Tuesday, November 24, 2009

Medical Musings Update 2

Just for interest, the mammogram/health care bill seems Clear As Mud, doesn't it?

1 - From the Washington Post : "As a health reform bill endorsed by President Obama marches toward its first Senate floor vote on Saturday, his opponents stepped up efforts to define the legislation as big-government ambition run amok that will interfere with intimate medical decisions and threaten the pocketbooks of average taxpayers.....Meanwhile, the surprise recommendation this week by a quasi-government panel that women should have fewer mammograms injected a volatile issue into the health debate....Conservatives on radio and television have seized on the controversial recommendation as an example of the big-government medical care that will follow if Obama gets his way.....But White House officials dismissed that as overheated rhetoric and expressed little concern that the issue would resonate with Democratic lawmakers or average Americans.....""Many of the opponents of health reform stopped relying on truth, facts and reasoned argument a long time ago," said Dan Pfeiffer, White House deputy communications director. " November 21, 2009

2 - Then I heard on Robin Mead this morning that perhaps that isn't quite so true due to a section of the bill and I did some checking on CNN.com but all I could find at short notice was this article "I want my mammogram". One excerpt says "Sebelius says the doctors and scientists on the task force "do not set federal policy, and they don't determine what services are covered by the federal government." [Sebelius is the Health and Human Services Secretary]. November 19

3 - So I googled "mammogram + health care bill" and found a number of people talking about Section 2708 of the Senate Health Care Bill. One such blog is here. Excerpt: "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements (other than minimal cost sharing in accordance with guidelines developed by the Secretary) for— (1) items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force;".......

Now read the USPSTF recommendation for mammograms: "The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. Grade: C recommendation."

Well isn't that just clear as mud??? Since Mammograms have been recommended at Grade C, what does that mean from the bill? I have yet to find anything that says insurers will cover Grade C, just Grades A and B.

But beyond that, why is the Health and Human Services Director saying that the Task Force does not set federal policy or determine what is covered, but the Section 2078 lists rules for insurers BASED ON recommendations of the Task Force? Sure maybe they don't 'set policy' themselves - but isn't that walking a very fine line? They don't set policy, but their recommendations are put into the policy. What the heck is the difference? To me it's just mincing words - careful wording that isn't exactly a bold-faced lie but it might as well be because at the end of the day, what the Task Force says, goes.

You can see a full list of recommendations and statements from the Task Force HERE and I suggest to watch for an update on the cervical cancer screenings in the near future. Currently it sits at Grade A (which I believe is where mammograms sat before last week), but new reports suggest the grading will change if the Task Force decides to do that.

But I thought they did not determine what gets covered? Oh that's right, it's the politicians who are determining that they will write policies on what the Task Forces determines. Clear as Mud.

What was stated in the Washington Post at the top of this entry? Oh yeah - ".Conservatives on radio and television have seized on the controversial recommendation as an example of the big-government medical care that will follow if Obama gets his way."

Sheesh those crazy conservatives have no idea what they are talking about eh?

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