Bill Overview
Title: Making Advances in Mammography and Medical Options for Veterans Act
Description: This bill addresses the Department of Veterans Affairs (VA) provision of mammograms and breast cancer treatment. Among other requirements, the VA must submit a strategic plan for improving breast imaging services for veterans; implement a three-year pilot program to provide telescreening mammography services for veterans who live in locations where access to breast imaging services at a VA facility is difficult or unfeasible; upgrade all mammography services at its facilities to use three-dimensional breast imaging; study the availability of access to testing for the breast cancer gene for veterans diagnosed with breast cancer, as recommended by the guidelines from the National Comprehensive Cancer Network; update guidelines to increase the use of molecular testing and genetic counseling for veterans diagnosed with breast cancer; study the accessibility of breast imaging services at VA facilities for veterans with paralysis, spinal cord injury or disorder, or another disability; and update its policies and directives to ensure that it confirms the accessibility of a breast imaging site when referring a veteran with a spinal cord injury or disorder to a non-VA provider. The Inspector General of the VA must report to the VA and to Congress on mammography services furnished by the VA. In addition, the VA must enter into a partnership with at least one cancer center of the National Cancer Institute of the National Institutes of Health in each Veterans Integrated Service Network to expand access to high-quality cancer care for women veterans. In implementing such partnerships, the VA must ensure that veterans with breast cancer who reside in rural areas or states without a partner cancer center are able to receive care through telehealth. Finally, the VA must collaborate with the Department of Defense and report on all current research and health care collaborations between the departments on treating veterans and members of the Armed Forces with breast cancer.
Sponsors: Sen. Tester, Jon [D-MT]
Target Audience
Population: Veterans who require mammograms and breast cancer treatment
Estimated Size: 20000000
- The bill focuses on providing improved mammogram and breast cancer treatment services through the Department of Veterans Affairs.
- This affects veterans who currently access health services through the VA, particularly those requiring breast imaging and cancer treatment.
- As of 2021, there were approximately 20 million veterans in the United States, with an increasing share being women, who are primarily impacted by breast cancer screening and treatment.
- About 10% of veterans are women, thus those women would be the primarily affected group by this legislation.
- The bill also targets veterans with disabilities, such as those with paralysis or spinal cord injuries, to ensure accessible care.
- In addition to U.S. veterans, similar veterans in allied nations that model their veteran care programs on U.S. legislation may also be indirectly affected.
Reasoning
- The veteran population predominantly benefiting from this policy is the approximately 2 million female veterans who would directly benefit from the improved breast cancer screening and treatment services.
- The budget constraints suggest that the services must be efficiently distributed, prioritizing areas with low accessibility to such services and veterans with disability or in rural areas.
- About 10% of the 20 million veterans in the US are females, a major target for breast cancer services, among whom those in rural areas and with additional accessibility needs are prioritized.
- The improvements will indirectly benefit the broader veteran population by possibly streamlining VA services, but those primarily affected are women requiring breast cancer services.
Simulated Interviews
Retired Army Nurse (Montana)
Age: 67 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I have had trouble accessing timely mammography services due to my location.
- Telehealth services could greatly improve my healthcare experience.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
Veterans Affairs Administration Staff (Washington)
Age: 52 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could streamline access to critical healthcare for many underserved women veterans.
- It could also relieve some of our administrative burdens.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 7 |
Civilian Medical Technician (Texas)
Age: 25 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- Having access to advanced mammography would give peace of mind, especially with my family history.
- The emphasis on genetic counseling is also reassuring.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
Veterans Advocate (Colorado)
Age: 47 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- This policy could significantly aid disabled veterans who face access challenges.
- Improving breast cancer care within the VA might help many of the women I assist.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
VA Hospital Technician (Ohio)
Age: 38 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- Upgraded mammography technology and telehealth options seem promising.
- Streamlining services could improve my workflow at the hospital.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 7 |
Navy Veteran, Community Health Worker (Alaska)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- Access to tele-screening mammography could be transformative for many veterans like myself in rural Alaska.
- I'm hopeful this collaboration with cancer institutes improves outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Marine Corps Veteran, Breast Cancer Survivor (Florida)
Age: 58 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 8.0 years
Commonness: 6/20
Statement of Opinion:
- Expanding breast imaging accessibility is critical, especially for those diagnosed later like me.
- I hope others can benefit more easily than I once did.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 7 |
Retired Air Force, Caregiver to Spouse with Cancer (New York)
Age: 63 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- This policy could lighten our burden and improve long-term care options for my wife.
- It's crucial for reducing stress on veterans and their families.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
Active Duty Army, Health Admin Student (California)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- The collaboration with cancer institutes is a proactive step for comprehensive care.
- We need more policies like this to cover all aspects of veterans’ wellness.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
Veteran, Disabled, Healthcare Advocate (Arizona)
Age: 54 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 2/20
Statement of Opinion:
- Ensuring accessibility at imaging sites is a major requirement ignored until now.
- I hope this will set a precedent for other disability-focused healthcare improvements.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Cost Estimates
Year 1: $50000000 (Low: $45000000, High: $60000000)
Year 2: $60000000 (Low: $55000000, High: $70000000)
Year 3: $70000000 (Low: $65000000, High: $80000000)
Year 5: $80000000 (Low: $75000000, High: $90000000)
Year 10: $90000000 (Low: $85000000, High: $100000000)
Year 100: $100000000 (Low: $95000000, High: $110000000)
Key Considerations
- Ensuring accessibility for veterans with disabilities, especially those with spinal cord injuries, requires specific infrastructural and logistical planning.
- The strategic partnership with the National Cancer Institute might face geographical and logistical challenges in rural areas.