Saturday, November 21, 2009

Why You Should be Very Worried About the Government Health Recommendations

In the last weeks, two recommendations have come from government sponsored panels that suggest the current standards for mammograms and pap smears, those supported but the American Cancer Society, encourage women to get these screenings too frequently and too early. There has been significant push back from the public and various organizations, but the government is downplaying the recommendations as mere suggestions based upon scientific inquiry. However, if you care about the women in your life and their ability to get these important cancer screenings you need to be very concerned because the Health Care Bill proposes to incorporate these "harmless recommendations" directly into your health insurance.

The Health Care Bill (I’m referencing the version passed by the House, HR 3962, because we don’t yet know what the Senate version will look like exactly; however, this language has appeared in all versions I have seen since July) contains several sections whereby advisory committees are established for the purpose of determining what treatments result in the best health outcomes. It may sound reasonable, even sensible, until you juxtapose it with the recent recommendations on mammography and pap smear. Section 223 establishes the “Health Benefits Advisory Committee” (Page 111 of the Bill, which can be viewed here). This committee is a “public-private” partnership with the express directive to “…be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.” In other words, the committee gets to decide what should be covered by your health insurance. Section 224 then gives the Secretary of Health and Human Services the authority to incorporate those recommendations.

Other examples from the Bill abound, such as page 1392 which states, “The program
19 under this section shall be designed to administer vaccines consistent with the recommendations of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) for the annual vaccination of all children 5 through 19 years of age.” Page 1478, “The Secretary, acting through the Director of the Center, in coordination with the Federal Interagency Committee on Emergency Medical Services, shall— ‘‘(A) promote and fund research in emergency medicine and trauma health care; ‘‘(B) promote regional partnerships and more effective emergency medical systems in order to enhance appropriate triage, distribution, and care of routine community patients; and ‘‘(C) promote local, regional, and State emergency medical systems’ preparedness for and response to public health events.” Page 1494 establishes the “Interagency Pain Research Coordinating Committee” with duties to include “make recommendations to ensure that the activities of the National Institutes of Health and other Federal agencies, including the Department of Defense and the Department of Veteran Affairs, are free of unnecessary duplication of effort;” How about this little gem on page 1507, “Before issuing the notice of proposed rulemaking preceding the final regulations described in subparagraph (A), the Secretary shall hold a public hearing before an advisory committee on the issue of which class II devices to include in the definition of covered devices.” In other words, there will be yet another committee deciding which medical devices should be covered by Medicaid and which shouldn’t.

I could certainly list more, but a simple search of the Bill for the word “committee” will allow you to find most of the other sections establishing a Government run committee for the purpose of making determinations about your level of coverage. However, let’s put this all together and see how sinister the purportedly innocuous recommendations really are. Section 241 of the Bill (page 131) establishes the Health Choices Commissioner who is to be appointed by the President. This Commissioner is tasked (section 242, page 132) with establishing the benefit standards for “qualified health plans.” Per Section 202, all health plans, even the plan you get through your employer, must become a “qualified health plan” within the sooner of 5 years or when any term or condition of your plan changes. At that time the Health Choices Commissioner will be the individual in charge of determining what your health plan covers and if the Committee established in section 223 decides women shouldn’t get mammograms until they’re 50, then guess what your health insurance plan isn’t going to pay for?

Admittedly, the Health Choices Commissioner establishes the minimum benefit standards for qualified health plans, but if your insurer provides better than the minimum it will probably be deemed a “Cadillac” plan and excessive taxes will be assessed. Naturally, no self-preserving insurer would subject itself to unnecessary taxation; therefore, mammograms will be paid out of your pocket until you’re 50. That assumes, of course, that you can find a doctor that will provide mammograms if this bill passes.

The moral of the story: call you senators and tell them to vote a resounding NO against the health care bill.

No comments:

Post a Comment