Consider the second leading cause of death in the country, namely cancer. Breast cancer will kill forty thousand women this year and 182,000 new cases will be diagnosed. Medicare and Medicaid will pay for annual mammograms. Only 35% of women have had regular screening mammograms. If American politicians were as interested in healthcare as in allowing lawsuits, we could reduce breast cancer deaths by 60% if the number of women screened could be increased three-fold. For colon cancer, the figures are just as bad. Last year 160,000 new cases of colon cancer were diagnosed and 64,000 patients died of the disease. The cost of care was a staggering 5.5 billion dollars. Most of that money came from your taxes. Medicare pays for annual hemoccult tests (hidden blood in the stool), short flexible sigmoidoscopy every five years to find early, curable disease and precancerous lesions. Beginning July 1, Medicare pays for a full colonoscopy each decade. These three colon cancer screening tests could reduce the incidence of colon cancer by 20%, 35% and 75% respectively if patients would have the tests done. Last year in Georgia, only 17% of adults over age fifty were screened for colon cancer. The small gains in cancer deaths over the past decade are due to the paltry screening effort. When it comes to healthcare policy that will save lives, patients and politicians should spend as much time listing responsibilities as they do rights. If they did, the following Costrini amendments could be added to the Bill before Congress.

1. Any patient who receives Medicare or Medicaid funds must have indicated mammography and colon cancer screening as a requirement for future payments.

2. Private insurance companies must cover these screening tests and enrollees must agree to have the tests as a condition for future insurance.

3. To limit lung cancer, Medicare /Medicaid recipients must take an anti-smoking program and be given nicotine patches for one year. The same policy should be adopted by the commercial insurance industry.

4. To provide for the cost of this mandated, medically necessary screening, hospital, clinic, and physician reimbursements for screening exams must be cut substantially. That is the necessary price the health profession must pay. If done, the nation will be supporting the costs of health rather than the higher costs of misery and cancer death. Cancer death is not only due to simple misfortune, but also due to, we must accept, our own healthcare irresponsibility.

If you agree that patients’ rights come with responsibilities, send this to your Congressman. If you think the amendments too radical and harsh, compare them to dying of a cancer that could have been cured or prevented. Physicians, unlike politicians, see this every day. We cannot sue; only weep.