Sen. Mikulski’s Pandora Box Amendment passes

Yesterday the Senate starting moving forward with the amendment phase of health care reform. Sen. Barbara Mikulski (D-MD) proposed an amendment (http://mikulski.senate.gov/_pdfs/BAI09N48.pdf) will require all health plans to cover comprehensive women's preventive care and screenings at no cost to women. The amendment passed 61-39. Currently the Sen. Reid's (D-NV) health care bill relies on the United States Preventive Services Task Force to recommend minimum coverage. It was the US Preventive Services Task Force that created a stir in the health word with their recommendation that women wait until 50 years old before getting mammograms.

Not only will mammograms be available for women at no cost so will cervical cancer screenings, pregnancy and postpartum depression screenings, screenings for domestic violence, annual women's health screening, and family planning services but will not include abortion; at least not yet. Passing the bill on the surface seems like a no brainer but it is a slippery slope. Remember the goal of health care reform is to reduce skyrocketing premiums and eliminate waste, inefficiencies, and fraud in the system to reduce costs. The amendment, as scored by the CBO, will cost taxpayers $940 million over 10 years. By requiring insurance companies to provide these preventative screenings will not result in the goals of health care reform.

Whenever a company, large or small, is taxed more, in this case told to cover additional services for free, the cost of the new tax is passed along to the consumer. The company does not feel charity and absorb the cost. So ask yourself, who is going to pay for the new services being offered at no cost? Everyone that pays a premium or uses a clinic or hospital for other services since the insurance company will need to recoup their "free" services someplace else. The slippery slope aspect comes into play because the next step will be to cover preventative screenings for men too. It only makes sense from the same rationale being applied to the requirement of preventative women screenings being offered for free. Then what? Everyone will see their premiums increase and the fees for other clinic and hospital services as well.

Now do not get me wrong. I think it is important for people to obtain preventative screenings to ensure themselves better health as they age. Where I struggle is to cloak this amendment and others like it, under the guise of "Health Care Reform". It is not reform to require an insurance company to provide services for free when the goals is to reduce costs and make insurance affordable for all. The Republicans offered, what some call a dual amendment, an amendment that would remove the US Preventative Task Force from the equation and leave preventative medicine decisions in the hands of the medical profession. That amendment failed.

I do not like sounding like a broken record, especially when some construe that to me being an ideologue, but in order to get real reform in the industry we need to open up competition. The easiest way and cost effective way to achieve increase competition is to remove the anti-trust exemption and allow interstate commerce of insurance. Allow the free market forces to work for the next three years, either bill being proposed wouldn't enact "reform" for at least three years from passage, and pass a law or regulation that prevents insurance companies from denying coverage for pre-existing conditions. Americans will find that by going this route that free market forces will achieve the goals of reform in regards to lower premiums and costs. Some may argue that if that is the case, "Why does it not already take place?" To that the answer is simple; anti-trust exemption.

The questions to ask ourselves going forward are: Does the amendment create a slippery slope? If so, is the slope worth it? Does the amendment assist in health care reform? Does the amendment reduce costs? Will the amendment make health insurance more affordable for all? Nearly everyone one of these questions were ignored or not brought up when debating the amendment. We cannot obtain real reform on emotional decisions.

U.S. Preventive Services Task Force practicing rationed care with guideline changes in mammograms?

A report by the U.S. Preventive Services Task Force established new guidelines on Monday for breast cancer examinations. The new guidelines are, which are for the general population and not patients deemed high risk for breast cancer, are (http://www.msnbc.msn.com/id/33973665/ns/health-womens_health/):

• Most women in their 40s should not routinely get mammograms.
  
• Women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown. (The task force's previous guidelines had no upper limit and called for exams every year or two.)
  
• The value of breast exams by doctors is unknown. And breast self-exams are of no value.
  

The confusion behind the new guidelines has already created a stir. Even though many in the cancer society are easing back the promotion of self-exams, they are still advocating that mammograms be performed for women earlier than the new guidelines. Dr. Otis Brawley, the society chief medical officer, said in a statement, "This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over." The World Health Organization recommends mammograms are performed every two years after a woman reaches 50 years of age while Britain looks to perform mammograms every three years.

Ask yourself this, why is the U.S. Preventive Services Task Force looking to change the age to start breast cancer detection? One only need to take a look at the current health care reform debate going on in Washington D.C. Part of the reform bill passed by the House; H.R. 3962 http://docs.house.gov/rules/health/111_ahcaa.pdf. An aspect of the bill that was labeled as "Death Panels" by the Right and said not to exist by the Left is indeed what is going on. See Sec. 223. Health Benefits Advisory Committee on page 111 of the H.R. 3962 bill. The U.S. Preventive Services Task Force is just the precursor to the Health Benefits Advisory Committee. The reason why the U.S. Preventive Service Task Force stated for moving the mammograms from age 40 to age 50 is because the research performed showed that screening 1.300 women in their 50's proved to save one life while it took 1,900 women in their 40's to save the same life.

While the change in guidelines only has immediate impact for those women on Medicare and Medicaid it does lay lend insight into what Americans can expect from the Health Benefits Advisory Committee if health care reform is passed in its current form. President Obama claims, repeatedly, that if one likes their insurance they will be able to keep it and that no government bureaucrat will get between the patient and their doctor; really? Isn't the change in guidelines by the U.S. Preventive Services Task Force doing just that? Granted it will, to start with, affect those on Medicare and Medicaid. Americans need to wake up and see what health care reform is really all about; more government control over your lives.

As I have stated several times, health care reform can be achieved without a 2,000 page bill or raising taxes or increasing spending. So, why do our leaders in Congress feel that adding a public option will increase choice and competition to the point that it will achieve the goal of lowering cost and premiums? I still have not seen an answer to this question – on any stage! One argument the Right has been making is that the current health care reform being proposed by the Progressives will lead to rationed care. I ask you, isn't that what the U.S. Preventive Service Task Force is doing with changing the guidelines of mammograms?

Women of America see the change guidelines for mammograms for what it is; a government bureaucrat coming between you and your doctor. Write your member in Congress and the president to voice your opinion on the change in guidelines. For the rest of Americans realize this is just the start if health care reform passes as the government will start decided when and how often other preventive services will be performed; essentially rationing care.