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 will meet their needs. Unfortunately, the health 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 health reform law undermines Americans’ control over their health care in multiple ways, and one of the most troubling provisions gives unchecked power to the United States Preventative Services Task Force. This task force’s recommendations will determine whether or not an insurance company must cover certain preventative services. If the task force does not favorably endorse a procedure that an individual and his doctor decide is important for his health care, the patient could be forced to pay for the service out of pocket or choose to forgo it altogether.
Before health reform, a recommendation from the task force would have been just that – a recommendation. A doctor might take it into consideration as he or she decided when and how often a specific patient should have a preventative service, such as a mammogram or colonoscopy. But the physician would also be looking at other key information like an individual’s 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 (CRS) to analyze the health reform law, and CRS reported 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 will directly affect patients’ access to preventative care.
It is stunning that in America today a single panel of bureaucrats has veto power over a patient’s access to potentially life-saving 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 health reform law.
In November of 2009, prior to health reform, the task force decided that women between the ages of 40 and 49 should not get annual breast cancer screenings. After the 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, and women from 40 to 49 have a one in 68 chance of getting the disease. The task force’s recommendation was dangerously off-base, and it posed a real threat to women’s health in our country. The opposition was so intense that the Democrats’ health care bill added a special exception to reverse the impact of the task force’s mammogram ruling.
In 1997, I was an original cosponsor of a resolution that specifically encouraged women in this age bracket to get regular mammograms. I was joined by 51 of my Senate colleagues from both sides of the aisle saying that early screening for breast cancer is crucial to increasing the survival rate of this disease. We listened to doctors who agreed that securing access to these preventative services would increase early detection, allow treatments to begin sooner, and ultimately save lives. One recommendation from this task force could undermine the work that has been done over the years to fight breast cancer.
I also asked CRS whether the mammogram exception in the health reform bill would be a permanent solution. The answer, not surprisingly, is "no." If the task force resubmits its mammogram recommendation, it will take Congressional intervention to once-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 should have the freedom to decide what is best for them – not the federal government. 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 is the senior U.S. Senator from Texas.