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January 2, 1991

Screening Mammography-Reply

JAMA. 1991;265(1):27-28. doi:10.1001/jama.1991.03460010027015

In Reply.—  We agree with Dr VomLehn that many public health department clients cannot afford mammography and that cost is an important barrier, particularly for low-income women. We hope the recent trend continues for the passage of state legislation to include payment for screening mammograms through Medicaid or third-party carriers1 and for the restoration of Medicare coverage for mammograms for women 65 years of age and over.2Without this coverage, health departments without mammography units are left with the option of encouraging radiology facilities to offer low-cost mammograms, either at a fixed cost (≤$50) or on a sliding scale basis. The six National Cancer Institute breast cancer screening projects have been able to encourage many facilities to offer low-cost mammograms. A recent General Accounting Office report has shown that low-cost screening mammograms can be profitable with batch reading and high-volume use and that these services do not compromise