Women in their 40s should stop routinely having annual mammograms and older women should cut back to one scheduled exam every other year, an influential federal task force has concluded, challenging the use of one of the most common medical tests.
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“We’re not saying women shouldn’t get screened. Screening does saves lives,” said Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations Monday in a paper being published in Tuesday’s Annals of Internal Medicine. “But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully.”
It’s one thing to have a task force issue a recommendation that people and groups can adopt or not adopt (and there are strongly held views on both sides of the screening-at-40 issue), but quite another if some task force can just change what is or is not available in most plans – which is exactly what would happen if President Barack Obama’s Super MedPAC proposal became law. Heritage Vice President for Domestic and Economic Policy Studies Stuart Butler explained this summer:
It appears the Senate Finance Committee may propose that the Medicare Payment Advisory Commission (MedPAC)–a board of health analysts drawn from universities, think tanks, and health care bodies–should have a key role in achieving health savings. MedPAC currently makes recommendations to Congress on broad aspects of Medicare, but Congress has no obligation to enact or even consider its proposals.
But rather than recast MedPAC as an advisory body with clout (whose recommendations would have to be considered for an expedited up-or-down vote, perhaps with other competing proposals, and implemented only if agreed to), it appears that the committee may enact a procedure whereby MedPAC’s recommendations would go into affect unless both houses of Congress block them.
This powerful default implementation for the decisions by an appointed board should be unacceptable to lawmakers and Americans. Like other efforts to insinuate an unelected and largely independent health board into the health system, these decisions, in practice, could easily go well beyond mere technical adjustments in payments and result in board control of medical practice, contrary to the intent of the original Medicare law. The relationship between doctor and patient should not be compromised or undermined by a distant board, council, or panel. If Congress gives serious consideration to a commission to develop proposals for savings, the mechanism should be expedited review of its recommendations, not the implementation of those recommendations by default.