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Transcript: Dr. Bernadine Healy on 'FNS'
Written by Chris Wallace / Published November 23, 2009 / Fox News Sunday
The following is a rush transcript of the November 22, 2009, edition of "FOX News Sunday With Chris Wallace." This copy may not be in its final form and may be updated.
CHRIS WALLACE, HOST: In the fight over health care reform this week, two new cancer screening studies became part of the argument.
First, a government task force recommended women delay starting routine mammograms from age 40 to age 50. And then an association of medical experts said women could delay their first screening for cervical cancer until age 21 and then be re-screened less often.
Joining us now to sort through this is Dr. Bernadine Healy, the first woman to head the National Institutes of Health. She is now health editor for U.S. News & World Report, and she comes to us from Cleveland.
Dr. Healy, let's start with some practical advice for women, many of whom, I'm sure, are understandably confused at the end of this week. What would you tell a woman patient with no particular history of breast cancer what she should do about getting mammograms?
DR. BERNADINE HEALY, FORMER HEAD OF THE NATIONAL INSTITUTES OF HEALTH: I think she should stick with the existing guidelines that come out of the medical professional organizations and have been in place for a long time, which is start your screening at age 40; if you are concerned about a risk, maybe a baseline of 35; and then — and then have it done every year in your 40s. You might go to every other year in your 50s.
And you and your doctor will decide for how much longer it should go.
WALLACE: So basically you're saying ignore the Preventative Task Force recommendations this week.
HEALY: Oh, I'm saying very powerfully ignore them, because unequivocally — and they agreed with this — this will increase the number of women dying of breast cancer. Women in their 40s have a very aggressive kind of breast cancer. They tend to progress fast. And to not screen women in that age group is astounding to me, and it goes against the bulk of individuals who are actually caring for patients. You may save some money, Chris, but you're not going to save lives.
WALLACE: And what would you tell a young woman about when she should start getting Pap tests to screen for cervical cancer?
HEALY: I think I — I think the new recommendations that came out of the ACOG, or the American society of OB-GYNs, is very responsible and reasonable, because we understand cervical cancer.
We know when it starts. It's a sexually transmitted disease. It takes a while to turn into cancer. You don't just get that infection and suddenly get cancer. It usually takes about 10, sometimes 20 years, unless you're immuno-suppressed.
So I think that to spread it out to two years instead of one year, to wait until you're 18 or 21 — I think it should be up to the doctor, but you don't have to do it every year.
And this is important because this infection causes some very nasty looking cells on a Pap smear, and sometimes that does lead to aggressive treatment that's not needed because this infection in 90 percent of women clears up — clears up — in a matter of about two years, one to two years.
WALLACE: Doctor, you say that this use of task forces to say what should and shouldn't be covered by government and private health insurance plans is a, quote, "sneaky kind of rationing."
But look, this was an independent group. Its members were appointed by President Bush, not President Obama. And they say that they were making decisions based on medicine, not on cost.
HEALY: Well, they were — they — I think you could get the answer you want and the orientation you want depending upon who was on the task force.
This particular task force has been in existence for about 25 years and its focus is on public health, modeling of health policy and economics.
It does not have people who are experts in hands-on patient care, for the most part, and on oncology or even in breast cancer or cervical cancer. It gets information from those groups, but it ultimately comes up with models.
You know, Chris, there's really been no new information here. It is a different way of looking at the same problem. Their perspective is if you can cut in half the money we're spending on screening for breast cancer and lose only, you know, maybe 10 percent, 20 percent of the benefit, that's a good tradeoff.
A doctor who is responsible ethically for their individual patient would not make that tradeoff.
WALLACE: But, Doctor...
HEALY: You know, we're doing just fine.
WALLACE: But, Doctor — and it certainly may be possible that this particular recommendation is a bad recommendation, but how are we ever — everybody agrees that health care costs are out of control.
How are we ever going to control health care costs if here you have an independent group making decisions on what it says is evidence-based medicine, and as soon as the politicians get some heat — and they got a lot of heat on the mammogram study — they run away?
HEALY: I agree with you, Chris, because there will be a lot of other decisions that people won't know about that will — that will get through, and they could be harmful.
The issue here is that we are listening to one voice. And unlike what the secretary said and Senator Stabenow just said, this is not just a recommendation. This is codified in law that this is the group that will be providing information.
This is not the voice that medicine has used that focuses on the individual patient rather than the good of society. And even if they included the other groups, like the obstetricians and gynecologists, and the oncologists, and the cancer society, that would be fine, but they didn't.
What doctors have had up until now is a choice. They've had a number of different guidelines from very responsible groups, and it gives them and their patient some choice within some narrow limits.
WALLACE: So in about...
HEALY: None of these...
WALLACE: ... in about 15 seconds, Dr. Healy, because we're out of time...
HEALY: Yes. OK.
WALLACE: .. are you saying that you're worried about government rationing in the Democratic health care plan?
HEALY: Hidden government rationing, pretending it's coming from experts and that it's going to be for your health and well being. These guidelines are not. We're going to see more people die of breast cancer. And breast cancer is 25 percent of the cancers that are out there.
WALLACE: Dr. Healy, we want to thank you so much for clearing up some of the confusion. Thanks again.
HEALY: Thank you, Chris.
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