Health insurance lobby behind mammogram fiasco?

The notion that politics may have been at work in the decision of a government medical panel to release a report recommending fewer mammograms for women under 50 seems, at first, rather remote.

After all, why would a bunch of brainiac doctors, whose influence is the result of a government appointment, choose to impact on the health care reform debate by providing Exhibit A in the case against government intrusion in medicine?

To be sure, the mammogram controversy has added some powerful ammunition to the arsenal of the ‘watch out for rationing’ crowd. Given the outcry in opposition to the newly issued mammogram guidelines, even the most ardent supporters of evidence based medicine’s role in policy find themselves wondering if health care reform opponents, like GOP Congresswoman Jean Schmidt, are right when they call this the first step on the road to rationing.

If not politically motivated, how is it that such an inflammatory report could find its way into the public consciousness at so sensitive a moment? While the medical panel involved – the United States Preventive Services Task Force- may be independent, they would have to be politically deaf, dumb and blind not to anticipate the impact their recommendations would have when arriving one week before the Senate was scheduled to take up the reform bill.

A review of the participants on the government appointed panel might provide some answers.

The independent task force involved is set up to include two classes of participants. There are the ‘members’- individuals who are primarily physicians but also include people from other medical disciplines and then there are the ‘partners’ – comprised of a variety of organizations, some medically based, some otherwise.

Here is the role of the ‘partners’ according to the task force’s website:

Partners to the U.S. Preventive Services Task Force are drawn from the fields of primary care, public health, health promotion, policy, and quality improvement. Liaisons from these groups and from Federal health agencies contribute their expertise in the peer review of draft USPSTF documents and help disseminate the work of the USPSTF to their members.

Via AHRQ.GOV

Who would have thought that this important, ‘independent’ medical panel comes complete with lobbyists built into the system?

And who tops the list of the ‘Policy, population, and quality improvement partners’?

AHIP – America’s Health Insurance Plans.

This is a name you are, no doubt, quite familiar with by now. This is the leading lobby acting on behalf of the health insurance companies in the effort to derail health care reform. These are the people who, while working to craft an acceptable approach in the early days of the debate, turned on health care reform when the Baucus bill lowered the penalties for those who fail to buy private health insurance per the government mandate. AHIP viewed this as a betrayal of their deal with the government which called for health insurance companies making coverage concessions in return for the government’s agreement to drive 40 million new customers into the waiting arms of the private insurance industry. In retaliation, AHIP brought us the now discredited Coopers Lybrand report suggesting the Baucus health care bill would add $1700 per year to the costs of health insurance premiums for a family in the year 2013.

So, just how ‘independent’ was the timing of this recommendation that found its way into the public consciousness at the worst possible moment for health care reform?

While one might, understandably, be accused of a higher degree of cynicism than what might be appropriate when it remains possible that the timing of the panel’s recommendation might well have been a coincidence, there is additional evidence that this is a tactic that is being purposefully employed.

Three days after the mammogram controversy broke out, and while still commanding top story billing, the American College of Obstetrics and Gynecology (ACOG) chose to release their recommendations calling for cutbacks in the number of pap smear tests being done. Instantly, fuel was poured onto the fires of the health care reform debate.  While, unlike the government task force calling for reductions in mammographs, the ACOG is not a government sponsored board but a private group representing obstetricians and gynecologist, nobody really noticed the difference. Women all over America viewed this as another example of their health being compromised by some medical panel telling them, and their doctors, what to do.

Was this report yet another coincidence of timing? Maybe. But it is worth noting that, like AHIP, the ACOG is also listed as a ‘partner’ on the  U.S.Preventative Services Task Force.

Making their decision to go anti-pap smear at this peculiar time is all the more peculiar given that, up until now, the ACOG were supporters of health care reform as they viewed the legislation as being helpful to women’s health. So why would they do something sure to cause even more trouble at this point of the game?

Could it be a reaction to the Stupak Amendment which promises to make it more difficult for women to pay for abortions with their private insurance?

Who is it that performs the abortions? Obstetricians and gynecologists….the very people who form the membership of the American College of Obstetrics and Gynecology. There is, no doubt, a lot of money at risk should abortion coverage become tougher to come by. So why not pick up on a tactic which provides an assist to those who benefit from scaring people into believing we are on the road to rationed health care?

Opponents of greater government involvement in health care have, in this week alone, been handed not one, but two juicy arguments to make their point.

Coincidence?

Maybe. But as the old saying goes, if it walks like a duck and quacks like a duck….