Americans know best what kind of health care coverage is right for them and their families. They should be able to work with their own trusted physicians to determine the treatments and services that meet their needs.
Unfortunately, the health care reform law, which was rushed through Congress and forced on the American public, empowers the government to make decisions that should be left to doctors and patients.
The new law undermines Americans’ control over their health care in multiple ways. One of the most troubling provisions gives unchecked power to the U.S. Preventive Services Task Force.
Edict, Not Recommendation
This task force’s recommendations determine whether an insurance company must cover certain preventive services. If the task force does not favorably endorse a procedure that an individual and his or her doctor decide is important, the patient could be forced to pay for the service out of pocket or choose to forgo it.
Before health reform, a recommendation from the task force would have been just that — a recommendation. A doctor might take it into consideration while deciding when and how often a specific patient should have a preventive service, like a mammogram or colonoscopy. But the physician would also be looking at other key information, such as medical risks and family history — factors that could easily defy a blanket task force recommendation.
Concerned about the reach of this task force provision, I asked the Congressional Research Service to analyze the health reform law. The research service reported back that the task force’s powers are indeed absolute. That means the panel’s decision is no longer a recommendation: It’s an edict that is likely to directly affect patients’ access to preventive care.
It is stunning that in America today, a single panel of bureaucrats has veto power over a patient’s access to potentially lifesaving medical care. What’s more alarming is that the only recourse for patients and physicians who oppose a task force ruling is for Congress to overrule the decision. Even the secretary of Health and Human Services lacks the power to reverse a task force proclamation under the new health reform law.
Lessons From Mammogram Decision
In November 2009, before health reform passed, the task force decided that women between the ages of 40 and 49 should not get annual breast cancer screenings. After this mammogram recommendation was issued, I heard from various cancer advocacy organizations and countless doctors and patients justifiably voicing their outrage.
Seventy-five percent of women who get breast cancer have no known risk factors. Women ages 40 to 49 have a 1-in-68 chance of getting the disease. I was an original co-sponsor of the 1997 resolution that specifically encouraged women in this age range to get regular mammograms. We listened to doctors who agreed that securing access to these preventive services would increase early detection, allow treatment to begin sooner and ultimately save lives. One recommendation from this task force could undermine all the work done over the years to fight breast cancer.
The task force’s recommendation was dangerously off-base and posed a real threat to women’s health in our country. Opposition was so intense that the Democrats’ health care bill added a special exception reversing the impact of the task force’s mammogram ruling. Yet CRS reports that if the task force resubmits its mammogram recommendation, it will take congressional intervention to again preserve women’s access to this cancer screening that we know saves lives.
For breast cancer and other life-threatening diseases, whether treatment will be covered by insurance should not be dependent on one government panel’s opinion — or, worse, on an act of Congress. This is an unacceptable health care policy, and it sets a bad precedent.
What will happen the next time patients, doctors and national experts disagree with the task force? Will Congress come to the rescue?
Patients and their doctors — not the federal government — should have the freedom to decide what is best. This is a prime reason that the health care law must be repealed and replaced with better reforms that will actually improve health care in America.
Kay Bailey Hutchison (http://hutchison.senate.gov) is a U.S. Senator from Texas.