC News Chief Medical Editor Nancy Snyderman. But that is – you look at even these two articles –
SNYDERMAN: I read them both this morning.
BRZEZINSKI: Wow. I mean, it is very confusing. Where do you begin to give advice?
NANCY SNYDERMAN: Well remember, this is not a government task force. These are independent people from Georgetown, Stanford, MD Anderson, Dana Farber, Harvard, who came together to look at all the data. All the randomized clinical trials –
BRZEZINSKI: Asked by the government?
SNYDERMAN: – asked independently by the government, all these independent universities, to look at this big body of research and say what are the numbers? Because that's what we do in science. We try to figure out where the truth is. And the conclusion is – and this is what I think has really been lost in the message: For women 40 to 49, with no risk factors for breast cancer, no family history, no genetics, the yield is so low that the suggestion is routine screening is unwarranted. Why? Because a 40-year-old woman's breast is denser. She has more estrogen. It's lumpier. So, you either miss cancers or you overcall them. And when you overcall them, that leads to more biopsies and more treatment, and, you know, we need to talk about health care costs at some point, and more worry. And you over-screen. You x-ray 1,900 women to find that one, and they're just saying, is that prudent?
BRZEZINSKI: Well I mean, it's a very practical assessment, but you know what people –
SNYDERMAN: But that's what science is. It's a practical assessment.
BRZEZINSKI: Right, okay. But you know what the concerns are here and what you're going to hear on the other side of this. That one person that is caught –
SNYDERMAN: Because we are caught talking anecdotes versus science. And I think that's where we've really gotten muddied in the last 48 hours. We all know someone. Or we have a family member, we have a loved one, we all know someone with breast cancer. And now I’m going to say something terribly politically incorrect. I've gotten enough hate mail over the last 48 hours. I feel like I'm bruised like a politician. We just came out of October, what I called the pinking of America. We have taken a woman's breast and we have politicized it. We have marketed it. We have made millions of dollars for agencies and non-profit groups off the breast. But in some ways we've not let women know the data. And in this country, we're smart enough to know anecdotes from science and give guidelines. This isn't the government trying to tell people what not to do, it’s not the insurance companies poised to pull your dollars away. But it is a chance for a 45-year-old woman to say, okay, now that I have more information, how can I better take care of myself? And I think that's the takeaway that has been lost in all of this.
JOE SCARBOROUGH: We have somebody that works on our team who's actually mom's a doctor who said, this is the beginning. This is the first sign of rationing. This is – you know, maybe we don't call it rationing.
SNYDERMAN: It is rationing.
BRZEZINSKI: It's definitely rationing.
SCARBOROUGH: You talk about the death panels. Forget the death panels. This is rationing saying, "Okay, we could do this. We could save some lives. It's just not worth the money."
SNYDERMAN: No, it is rationing. Let's be clear. But, you've heard me talk about rationing for a long time. But, you ration what food you eat. You ration how much sleep you get. And this is saying we should question about how we spend our health care dollars. And if it isn't prudent to irradiate that many women in their 40s and you take that money and you say, okay, – let's finds something better than mammography, which is isn't great anyway. Let's take the money and invest in new treatment tools. Then that, to me, is smart health care rationing.
BRZEZINSKI: I totally agree with you. But is it also true that women in their 40s who have gotten mammograms, there are some who have had breast cancer discovered early and therefore are alive today?
BRZEZINSKI: That's the crux of the controversy.