Health Care Blog

Reality Check: Beware What “Critics Say” on Reform and Mammograms

One of the hallmark tactics from opponents of health insurance reform has been to grab onto any convenient piece of information and twist it into some misguided attack on reform, no matter how unrelated it may actually be.  The hope appears to be that some media outlet will give them unchecked airtime under the banner of covering the “controversy.”  Today they’re going back to that playbook again, and Fox News obliges them with the headline “Critics See Health Care Rationing Behind New Mammography Recommendations.”   The story refers to new recommendations from the independent U.S. Preventive Services Task Force:

"Some lawmakers on Capitol Hill are blasting new guidelines from a government task force that recommends against routine mammographies for women under 50,  questioning whether they are tantamount to health care ‘rationing’ in the fight against the No. 2 cancer killer in U.S. women."

There’s only one problem: the recommendations of this task force would actually be used to provide access to effective preventive services for free or at low-cost. The USPTF would have no power to deny insurance coverage in any way.   The line of attack is actually somewhat ironic, because one of the guiding principles of reform from the very beginning in March has been to invest in significantly increased  effective preventive care, something these “critics” never seemed to care much about over the past 8 months. 

Just so there’s no ambiguity, here are the answers to about every question you (or “critics”) might have on the U.S. Preventive Services Task Force: 

Will Medicare now stop paying for breast cancer mammography for women because of this recommendation?

Women who are currently getting mammograms under Medicare will continue to be able to get them. There are no plans to change that. The law states that in order to change Medicare coverage of mammograms a formal rule making process must be undertaken and that is not happening.

Isn’t this the first step toward denying coverage for mammograms?

No. The Task force is an independent panel of experts in prevention and primary care that evaluates available evidence and makes recommendations about effective clinical preventive services based on scientific information. Under the health insurance reform legislation, the USPTF would have no power to deny insurance coverage in any way. Their recommendations would be used in health reform to identify effective clinical preventive services.

How will this recommendation affect private health insurance coverage?

The Task Force does not address insurance coverage and payment issues; it focuses on the science of the clinical services it evaluates.   Each insurance company is different and makes its own coverage decisions.  The Task Force recognizes that clinical and policy decisions involve more consideration that this body of evidence alone.  Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation.

Tommy Thompson said the Task Force recommendations were the official position of the U.S. Government. Is that your position?

We have tremendous respect for the Task Force and the work they have done.  They are an independent scientific body that makes recommendations based on scientific evidence; however they do not set official policy for the federal government. Under health reform, their recommendations would be used to identify preventive services that must be provided for little or no cost.

Won’t the USPSTF be used to ration care under health reform?

Absolutely not.  The USPSTF, an independent task force made up of some of the nation’s top doctors and scientists provides science-based recommendations regarding the most effective preventive, treatment and screening services. The Task Force’s recommendations would be used to help determine the types of services that must be provided for at little or no cost and the Task Force would have no power to deny insurance coverage in any way..

What do these recommendations mean for the current health reform bills?

While the bills are still being drafted and debated in Congress, health insurance reform legislation generally calls for the Task Force’s recommendations to help determine the types of preventive services that must be provided for little or no cost. The recommendations alone cannot be used to deny treatment.

Word from the White House: Talking Points: Reform Opponents' Pre-Determined "Study"

It's no secret that institutions of all stripes focus their communications on certain messages day to day. We thought it would all be a little more open and transparent if we went ahead and published what our focus will be for the day, along with any related articles, documents, or reports.

Supporting article: "Health bill foes solicit funds for economic study," Washington Post, 11/16/09

Supporting report: "Health Care Reform: Creating a Sustainable Health Care Marketplace," Business Roundtable, November 2009 (pdf)

Talking Points: Reform Opponents' Pre-Determined "Study"

• Today's article unmasking their plan to pay a "respected economist" handsomely to produce a "study" with predetermined outcomes is just the latest proof that reform’s opponents will not let the facts get in the way of their efforts to defend to a status quo that has been so profitable for the insurance companies.
• This so-called study would be at least the third intentionally skewed report as part of the last-ditch effort to safeguard the insurance companies' bottom line at the expense of the American people.
  • You may recall that last month, the insurance lobby offered an "analysis" that even the company who produced it said was skewed because that’s what the insurance companies paid for.
  • And just days after that report, another insurance company produced a similarly flawed study.
• The only difference this time is that the insurance industry's defenders were caught red-handed before producing their intentionally misleading "study".
• So whenever we finally see this supposed analysis, we should all take it with a huge grain of salt.
• The reality is that health insurance reform will save jobs and lower costs for American businesses, families, and the country as a whole.
• MIT Economist Jon Gruber reports that reform will save about 80,000 jobs in the small business sector over the next decade and could save a typical family thousands of dollars on health care costs.
• And a recent study from the Business Roundtable confirms that the health care status quo is unsustainable and that reform legislation in Congress is moving in the right direction on cost containment and could reduce premiums by $3,000 over the next decade.

Talking Points: Controlling Costs for Families, Small Businesses, and the Government

• From the beginning of this process, President Obama has been clear that health insurance reform must not only provide security and stability for Americans with insurance and affordable options for uninsured Americans, but also slow the unsustainable cost growth that is burdening families, threatening businesses’ viability, and exploding our national deficit.
• Fortunately, the House and Senate versions of reform share a variety of measures that will reduce the rapid growth in health care costs while also providing Americans with higher quality care including:
  • Changing the way we handle hospitalizations, to prevent mistakes and to prevent unnecessary readmissions.
  • Creating incentives in the payment system to reward quality of care rather than just the quantity of procedures.
  • Giving physicians incentives to collaborate in the coordination of patient care.
  • Investing in research into what works and what doesn't in health care.
  • Reducing hospital-acquired infections and other avoidable health-center acquired conditions through rigorous reporting and transparency.
  • Putting prevention first, rewarding care that focuses on wellness and treating the whole patient in an integrated and coordinated delivery system.
  • Tackling the insurance bureaucracy, streamlining the payment system to save time and money that is now spent processing claims and navigating through the byzantine insurance system.
  • Establishing a health insurance exchange with a public insurance option, where individuals and small businesses can buy lower-cost insurance that will spur competition and put downward pressure on costs.
• These measures build upon the significant down payment we already made in the American Reinvestment and Recovery Act to begin switching from paper records to computerized records; to strengthen preventive care; to invest in patient-centered health research; and to build up the workforce of primary care providers.
• And there are also ideas that will further control cost growth that have been proposed and are being looked at as the legislative process continues, such as:
  • A fee on insurance companies offering high-premium plans — which would create a strong incentive for more efficient plans that would help reduce the growth of premiums.
  • Establishing a Medicare commission — which would develop and submit proposals to Congress aimed at extending the solvency of Medicare, slowing Medicare cost growth, and improving the quality of care delivered to Medicare beneficiaries.