The Wall Street Journal 02/16/12 - Scott Gottlieb
“Meet the ObamaCare Mandate Committee”
Offended by President Obama's decision to force health insurers to pay for contraception and surgical sterilization? It gets worse: In the future, thanks to ObamaCare, the government will issue such health edicts on a routine basis—and largely insulated from public view. This goes beyond contraception to cancer screenings, the use of common drugs like aspirin, and much more.
Under ObamaCare, a single committee—the United States Preventative Services Task Force—is empowered to evaluate preventive health services and decide which will be covered by health-insurance plans.
The task force already rates services with letter grades of "A" through "D" (or "I," if it has "insufficient evidence" to make a rating). But under ObamaCare, services rated "A" or "B"—such as colon cancer screening for adults aged 50-75—must be covered by health plans in full, without any co-pays. Many services that get "Cs" and "Ds"—such as screening for ovarian or testicular cancer—could get nixed from coverage entirely.
The task force is also the only federal health agency to have the explicit legal authority to consider cost as one criterion in recommending whether patients should use a medical test or treatment.
The task force's problems are compounded by the fact that it is deliberately exempted from the rules that govern other government advisory boards and regulatory agencies. Thus it has no obligation to hold its meetings in public, announce decisions in draft form or even consider public comments. Consumers have no way to directly appeal its decisions. And health providers or product developers affected by its decisions can't sue it for recourse.
Common Sense Review
Let’s meet the US Preventive Services Task Force:
The Task force “strives to make accurate, up-to-date, and relevant recommendations about preventive services in primary care” and “recommend a services were benefits of the service must outweigh the harm” as well as “focuses on maintenance of health and quality of life as the major benefits of clinical preventive services”.
The USPSTF updated its definitions of the grades it assigns to recommendations and now includes "suggestions for practice" associated with each grade. The USPSTF has also defined levels of certainty regarding net benefit. These definitions apply to USPSTF recommendations voted on after May 2007.
Grade Definition Suggestions for Practice
A The USPSTF recommends the service. There is high certainty that the net benefit is substantial. Offer or provide this service.
B The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. Offer or provide this service.
C Clinicians may provide this service to selected patients depending on individual circumstances. However, for most individuals without signs or symptoms there is likely to be only a small benefit from this service. Offer or provide this service only if other considerations support the offering or providing the service in an individual patient. Note: The following statement is undergoing revision.
D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Discourage the use of this service.
I The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms.
How dare a group of 16 people dare to dictate the 307 million people in American what medical treatment they can receive. I don’t know how they got this position, but how can they justify playing God.
