Government should not be in healthcare business

chare · Feb 21, 2016

Are you suggesting the the federal government, as a result of the ACA has determined that PSA testing is unnecessary? If so, are you the suggesting that PSA testing will no longer be covered? Could you provide a source for these allegations?

elkpark · Feb 21, 2016

It's not that the government doesn't "believe" in the testing -- it's that the research that has been done doesn't support the benefits of routine testing outweighing the risks. And it has nothing to do with the ACA -- it's a recommendation of the USPSTF (United States Preventive Services Task Force). Their website states:

"Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services."

Here is the link for the USPSTF website page on PSA testing: Final Recommendation Statement: Prostate Cancer: Screening - US Preventive Services Task Force

And, while I'm a fan of ProPublic and their healthcare related efforts, I don't see what the "Surgeon Scorecard" page you linked has to do with PSA testing. Maybe I'm just overlooking something.

Susie2310 · Feb 22, 2016

The PSA test is considered valuable by urologists as an indication of the prostate's health. Rising PSA values can indicate infection, prostate cancer, and other prostate conditions, and urologists do order this test. I know this from personal experience. You can research this topic online.

heron, ASN, RN · Feb 22, 2016

So, OP -what part of healthcare do you want government to stop doing? Epidemiology and public health? Basic research? Medical and nursing education? Licensing standards? Health insurance for the elderly and indigent?

If you're hanging your argument solely on changing recommendations for doing PSAs, you might want to think it through a bit more.

Susie2310 · Feb 22, 2016

Even if one's PCP does not provide routine PSA testing for patients, one can still discuss with their doctor PSA screening/importance of a PSA baseline/family history of prostate cancer and other risk factors based on one's own individual health history/risk factors. One has the power to advocate for oneself and one can tell their doctor if they would like to have this test. The USPSTF recommendation is a recommendation, not a decree that is set in stone to apply under all conditions to all patients.

brownbook · Feb 24, 2016

I agree, magnanimous private health insurance companies, whose ONLY concern is the health of their customers, "Damn the costs", should be in charge of our health care needs. I'm certain they would pay for every adult male's yearly PSA test if it weren't for Obama!

NOT!

heron, ASN, RN · Feb 24, 2016

OP has sea gulled.

Tenebrae, BSN, RN · Feb 27, 2016

PSA on its own is not a reliable screening tool for prostate cancer. It should be followed up with other tests.

2011RN · Feb 27, 2016

The government does not believe in PSA testing.
So typical of government that we have a bunch of chuckleheads making a determination about something in which they do not specialize. And then you have government referring to this as proven scienceâ€ and thereby denying preventative treatment. On Friday I learned about a site called Propublica Surgeon Scorecard.
Now, ask yourself, given these statistics, why is it that one of the aftermaths of Obamacare is that PSA tests are now deemed unnecessary?
Way too much attention is given to breast cancer!!! I worked in a breast cancer clinic for 4 years. Come on people. Prostate cancer is the second leading cause of death of cancers in men.
Stay out of healthcare Obama!

Are you aware that the insurance policies that you can purchase through the exchange are still offered by and operated by private insurance corporations? They are not government owned and operated.

Altra, BSN, RN · Feb 27, 2016

Regarding use of the PSA test as screening tool, from the American Cancer Society's annual "Cancer Facts and Statistics" publication, available at Cancer Facts and Statistics | American Cancer Society :

"Among men in the US, cancer of the prostate is the most common type of cancer (other than skin cancer) and the second leading cause of cancer death.

³

Mortality trends for prostate cancer have been declining, which is thought to be in part due to early detection using the prostate-specific antigen (PSA) test (a blood test to assess the levels of a protein made by the prostate). However, the results of three large clinical trials designed

to determine the efficacy of PSA testing were not in agreement. Two European studies found a lower risk of death from prostate cancer among men receiving PSA screening, while a US study did not.

^303-305

Further analyses of these studies are underway. Most experts agree that the current evidence is insufficient to recommend for or against routine testing for early prostate cancer detection given concerns about frequent overdiagnosis (diagnosis of cancer that would not have caused harm) and substantial risk for serious side effects from prostate cancer treatment.

^306-308"

A literature search also provides numerous scholarly articles regarding current investigation of the risks and benefits of use of the PSA test, and debate over whether various test threshholds contribute to over-diagnosis. Many of these published articles date to the late 1990s ... well ahead of Congressional passage of the Affordable Care Act in 2010.

OP, I cannot tell if you intended to state your belief in the PSA test as a superior cancer screening tool, express dissatisfaction with the ACA, or offer an opinion of ProPublica. Unfortunately, you haven't made a convincing case for any of these.