Fox News' Siegel falsely claims insurers would be required to deny preventive care under health care reform
Research ››› ››› CHRISTINE SCHWEN
In a November 19 New York Post column, Fox News contributor Dr. Marc Siegel cited task force recommendations against regular mammograms for some women to fearmonger that "under ObamaCare, guidelines will quickly become mandates" and that "[a]ll the major 'reform' bills create lots of new panels and other bureaucrats empowered to suggest things that doctors shouldn't do." But under Senate and House health care reform bills, insurers are required only to implement task force recommendations in favor of specific preventive care and are not required to adopt those that recommend against preventive screening.
Siegel misleadingly claims that health care reform bills empower panels like preventive task force to "suggest things that doctors shouldn't do" and turn guidelines into mandates
Siegel: "[U]nder Obama care, guidelines will quickly become mandates"; "All the major 'reform' bills create lots of new panels and other bureaucrats empowered to suggest things that doctors shouldn't do." In his column, Siegel wrote of the new mammogram guidelines from the U.S. Preventive Services Task Force (USPSTF):
This week's decision by a government panel to discourage most women in their 40s from having routine mammograms isn't just bad medicine, but also a small taste of what ObamaCare will mean.
Happily, these rulings from on high don't have much force now. But under ObamaCare, guidelines will quickly become mandates, and patients will routinely face the choice of paying hundreds of dollars out of pocket or accept higher risks of cancer. It will take government bureaucrats years to admit mistakes, if they ever do -- and by that time thousands of women will have needlessly gotten sick or even died of cancer.
All the major "reform" bills create lots of new panels and other bureaucrats empowered to "suggest" things doctors shouldn't do -- and even to penalize doctors who order "too many" tests.
Senate bill does not require insurers to adopt USPSTF recommendations against preventive screenings, only those in favor of specific preventive screenings. The Senate health care reform bill, the Patient Protection and Affordable Care Act, requires insurance companies to cover screenings that the USPSTF rates as A or B recommendations. It does not require insurers to adopt guidelines -- like those cited by Siegel -- that recommend against preventive screenings:
''SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
''(a) IN GENERAL. -- 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 for --
''(1) evidence-based 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;
House bill requires insurers to adopt task force recommendations in favor of specific coverage, but not those against coverage. Similarly, the House health care reform bill, the Affordable Health Care for America Act, requires insurance companies to cover the A or B recommendations of a new task force, the "Task Force on Community Preventive Services," but does not require that lower-rated recommendations against preventive services be denied:
''SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO ENCOURAGE WELLNESS AND HEALTHY BEHAVIORS.
''(c) INCLUSION IN ESSENTIAL BENEFITS PACKAGE. -- If, on the basis of the findings of research and demonstration projects under subsection (a) or other sources consistent with section 3131, the Task Force on Clinical Preventive Services determines that a subsidy or reward meets the Task Force's standards for a grade A or B, the Secretary shall ensure that the subsidy or reward is included in the essential benefits package under section 222.
Media conservatives -- including Siegel -- have repeatedly fearmongered that task force recommendations represent government rationing
Conservatives fearmonger that breast cancer screening recommendations foreshadow government rationing. Media conservatives have repeatedly fearmongered that the nonbinding recommendations represent government rationing -- with some tying the guidelines to the debunked "death panel" smear. Siegel himself appeared on Fox News to claim that the recommendations were "absolutely" about health care reform, adding, "[T]his kind of health reform is not what we need." In fact, the task force recommendations are not legally binding, and the claim is undermined by the fact that the task force previously recommended against certain preventive cancer screenings under President Bush.