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Okay, here's a terrific example of how health care reform will help save people from illness and early death- and save us, the taxpayers, a bunch of money, too.

An article in USA Today on March 18th talking about how the vaccination against Human Papilloma Virus (HPV) is not being received by many girls and young women.

Almost all cases of cervical cancer are linked to HPV.  70% of the cases of cervical cancer are linked to HPV types 16 and 18.  Cervical cancer killed over 4,000 women in 2009, and over 11,000 cases of cervical cancer were diagnosed.

So while the vaccination (there's two drugs, one called Gardisil and one called Cervarix) doesn't directly prevent cancer, it prevents girls and women from being infected with HPV, and HPV later in life can lead to cervical cancer.  Make sense?

Okay, so here's where the article comes into play.  The two states in the union that have the highest death rates from cervical cancer are Mississippi and Arkansas.  One really big reason they have high death rates from cervical cancer, even though overall deaths from cervical cancer have been falling for years, is because these are two of the poorest states- and women don't have access to health care because they don't have insurance coverage.

If they had the coverage, they'd be getting the regular Pap smear tests which help with the early diagnosis and treatment of cervical cancer.

What's more, in those states...

Yet in Mississippi, where the vaccine could perhaps save the greatest number of lives, only 16% of teen girls in 2008 received the shot, called Gardasil, according to Bach's paper in Saturday's The Lancet. About 22% of Arkansas girls ages 13 to 17 got the vaccine, which costs $390 for three shots.

In the wealthier state of Rhode Island, where cervical cancer mortality is half as high as in Mississippi and Arkansas, 55% of girls received Gardasil, the paper says.

With me on all this?  These states with more poor people have more death because of the lack of health care access, and the young women who can now be protected from the cancer aren't getting the vaccine.

Plainly, by getting 35 million more people covered by health care insurance (which the health care reform bill is designed to do) we'll save thousands of women from cervical cancer.  They'll have access to tests for early diagnosis for the women when they do get it, and the girls will have access to the (expensive) shots that protect the next generation from getting it.

So health care reform will save lives and save people from illness, plain and simple.

Oh, and money-wise?  We win there, too.  The reason is that treating someone with early tests and diagnosis, or vaccinating them up front so they don't get sick in the first place are FAR less expensive than when these women get sick with cancer and wind up on state healthcare bills for late-stage treatment.  That saves the taxpayers a BUNCH of money.

(Of course, if we'd just let them die and deny them treatment at all, we'd save plenty of money, but thankfully we don't do that in America; if someone shows up at an ER, we treat them.  We're not all Ayn Rand-worshipping monsters here.)

This is a perfect example of how health care reform WORKS.  Get women access to the tests so the ones that have HPV already and who will come down with cervical cancer can get earlier, more successful, less expensive treatment; get girls vaccinated so we cut back something around 70% of the future cases of cervical cancer in the first place; save money in the meanwhile.

Win, win, win situation all around.

When those tea party protesters are out there yelling "Kill the bill", what they're really saying is "keep killing poor women and doom poor girls to cancer!"

Originally posted to Blue Eyed Buddhist on Sun Mar 21, 2010 at 08:14 PM PDT.

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Comment Preferences

    •  Would need more information (1+ / 0-)
      Recommended by:
      Blue Eyed Buddhist

      to know if it actually saves money. A vaccination series costs $390. How many incidences of cancer will they prevent compared to the number of vaccinations received, and what is the cost of each incidence?

      Don't get me wrong. Preventing cancer and preventing death are obviously good things even if vaccinating won't save money. But I'm a math teacher, and this is a reality-based community. It is possible that the cost of providing universal access to the vaccine, Pap smears, and early diagnosis may far exceed the costs of treating those who would otherwise contract the disease, or in whom it would be discovered at a later stage, because they didn't have access to those measures.

      Relax - the adults are in charge now.

      by NWTerriD on Sun Mar 21, 2010 at 08:36:22 PM PDT

      [ Parent ]

      •  Well... (0+ / 0-)

        some cocktail-napkin figuring...

        70% of the cases of cervical cancer are caused by HPV types 16 and 18, both of which are covered by the HPV vaccines.

        Vaccination is almost 100% effective in preventing HPV infections of these types.

        For the sake of argument, let's say it's 98% effective, and let's say we manage to vaccinate 95% of the female population. That means that vaccination will prevent:

        .98 X .7 X .95 X 11,000 = 7168 new cases of cervical cancer; and

        .98 X .7 X .95 X 4,000 = 2606 deaths prevented

        I found a link here that indicates in 2000, it cost around $20,200 to treat cervical cancer.  That comes to around $25,000 in 2009 dollars.

        7168 X $25,000 = $179,200,000 per year in treating cervical cancer.

        This same paper seems to indicate that early screening and treatment is quite cost-effective on a strictly-numbers basis, not to mention the obvious benefit to people's happiness.

        I also found this link which seems to say that vaccination is a big money-saver for younger females (say, age 12) but becomes less effective as they get older.  This is because as they get older, they get exposed to the HPV virus through sexual contact, and if they've already got HPV the vaccine doesn't work.

        Between these two sources it sounds as though we're best off to vaccinate girls when they're 10 to 12 years old; if they're older than that then we're better off doing regular Pap smear tests for early detection and treatment.

        •  And what will it cost to vaccinate (0+ / 0-)

          95% of the female population?

          Some quick research showed about 4 million babies are born in the US each year. Presumably half female. So at almost $400 a pop, the vaccine costs would be about 4 to 5 times the treatment costs saved in your example. Although your example may be erring on the low side. I understand how you calculated it, but the article you cited put the total treatment costs

          And the cost of regular Pap smears for all women in the relevant age range would . . . what? Double that number? Triple it? (Pap smear costs less than one-tenth as much as the vaccinations, but in any given year should be done on a third of adult women under 65. So that's about 15 to 20 cohort-years worth of women. $35 x 2 million x 15 = a bit over a billion per year.)

          So we're at close to a couple billion a year for prevention, although some significant portion of that is already being spent in the current iteration of the health care system, so we can't count that whole amount as additional costs of prevention. So maybe an increase of a billion? 1.5 billion?

          Relax - the adults are in charge now.

          by NWTerriD on Sun Mar 21, 2010 at 09:52:54 PM PDT

          [ Parent ]

  •  vaccination (1+ / 0-)
    Recommended by:
    Blue Eyed Buddhist

    As someone who works in a state government office that helps doctor's offices get vaccines for their uninsured, under-insured, Medicare and Native American patients, I have to say that the administrative costs of our crazy insurance mess is only one chunk of the puzzle. The other is the unholy alliance between the kooky teabaggers and the anti-thimerosal crowd.

  •  How will you (1+ / 0-)
    Recommended by:
    Blue Eyed Buddhist

    get them to the doctor and pay for their visits? Medical care under this bill is not free. Medicaid only helps those who can find a doctor willing to accept it.

    If wanting the country to succeed is wrong, I don't want to be right.

    by Angela Quattrano on Sun Mar 21, 2010 at 08:59:18 PM PDT

    •  a fair question (0+ / 0-)

      but I have to think that the primary reason that only 16% of the girls in Mississippi but 55% of the girls in Rhode Island are getting vaccinated is pretty simple- the girls in RI have health insurance.

      Get people coverage and they'll get to the doctor or nurse for the shots.

      Of course we have a lot of issues with having enough medical professionals, but those are also things we can work on.  Point is that saying "well we don't have enough doctors so we shouldn't even TRY" is not a wise move, IMO.

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