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Read The Bill, Connect The Dots, Mammograms And Rationing

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Location: Washington D.C.

Read The Bill, Connect The Dots, Mammograms And Rationing

This week, the U.S. Preventive Services Task Force, an agency within the Department of Health and Human Services, published a study recommending that women under 50 do not need to receive annual mammograms. The study created an uproar in Washington while angering and confusing women across America.

Setting the scientific evidence in the study, its methodology, and the troubling implications for women's health aside, I'd like to show how the Democrat health care bill, H.R 3962 (Full Text Linked Here) will give this troubling study the force of law and result in limited access to mammograms for women enrolled in a health insurance exchange plan or the public option. In short, connecting the dots through H.R. 3962 will illustrate how these regulations place us all on the slippery slope to health care rationing.

STEP 1: Provider Networks And Essential Benefits
Lets start with the full text of H.R. 3962 as finally passed by the House this month. Page 106 of the bill, starting at line 7, sets forth guidelines that all health insurance plans and the public option must comply with. Page 107 goes on to define these plans as "provider networks."

Jumping a few pages ahead, to page 110, we see on line 3 that the bill lays out precisely what essential health care benefits must be in these approved plans. Those services begin to be outlined on page 111, line 8 . Service 8 (number "8" on line 1 of page 112) says that "preventive services, including those services with a grade of A or B by the Task Force on Clinical Preventive Services" must be covered.

STEP 2: The Task Force
Who is this Task Force on Clinical Preventive Services? Well, their authority begins to be laid out in Section 2301 of the bill, starting at line 18 of page 1296. Their specific authority begins to be spelled out on page 1301 at line 15. The bill says that The Task Force will identify clinical preventive services for review." The Task Force will "review the scientific evidence related to the benefits, effectiveness, appropriateness, and costs of clinical preventive services." (page 1302 lines 1-3) The Task Force will then, "determine whether subsidies and rewards meet The Task Force's standards for a grade of A or B." (page 1302 lines 14-16)

STEP 3: Services Graded And Provided
On page 1317 at line 21 the bill reiterates that the Secretary of Health and Human Services must include those A and B graded services among essential benefits that all health care plans must include.

Here is where we have to inject a little common sense into H.R. 3962. The bill mandates that all Americans must be able to purchase plans in the exchange and be provided these essential benefits; in this case, preventative care ranked with a grade of A or B. This will be enormously expensive for private plans and for the Federal Government under the pubic option since everyone must be covered.

Because there is no mandate or incentive in the bill to provide coverage for services graded as C or below, it is reasonable to conclude that costs will keep health care plans from providing these services.

Going back to the text of H.R. 3962; on page 1329, line 21 the bill goes into more detail about the Task Force's recommendations. It says "all recommendations of the Preventive Services Task Force [the panel that issued this week's mammogram reccomendation]… as in existence on the day before the date of the enactment of this Act shall be considered to be recommendations of the Task Force on Clinical Preventive Services…" It goes on to say, and I find this remarkable, that the Preventive Services Task Force automatically becomes the Task Force on Clinical Preventive Services.

STEP 4: What This Means For Mammograms
The very mammogram study that we heard so much about this week, the one conducted by the Preventive Services Task Force, will automatically be the guideline for determining what grade mammograms for women under 50 receive. As you can see here the study recommended a grade of "C" for that service. This all means that getting a mammogram under the age of 50 is not considered an "essential benefit" and will not be covered under the new health care regime.


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